Labour induction: what to expect when you’re being induced

There are many reasons your health professional might recommend an induction, but the process involves just three basic steps. <a href="https://www.greenslopesprivate.com.au/Our-Doctors/Specialists/greenslopes-private-hospital/obstetrics-and-gynaecology/105633/dr-dora-ng">Dr. Dora Ng</a> obstetrician, gynaecologist and mother, explains.

Why would someone need to have labour induced?

There are several reasons for induction of labour, including:

• a pregnancy that has gone over the due date
• high blood pressure in pregnancy
• gestational diabetes
• a big baby
• a small baby.

If you attend a checkup and your obstetrician or midwife recommends you be induced, they will explain the reasons for this and let you know the next steps, including whether you are able to go home and come back or whether you will need to stay in the hospital and be induced straightaway. All of these factors will vary based on your individual situation.

Once you are ready to be induced, a three step process will begin. Some women will need all three steps to get into labour, but others might only need one or two. Your obstetrician or midwife will advise you as to the best method for you.

Step one: Softening the cervix

Softening of the cervix is usually started in the evening and takes a few minutes to perform. It can be achieved in various ways and the method might depend on the number of babies you’ve had before or how you’ve had them.

In general, a medicine (a type of prostaglandin) in the form of a gel or a medicated tape will be used. Sometimes a balloon catheter is used. This is a tubing which is placed into the cervix. Two small balloons on the tubing are then inflated, on either side of the cervix, to help the cervix open up.

Step two: Breaking the waters

Once the cervix is softened (usually by the morning after the procedure), it is time to move on to the second step of induction – breaking the waters.

This involves an internal examination with the fingers. A tiny hook on the end of a long thin instrument is then used to make a small hole in the membranes surrounding the baby. This process usually takes just a minute or two. You will likely then feel a gush of fluid as the ‘waters are broken’. Fluid will continue to leak out until your baby is born.

Step three: Contractions

In the third step of induction, an intravenous cannula (or ‘drip’) is inserted and medication (syntocinon) is given through this to stimulate your womb to contract.

The medication will be increased or decreased during your labour to optimise the number, frequency and strength of your contractions to allow your cervix to open up (or ‘dilate’).

While some women respond to this quite quickly, others may take longer. In some cases, the cervix does not dilate despite many hours on the medication.

Your contractions and your baby’s heartbeat are monitored continuously while you are on the medication. Contractions from induction via syntocinon can come on more quickly and be more intense than those from a naturally occurring labour. Some women may find they need stronger pain relief than they were planning to have. Your doctor or midwife will be able to help with your choices for pain relief.

As with any medical procedure, you are entitled to ask questions about being induced and to be fully informed about what is happening to you and your body. Always talk to your midwife, obstetrician or other health professional if you have any concerns.

Editor’s note: This article is of a general nature only and is not intended as personal advice. Ramsay Health Care recommends seeking medical advice specific to your individual circumstances.