Induction of labour

This information has been developed to help you to understand what induction of labour is, the reasons why you might be offered induction of labour, what the risks and benefits are, how labour is induced and what methods are used.

There is also an explanation of what will happen on the day of your induction.

It is not intended to replace the discussion between you and your midwife or doctor, but it could help answer some of your questions and act as a starting point for a discussion about induction of labour.

If after viewing this information, you have any concerns or require further explanation, please discuss this with your midwife or doctor.

Outstanding Maternity Services

Outstanding Maternity Services

The Outstanding Maternity Services programme has been running since 2020. It is a programme of improvement of work which aims to transform Bradford Teaching Hospitals maternity services to become outstanding. Essential in our journey to outstanding, is the voice of the people who use the service and the staff that are giving care. People using our service told us they wanted improvements to our Induction of labour care pathway this included better patient information. This page has been developed as part of this improvement work.

You can find more information about this exciting programme of work by visiting the Women’s and Newborn Unit page.

Why might I be offered induction of labour?

Dr Nicola Cawley talks about why induction of labour might be recommended to you. There is lots to think about when you are making decisions about whether to have your labour induced.

Why induction of labour might be recommended?
  • If you are overdue
  • If your waters have broken before labour starts
  • If you or your baby have a health problem
What are the risks versus benefits of induction of labour?
  • When induction of labour is offered, it is largely when the benefits of your baby being born are greater than prolonging the pregnancy and awaiting labour to start naturally.
  • Most babies will be born healthy, but there is always a small risk of stillbirth at any stage in pregnancy and this risk increases as you go further past your due date. Current National Institute for Health and Clinical Excellence (NICE 2021) guidance on Induction of Labour tells us that the average risk of stillbirth at 40 weeks is approximately 1 in 800 pregnancies and that this risk doubles by 42 weeks when the risk is around 1 in 400 pregnancies. This is because the placenta might not function as well, and this can reduce the oxygen and nutrients available to your baby.
  • Induction of labour can be different to labour starting naturally. Induced labour may involve more vaginal examinations and a longer stay in hospital, this is because the process can take several days until your baby is born.
  • Some women report induction of labour to be more painful than a labour that starts naturally. Whilst some women go into labour quickly, for other women it can take longer and increase the amount of intervention and pain relief required.
  • Sometimes the hormones used during induction of labour (Prostaglandins) can cause the womb to contract too frequently and this can affect the pattern of your baby’s heartbeat.
  • There is a small chance that the induction of labour process will not work. If this happens a doctor will discuss your options with you, and you will be able to decide how to proceed.
  • There may be other risks to consider for some women. These will be discussed with you on an individual basis, considering your medical history, previous pregnancies, and current pregnancy.

The doctor or midwife will explain the risk versus benefit to you. If you choose not to have an induction of labour an individual plan of care will be made with you and your doctor or midwife. We often call this a wellbeing plan

How is labour induced and by what methods?

Caroline Lamb, our parent education midwife, talks about how labour is induced and what methods of induction of labour we offer in Bradford.

Please see the guides to some of the terms used below:

Balloon catheter

A balloon catheter is a soft narrow tube with a balloon at the end which is normally inserted into the bladder to help drain urine. It can also be used to help dilate the cervix (neck of the womb) by inserting the catheter into the opening of the cervix and inflating the balloon. This is known as a mechanical method of induction of labour.

Prostaglandin

Prostaglandin is a drug which acts like a natural hormone and prepares the cervix (neck of the womb) for labour. It is inserted as gel into the vagina and works over 6 hours. You may need more than one dose to prepare the cervix for labour

Artificial rupture of membranes (breaking your waters)

If the waters in front of your baby’s head do not break on their own, a procedure called an ARM will be advised. This is when a midwife or doctor makes a hole in the bag of water surrounding your baby to release the fluid inside.

This procedure involves a vaginal examination using an amnihook. An amnihook resembles a crochet instrument with a small hook on the end. Sometimes breaking the waters is enough to encourage your labour to start. However, it is common that some individuals will also require an
oxytocin infusion.

Oxytocin

Oxytocin is a hormone that causes contractions of your womb, and it can be used to start labour or speed up labour

Stretch and sweep (membrane sweep)

A membrane sweep is performed during a vaginal examination. A midwife or doctor will use their fingers to gently “stretch” your cervix (opening to the womb). They will then “sweep” around the inside of your cervix to separate the membranes (baby’s water sac) away from the cervix. This encourages a natural hormone called prostaglandin to be released which can help labour to start and may reduce your need for an induction of labour. You will be offered this after 39 weeks but it may be offered from 37 weeks if there is a medical reason for you to have an earlier induction of labour. In some circumstances a stretch and sweep is not appropriate and the reasons for this will be discussed with you. Following a membrane sweep it is normal to experience some discomfort and experience a blood-stained vaginal loss that should be sticky or mucousy. If you experience any “runny” fresh, red bleeding or are concerned please contact the Maternity Assessment Centre (MAC) for advice.

What will happen on the day you come into hospital?

Shaheen Akhtar, one of our Induction of labour midwives and Quality Improvement Practitioners, talks you through what will happen on the day of your induction of labour.

Where we are located?

The Induction of Labour Suite is located on ward M3 in the Women’s and New-born Unit. Access to the Women’s and New-born Unit is via Smith Lane, Gate 5.
You can call us on: 01274 383583 (24hrs)
You can find us at this postcode: BD9 6DA
You can click here for more travel info: Getting to our hospital