Induction of Labour

What is Induction of labour (IOL)?

Induction of labour is a process used to start labour. In the UK every year, around one-in-three labours are induced.

Why might I be offered IOL?

  • There are many different reasons, including:
  • being overdue
  • a medical condition you may have such as diabetes or high blood pressure
  • your waters have broken but labour has not started
  • a change to the frequency or pattern of your baby’s movements
  • any other concerns with you or your baby

What should I bring with me?

You will need to bring your handheld notes, your overnight stay bag and any medication with you. For visiting times please click here.

Monitoring and support during IOL

You and your baby will be monitored regularly throughout the process. You will have a call bell to gain the attention of the midwives whenever you need it.

What is the aim of induction?

The aim is to encourage your body to go into labour before this occurs naturally so that your baby is born. The first phase of this process usually happens on the antenatal ward. For this to happen, your cervix (opening to the womb) needs to shorten and then open. Your midwife or doctor will assess if this is happening by performing a vaginal examination, with your consent.

Day of your IOL

On the day of your IOL please call Katherine Ward at 8am to be given a time to attend. Tel: 01895 279462.

Labour Ward transfer

Once you are transferred to Labour Ward your birthing partners (a maximum of two) may attend to be with you regardless of the time.

Your IOL journey

1.    Antenatal appointments
Induction should be mentioned and discussed throughout your antenatal care with your doctor or midwife at your antenatal appointments. You can use your personalised care plan on the Mum & Baby app to record questions you may wish to ask at your appointment.

2.    Decision for IOL
This is a joint decision based on your personal circumstances. If you are unsure or anxious, speak to your midwife.

3.    Admission
Depending on your situation after discussion with your doctor or midwife, you may be able to commence the process as an outpatient in our Day Assessment Unit, be given a date to attend the hospital, or you may be admitted the same day to the antenatal ward. Recommendation for IOL does not mean that there is immediate cause for concern with your baby. If you are anxious, please speak to your midwife.

4.    The process of IOL
Once your cervix has changed enough, the next part of the process could take place (breaking your waters and/or commencing a hormone IV drip). You will then be required to go to the Labour Ward to continue the induction process.
While you are waiting to start the next step of your induction, you may go into established labour yourself. This may mean you require moving to the Labour Ward or our Midwifery-Led Unit to have one-to-one care from a midwife.

5.    Transfer to Labour Ward
You and your baby will continue to be monitored. Pain relief (except an epidural) can be given on the Antenatal Ward. You will be transferred to the Labour Ward as soon as it is safe and appropriate.

Important notes

The induction and labour process and experience is different for everyone and does not always follow the same timeframe. If there are no concerns regarding you or your baby or your induction is progressing as expected, then you may need to wait to be transferred to the Labour Ward to allow a midwife to become available for you.

Your transfer may be delayed due to urgent transfers or emergencies into the unit. You will be transferred to the Labour Ward as soon as we are able to do this, and when it is safe to do so. Pain relief (except an epidural) can be given on the Antenatal Ward should you require it and you and your baby will receive additional monitoring if required whilst waiting. Your midwife will inform you of any updates to the situation as they occur and the situation is continuously assessed.
 
On your arrival to the ward you will be shown to a bed. Our Antenatal Ward is staffed by midwives and midwifery support workers 24 hours a day. Doctors will review anyone undergoing the induction process at least once daily.

Options for inducing labour

  • There are a few different options to induce labour which will be explained in more detail, discussed and agreed with you by your doctor or midwife.
  • Propess vaginal pessary
  • Prostin gel
  • cervical balloon

The aim of induction is to artificially start your labour using manual dilation of the cervix or medication inserted into the vagina, such as the pessary or gel, to make the cervix shorten and open. This may cause contractions and start off your labour or will allow your waters to be broken and the next part of the process to begin. This can be a lengthy process and make take a few days, depending on how many doses of medication you require.

  • Pain relief can be offered on the Antenatal Ward by your midwife. Options available include:
  • paracetamol
  • codeine
  • diamorphine
  • pethidine

Your midwife will discuss all options with you. You will be supported and encouraged to use your own ways of coping too, such as:

  • using a TENS machine
  • staying mobile/ changing positions frequently
  • having a warm shower
  • hypnobirthing
  • using breathing techniques

As your cervix softens and thins out you may experience painful period-like pains over your lower stomach and/or back. These pains vary in strength, duration and frequency and this is called the latent phase of labour and can last some days. You may find it harder to sleep or rest as normal.
 
Once on the Labour Ward, if you are not yet in established labour we may suggest breaking your waters to move forward with the induction process.
This may cause your body to start contracting on its own, or an intravenous oxytocin infusion (a hormone drip) may be offered, which is adjusted until you are having enough strong contractions to progress your labour (three to four contractions in 10 minutes). If your waters have been broken for over 24 hours then we would also recommend intravenous antibiotics once in established labour, to help protect you and your baby against possible infection.

More information

For more information on IOL,  see the NHS website here.

Any questions?

If you have further questions regarding the induction process, please speak to your doctor or midwife at any antenatal appointment, or contact Katherine Ward on 01895 279462. For any pregnancy-related urgent queries, please contact our Maternity Triage Team on 01895 279054.