Inducing labour

An induced labour is one that's started artificially.

It's common for labour to be induced if your baby is overdue or there's any risk to you or your baby's health.

This risk could be if you have a health condition such as high blood pressure, for example, or your baby is not growing.

Induction will usually be planned in advance. 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.

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.

Why you might be induced

• if you're overdue
• if your waters have broken
• if you or your baby have a health problem

If you're overdue

Induction will be offered if you do not go into labour naturally by 41 weeks, as there will be a higher risk of stillbirth or problems for the baby.

If your waters break early

If your waters break more than 24 hours before labour starts, there's an increased risk of infection to you and your baby.

If your waters break after 34 weeks, you'll have the choice of induction or expectant management.

Expectant management is when your healthcare professionals monitor your condition and your baby's wellbeing, and your pregnancy can progress naturally as long as it's safe for both of you.

Your midwife or doctor should discuss your options with you before you make a decision.

They should also let you know about the newborn (neonatal) special care hospital facilities in your area.

If your baby is born earlier than 37 weeks, they may be vulnerable to problems related to being premature. 

If your waters break before 34 weeks, you'll only be offered induction if there are other factors that suggest it's the best thing for you and your baby.

If you have a health condition or your baby is not thriving

You may be offered an induction if you have a condition that means it'll be safer to have your baby sooner, such as diabetes, high blood pressure or intrahepatic cholestasis of pregnancy.

If this is the case, your doctor and midwife will explain your options to you so you can decide whether or not to have your labour induced.

Membrane sweep

Before inducing labour, you'll be offered a membrane sweep, also known as a cervical sweep, to bring on labour.

A membrane sweep would usually be offered to you after 39 weeks.

To carry out a membrane sweep, your midwife or doctor sweeps their finger around your cervix during an internal examination.

This action should separate the membranes of the amniotic sac surrounding your baby from your cervix. This separation releases hormones (prostaglandins), which may start your labour.

Some women find the procedure uncomfortable or painful. You may get some cramping and vaginal bleeding afterwards.

If labour does not start after a membrane sweep you may be offered an additional sweep or induction of labour.

Induction is always carried out in a hospital maternity unit. You'll be looked after by midwives and doctors will be available if you need their help.

How labour is induced

If you're being induced, you'll go into the hospital maternity unit.

There are 2 main ways labour can be induced:

• Hormones can be put inside your vagina using a vaginal tablet (pessary) or a gel, or given as tablets that you swallow.
• Devices such as balloon catheter (a small balloon, full of water) or an osmotic dilator (a type of sponge) can be used to widen your cervix.

You’ll usually be offered hormones first to see if they work, unless there’s a medical reason you cannot take hormones.

It usually takes many hours for these treatments to start working. You will usually stay in the hospital maternity unit, though you may be able to go home in some cases.

Sometimes a hormone drip is needed to speed up the labour. You may also need to have your waters broken artificially.

What induced labour feels like

If you need to be induced it may affect where you can give birth. You may need to stay in hospital for longer and have more examinations.

Induced labour is usually more painful than labour that starts on its own.

Your pain relief options during labour are not restricted by being induced.

You should have access to all the pain relief options usually available, such as an epidural or water birth.

If you are induced you'll be more likely to have an assisted delivery, where forceps or ventouse suction are used to help the baby out.

If induction of labour does not work

Induction is not always successful, and labour may not start.

Your obstetrician and midwife will assess your condition and your baby's wellbeing. You may be offered another method of induction or a caesarean section, or you may be able to wait a few hours and then be assessed again.

Your midwife and doctor will discuss all your options with you.

Natural ways to start labour

There are no proven ways of starting your labour yourself at home.

You may have heard that certain things can trigger labour, such hot baths, certain food or drinks, having sex or herbal supplements. But there's no evidence that these work. Also there’s no information about the safety of herbal supplements and they could be harmful to you or your baby.

Having sex will not cause harm, but you should avoid having sex if your waters have broken as there's an increased risk of infection.

For more information on induction, you can read the NICE information for the public on induction of labour.