Pregnancy and baby

Inducing labour

When would I be induced and what's involved?

When is labour induced?

Sometimes labour can be induced (started artificially) if your baby is overdue or there is any sort of risk to you or your baby's health, for example if you have high blood pressure or if your baby is failing to grow and develop.

Induction is always planned in advance, so you'll be able to discuss the advantages and disadvantages with your doctor and midwife, and find out why they think your labour should be induced. It's your choice whether to have your labour induced or not.

Most women go into labour spontaneously by the time they are 42 weeks pregnant. If your pregnancy lasts longer than 42 weeks and you decide not to have your labour induced, you should be offered increased monitoring to check your baby's wellbeing.

There is a higher risk of stillbirth or foetal compromise (your baby's health being put at risk) if you go over 42 weeks pregnant, but not every pregnancy over 42 weeks is affected this way. At the moment there is no way to find out which babies might be affected, so induction is offered to all women who don't go into labour by 42 weeks.

Before formal induction of labour, you will be offered a vaginal examination with membrane sweeping to encourage labour to start. This will usually be done twice after 41 weeks. Then if labour does not start, you'll be offered induction of labour. Induction is always carried out in a hospital maternity unit. You will still be looked after by midwives, but doctors will be available if you need their help.

Read guidelines produced by the National Institute for Health and Clinical Excellence (NICE) about the care you can expect to receive during labour (PDF, 213kb).

How labour is induced

Contractions can be started by inserting a pessary or gel into the vagina, and sometimes both are used. Induction of labour may take a while, particularly if the cervix (the neck of the uterus) needs to be softened with pessaries or gels.

Sometimes a hormone drip is needed to speed up the labour. Once labour starts, it should proceed normally, but it can sometimes take 24-48 hours to get you into labour.

For more information on induction, you can read guidelines on induction of labour (PDF, 132kb) produced by NICE. NICE advises that induced labour is usually more painful than spontaneous labour (labour that starts on its own), and epidural anaesthesia and assisted delivery are more likely to be required.

If induction does not work, your doctor and midwife will assess your condition and your baby's wellbeing. You may be offered another induction, or a caesarean section – your midwife and doctor will discuss all the options with you.

 


Last reviewed: 11/03/2011

Next review due: 11/03/2013

Comments are personal views. Any information they give has not been checked and may not be accurate.

pammyd26 said on 13 May 2012

i think it would be silly for enyone to think about going hat things started ging wrongover 42 weeks i had a still birth at 41 plus6 i felt this was to late and i truly belive my child was starved of oxegen as the whom is only desinged to work for 40wks i think they should induce you on the due date i had mo problems before 40 wks perfectly healthy baby if my baby was born then she would have been alive now.

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Koyah1970 said on 04 May 2012

Hi,

Thanks that really helpful and I will take a look at the link you suggest. Its good to hear other experiences, as there is so limited information especially for inducing early.

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lotty mays said on 26 April 2012


Hi, I agree that there is not enough info on this site with regards induction. I went to 42 weeks pregnancy with several of my pregnancies, and 43 weeks with my last pregnancy. I was not induced, even for maternal age (42) Two of my daughters also went to 42 weeks before going into labour. You do not have to be induced, and you should be offered expectant management if you do not want to be induced in accordance with NICE guidelines 2008. There are risks to induction, and these are not listed here. There is no evidence to suggest that the placenta packs up at 40+ weeks. Your baby will not suddenly grow huge in a fortnight. Recent research finds no difference in outcomes whether women choose induction or further monitoring. There are many reason why women may go 'overdue' including ethnicity, familial tendencies ( runs in the family) male fetus,etc.
another good site is AIMS ( Association for improvements in maternity services) and you may be able to link to the site below. Just copy and paste into the search link.
Induction of Labour balancing risks - Midwife Thinking.
Hope you all find some useful info and good luck with your pregnancies.

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Koyah1970 said on 23 April 2012

Early induction at 38 weeks due to age:
I am 41 years old and 34 weeks pregnant with my first child. (following 4 IVF attempts).
At my 20 week scan I was found to have a posterior placenta covering my cervix. I was scanned again at 32 weeks and the placenta is now 7.5mm from my cervix and they baby is currently in the breech position. I am due to be scanned again at 36 weeks.
Because of my age I have been seeing a consultant who we first saw after the 20 week scan.
He has recommended the following: if the placenta doesn't move enough I should have a C-section at 38 weeks.
If the placenta does move I should be induced at 38 weeks. The reason being that he states that in older women the placenta can stop working at 38 weeks and there is a small risk of sudden fetal death.
I have read the NICE guidleines on Induction and ealry induction due to age of mother is not listed as a reason for early induction.
I am not very happy with the prospect of an induction due to what I have read, potential stresses etc on the baby etc.
At our last appointment with our consultant he states that if I don't want an induction, (and obvioulsy that I don't need a C-section as my placenta has moved) they would monitor me regulary to check the baby was okay and wait for the baby to come along naturally.
I asked if I could have a c-section anyway at 38 weeks if he believes there is such a risk to the baby instead but my consultant said no.
I feel that we are left with no choice but to have an early induction, even though I don't want one, as albeit a small risk I am now really worried that something may happen to the baby.
I would appreciate any other thoughts / opiions and knowledge on this advice we have been given as I am now feeling quite distressed about the whole process.

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Martiali said on 09 November 2011

I have been told that I will need to induse labor at week 39 because of Gestational Diabetes. I was forwarded from the GD page to this to understand what the induction implies and:

a) No information about early induction at all
b) Insuficient information on induction anyway.

This article is woefully incomplete, unclear, does not provide numbers and statistics or alternatives. Very bad indeed!!!

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Letetia said on 06 November 2011

Morning Ladies, i was induced with my first baby as my waters broke at 36 weeks. The midwives/doctors at our hospital were very reassuring and said the reason they needed to induce me (in 24 hours if nothing had happened) is that if your waters break, the baby is no longer protected against infection, so they gave me antibiotics until they took me for induction. I never felt that I was kept in the dark, or was being pushed into anything and the whole thing went smoothly. It wasn't a really long labour either, only 7 3/4 hours from start to finish which is pretty good for a first baby, i think. I'm now due my second baby on Thursday, really thought this one was going to be earl y too, but no such luck!! I hope that this makes those of you being induced feel a little more comfortable about things, I would give anything for this birth to have gone the same as my first and I'm sure I will find out soon. Good luck to you all. x

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littleacceb said on 10 October 2011

"Induction is always planned in advance, so you'll be able to discuss the advantages and disadvantages with your doctor and midwife, and find out why they think your labour should be induced. It's your choice whether to have your labour induced or not."

This is not true. My hind waters broke, and I was frightened into induction by a registrar who kept calling the placenta "afterbirth", and insisted that if I went home, I'd get an infection and risk my baby's life.

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BHamel said on 04 May 2011

Hi Lara,

I hope your pregnancy is going well! I'm a medical student revising for finals and came across this article. I feel that it is best supplemented by a link to this leaflet giving information about the NICE guidelines (instead of the link to full guidelines provided here).

www.nice.org.uk/nicemedia/pdf/CG70publicinfo.pdf

or google

nice cg70 publicinfo (without the space)

As for the comment from someone else about why induction is recommended after 42 weeks....

There is a lot of evidence to say that the risks of continuing a pregnancy beyond this date are greater than the risks of induction. A post-term baby can often be quite large, making it difficult for them to come through the birth canal - the baby may end up with a dislocated shoulder and the mum may get a tear. There is a greater chance of instrumental delivery.

There is also a risk of infection to the baby due to meconium aspiration. The placenta becomes inefficient after 42 weeks because it is not designed to work for that long. A 2010 study published in the Journal of the American Medical Association also demonstrated an increased risk of cerebral palsy in babies born >42 weeks in comparison to those born at 40 weeks (the risk is also higher in pre-term deliveries <36wks).

Induction of labour is almost routine these days, for many different reasons. If you have any concerns then discuss them fully with your midwife. I hope this information helps and good luck with your pregnancies!

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laralambert said on 15 April 2011

i have 3 children already one 20yr one19yr & one 9yr, i am with a new partner and we are having a little boy in august, as im 41yr i have been told i will not be allowed to go over my date as it can be dangerous, i have been told i will be given a sweep but i know people that have had a sweep and it hasnt done anything for them so bit worried now if it doesnt work what they will doand how long they will wait after the sweep

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M2B11 said on 30 March 2011

The guidelines say ' sometimes it can be best to induce labour if a pregnancy lasts longer then 42 weeks'. Why????? Come on Nhs, we need reasons, not just an arbitrary timeline. What are the issues with going longer than 42 weeks? How are we supposed to make informed decisions with no information? Very poor indeed.

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Marisa1979 said on 24 February 2010

Not very useful information at all for any expectant mother. I was told that my labour will be inducted on my due date, was given a leaflet and referred to this website. I must say I am more worried now than I was before I looked at this because of the distinctive lack of information on risks, advantages and disadvantages. I was briefly explained that labour could be longer when inducted and that i might need more pain relief - where is the information on this? Thumbs down to the NHS.

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User31703 said on 02 May 2009

This article doesn't say much that is useful. What about studies on the advantages/disadvantages of different forms of induction? What about the connection with needing additional forms of pain relief? What are your rights re: induction? If you choose not to proceed, what will happen i.e. monitoring etc. Can you go overdue or be induced and still have a home or birth centre birth? Many many babies are overude - how many? Does the UK have a higher than average induction rate? Is there a correlation with cesarians/assisted births? This article is suspicious in its lack of useful information or re-direction to other sources.

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