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 is offered to all women who don't go into labour naturally by 42 weeks, as there's a higher risk of stillbirth or problems for the baby if you go over 42 weeks pregnant.
You can find out more about the induction of labour compared with staying pregnant by reading Choices when pregnancy reaches 41 weeks (PDF, 536kb).
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, she or he 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 isn't 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 obstetric cholestasis (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.
Before inducing labour, you'll be offered a "membrane sweep", also known as a "cervical sweep", to bring on labour.
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 kick-start your labour.
Having a membrane sweep doesn't hurt, but expect some discomfort or slight bleeding afterwards.
If labour doesn't start after a membrane sweep, you'll be offered induction of labour.
Induction is always carried out in a hospital maternity unit. You'll still be looked after by midwives, but 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.
Contractions can be started by inserting a tablet (pessary) or gel into the vagina.
Induction of labour may take a while, particularly if the cervix (the neck of the uterus) needs to be softened with pessaries or gels.
If you have a vaginal tablet or gel, you may be allowed to go home while you wait for it to work.
You should contact your midwife or obstetrician if:
- your contractions begin
- you haven't had any contractions after 6 hours
If you've had no contractions after 6 hours, you may be offered another tablet or gel.
If you have a controlled-release pessary inserted into your vagina, it can take 24 hours to work. If you aren't having contractions after 24 hours, you may be offered another dose.
Sometimes a hormone drip is needed to speed up the labour. Once labour starts, it should proceed normally, but it can sometimes take 24 to 48 hours to get you into labour.
What induced labour feels like
Induced labour is usually more painful than labour that starts on its own, and women who are induced are more likely to ask for an epidural.
Your pain relief options during labour aren't restricted by being induced. You should have access to all the pain relief options usually available in the maternity unit.
Women who are induced are also more likely to have an assisted delivery, where forceps or ventouse suction are used to help the baby out.
If induction of labour doesn't work
Induction isn't always successful, and labour may not start.
Your obstetrician and midwife will assess your condition and your baby's wellbeing, and you may be offered another induction or a caesarean section.
Your midwife and doctor will discuss all your options with you.
Side effects of induction of labour
In 2004-05, 1 in every 5 births in the UK were induced, according to the National Institute for Health and Care Excellence (NICE).
Among these induced births, when labour was started using drugs:
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 as herbal supplements and having sex, but there's no evidence that these work.
Having sex won't cause harm, but you should avoid having sex if your waters have broken as there's an increased risk of infection.
You can find pregnancy and baby apps and tools in the NHS apps library.