Induction of Labour
Induction means that labour is started artificially. Once induction begins, it may take more than 24 hours before labour actually starts. During this time, prior to labour, you may stay in a shared room, the “Induction Room”, or on a ward.
Why is labour induced?
There are times, when it will be considered advisable by the doctor to induce your labour, due to the risks of continuing your pregnancy. For example:
- If your baby is growing too slowly
- If you go beyond the expected agreed date of delivery by 10-14 days
- If you have medical problems like Diabetes
What are the risks of induction of labour?
- Failure of Induction
This may lead the doctor to postpone the induction or to consider a caesarean section
- Increased chance of assisted delivery or Caesarean section
Assisted delivery means the use of forceps or a suction Ventouse. This may be due to the reason for the induction, or the induction process itself. This is partly why the decision to induce is not taken without good reason.
- Need for pain relief
You will be offered support and appropriate pain relief.
How is labour induced?
Labour can be induced by the use of prostaglandin, artificial rupture of the membranes or by an oxytocin drip, or a combination of all three of these methods.
1) Prostaglandins
Prostaglandins are substances which are normally produced in the body. They will soften the cervix and encourage labour to begin.
During an internal vaginal examination prostaglandin gel is placed alongside the cervix (neck of the womb). Once the prostaglandin gel has been inserted you will be advised to stay in bed for approximately 30minutes so that the gel is absorbed.
Afterwards, your baby’s heart beat will be monitored on a machine. You may notice some tightenings following the insertion of the prostin. This is normal, it does not necessarily mean that you have gone into labour. Your midwife will advise you about the various ways of dealing with any discomfort.
It may be necessary to repeat the prostaglandin gel at specific intervals (usually every 6 hours) until it has an effect on the cervix. This procedure is no more uncomfortable than an internal examination.
2) Artificial rupture of the membranes (ARM)
Artificial rupture of the membranes or “Breaking the Waters” may also be used to encourage the womb to contract.
During an internal examination the doctor or midwife will gently “break the waters”. This is the part of the sac around the baby which is nearest to your cervix.
This will allow release of the fluid around the baby. This can only be performed once the cervix is softened and open. This takes a few minutes and is a little uncomfortable.
Again the baby’s heart beat will be monitored on a machine for approximately 30 minutes. Then, provided there is no reason to continue the monitoring, you will be encouraged to mobilise (such as walking or sitting on a birthing ball).
3) Oxytocin
Oxytocin is another natural substance which causes the womb to contract. Syntocinon is a synthetic form of oxytocin. It may be used for induction. It may also be used. if you are not contracting effectively or if your cervix is not opening. It will help the contractions to become more efficient.
Syntocinon is given through a drip into a vein in your arm. The amount is gradually increased until your contractions are coming at the right strength and frequency. Once a Syntocinon drip has started, your baby’s heart beat will be monitored continuously.
Sometimes a combination of one or more of these methods are used together to induce labour. Prostaglandin gel may be inserted, followed by “breaking the waters” as well as a syntocinon drip. Or, alternatively, you may require only one of these procedures.
The staff in the Antenatal Clinic will confirm the date and time you are to be admitted for induction. This admission may be directly to the Delivery Suite or initially to the Antenatal ward.
At all stages you will be kept informed of the procedures. Please do not hesitate to ask questions, if you do not fully understand what is being said.