Medical Disclaimer: The information in this article is for general informational purposes only and does not constitute medical advice. Decisions about induction of labour should be made in consultation with your midwife and obstetric team based on your individual circumstances.
Induction of labour is offered to around one in three pregnant women in the UK, making it one of the most common obstetric interventions. Yet it remains one of the least understood. If your midwife or doctor has suggested induction, or if you are approaching your due date and wondering what will happen next, this comprehensive guide explains everything you need to know.
What Is Induction of Labour?
Induction of labour is the process of artificially starting labour using medical methods. It is carried out when the benefits of delivering your baby outweigh the benefits of continuing the pregnancy. This might be because the pregnancy has gone past 41 or 42 weeks, because your waters have broken but labour has not started, or because of a health concern affecting you or your baby.
Reasons for Induction
Post-Dates Pregnancy
The most common reason for induction is going past your due date. In the UK, induction is typically offered between 41 and 42 weeks of pregnancy, as the risk of stillbirth increases after this point. The ARRIVE trial (US) and similar studies have shown that induction at 39 weeks for low-risk women does not increase the caesarean rate and may slightly reduce certain risks. This has led some UK trusts to offer earlier induction in uncomplicated pregnancies, though practice varies.
Pre-Eclampsia or Hypertension
If you develop pre-eclampsia or high blood pressure during pregnancy, your team may recommend induction to reduce risks to you and your baby. The timing depends on the severity of your condition.
Gestational Diabetes
Women with gestational diabetes are often offered induction at 38 to 40 weeks, as the baby may be larger than average and the risk of complications increases after this point.
Reduced Fetal Movements or Growth Concerns
If your baby is growing more slowly than expected or you report significantly reduced movement, your team may recommend induction to prevent stillbirth.
Prolonged Rupture of Membranes
If your waters break but labour does not start within 24 hours, induction is usually offered to reduce the risk of infection.
Methods of Induction
Membrane Sweep
A membrane sweep, also called a stretch and sweep, is a non-medical first step offered before formal induction. Your midwife inserts a finger into your cervix and makes a circular, sweeping movement to separate the membranes from the cervix. This releases prostaglandins and can trigger labour within 48 hours in some women. It can be uncomfortable but is usually done in a clinic or at home by your community midwife.
Prostaglandin Pessary or Gel
The first step of hospital induction usually involves placing a prostaglandin pessary (tablet) or gel into the vagina near the cervix. This softens and ripens the cervix over 6 to 24 hours. You may need more than one dose. Contractions can begin during this stage, sometimes resulting in labour without needing further intervention.
Balloon Catheter (Mechanical Induction)
A Foley catheter with a small balloon at its tip is inserted through the cervix and inflated with water. The pressure of the balloon against the cervix stimulates dilation and prostaglandin release. This method is used increasingly as an alternative to prostaglandins, particularly for women who have had a previous caesarean where prostaglandins carry a slightly higher risk of uterine rupture.
Artificial Rupture of Membranes (Amniotomy)
Once the cervix is ripe and dilating, your waters can be broken artificially using a small plastic hook. This is done during an internal examination and feels like a scratch or pinch. Breaking the waters usually intensifies contractions and speeds up labour.
Syntocinon Drip
If contractions are not strong or regular enough after the waters are broken, an intravenous drip of synthetic oxytocin (syntocinon) is used to stimulate and regulate contractions. The dose is gradually increased until contractions are coming every 3 minutes or so. Syntocinon induction requires continuous electronic foetal monitoring.
Is Induced Labour More Painful?
This is one of the most common questions about induction, and the honest answer is: it can be. Natural labour typically builds gradually, giving the body time to release endorphins in response to increasing pain. Syntocinon-induced contractions can come on quickly and intensely, with less of a gradual build-up. Many women who have an induced labour request an epidural, which is entirely understandable. Knowing this in advance allows you to approach induction with realistic expectations and a flexible pain relief plan.
How Long Does Induction Take?
Induction can take anywhere from a few hours to several days. The cervix may need multiple rounds of ripening before active labour begins. This can be frustrating and tiring, particularly if you are in hospital waiting for progress. Having someone with you, things to keep you occupied, and comfortable clothing makes the process more bearable.
Products to Pack for an Induction
Frequently Asked Questions
Can I refuse induction?
Yes. Induction is always offered, never imposed. If you decline induction after being fully informed of the risks and benefits, your care team should support you with a plan for monitoring your pregnancy closely instead. The key is making an informed decision. BRAIN is a useful framework: Benefits, Risks, Alternatives, Instinct, and Nothing (what happens if you do nothing).
Does induction increase my chance of a C-section?
Current evidence suggests that when compared to expectant management (waiting), induction at term does not increase the caesarean rate and may actually reduce it slightly. This is a reversal of older thinking. However, a failed induction where the cervix does not respond may result in a caesarean.
Will my baby be monitored more during an induced labour?
Yes. If you are receiving syntocinon, continuous electronic foetal monitoring (a CTG machine) is required throughout labour. This means you will have two monitors strapped to your abdomen and your mobility will be limited, though wireless monitors are becoming more widely available.
Sources
- NHS. Inducing labour. www.nhs.uk
- NICE. Inducing labour (NG207). www.nice.org.uk
- ACOG. Induction of Labor. www.acog.org
- RCOG. Induction of Labour at Term in Older Mothers. www.rcog.org.uk
Affiliate Disclosure: This article contains affiliate links. If you purchase through these links, Mother & Main may earn a small commission at no extra cost to you. We only recommend products we believe are genuinely useful for expectant parents.
