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What is induction of labour?
Induction of labour is a process whereby labour is started artificially. Depending on your individual circumstances, we will recommend the most suitable method of induction for you. Each method of induction is discussed below.
When is induction recommended?
Induction is recommended when it is felt that either you or your baby will benefit. On average 1 in 5 women are induced.
The most common reasons for induction include:
- Your baby is overdue, one week or more past your due date.
- Your 'waters' have broken before you go into labour.
- You have conditions such as diabetes or raised blood pressure that have affected your health or pregnancy.
What are the different ways to induce your labour?
You may be offered one or all of them depending on your individual circumstances. They are:
- A 'stretch and sweep'.
- Artificial rupture of membranes (ARM).
- Prostaglandin gel.
- Syntocinon drip.
What is a 'stretch and sweep'?
It is safe and natural method to increase your chances of natural labour. It is done as part of an internal vaginal examination in outpatients. Using one finger, the Consultant will attempt to slightly separate the membranes from the neck of your womb (cervix ) using a circular sweeping movement - commonly known as a 'stretch and sweep'.
A 'stretch and sweep' releases natural hormones (prostaglandins) that increase your chances of labour starting naturally within 48 hours. This procedure may be uncomfortable and may cause slight bleeding but will not harm your baby.
What are prostaglandins?
Prostaglandins are drugs that mimic the actions of your natural hormones by encouraging the neck of your womb (cervix) to open up and start contracting. It is given in the form of a gel. The gel is inserted into your vagina. This procedure is done in hospital. More than one dose may be necessary and if so, a six-hour gap is required between doses.
Before giving the prostaglandin gel, the midwife will check your baby's heartbeat using a 'CTG' (cardiotocograph) electronic fetal heart rate monitor. After having your prostaglandin gel, you should avoid standing up for at least 45 minutes. This helps the gel to remain in the vagina and be absorbed. The midwife will check your baby's heartbeat again using a 'CTG' after you have had the gel and once your contractions start.
Very occasionally, prostaglandins can cause the uterus to contract too frequently. This may affect the pattern of your baby's heartbeat. If this happens, you may be given an injection to help relax the uterus.
Artificial rupture of membranes
To break your 'waters', we will make a small hole in the bag holding the waters. This is done during an internal vaginal examination and generally is no more uncomfortable than any other vaginal examination. You should usually be in early labour with the cervix 2-3 cms dilated. This will cause no harm to your baby. It has the effect of releasing natural prostaglandins from the amniotic fluid and this strengthens the contractions.
What is a syntocinon drip?
When you are in labour, your body naturally produces a hormone called oxytocin. Syntocinon is the synthetic version of this hormone. Your waters should be broken before you start on a syntocinon drip. Oxytocin is given through a drip (tiny plastic tube) into a vein in your arm. Once your contractions have begun, the rate of the drip can be adjusted so that your contractions occur regularly until your baby is born. Your baby's heartbeat will be monitored continuously by the midwife, whilst you are on the oxytocin drip. This method of induction is done on the labour ward.
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