Induction of labour
In most pregnancies, labour will begin spontaneously between 37 and 42 weeks. If your labour has not commenced by 41 weeks, or if there is any risk to you, or to your baby’s health, you will receive a phonecall from a midwife to discuss an induction of labour (IOL) This means that the process of labour is encouraged to start artificially.
Your doctor or midwife will explain to you, and your partner, why IOL is recommended for you; the risks and benefits of IOL; and the proposed induction methods. They will also be able to answer any questions you may have.
Induction of labour can be achieved by:
- inserting a balloon catheter (a soft silicon tube with two a small balloons on the end is placed on either side of the cervix and helps to gradually open and thin the cervix)
- inserting prostaglandin gel (a synthetic drug, placed into the vagina, that brings about hormone changes in the cervix to make it more open and thin)
- breaking your waters
- giving you a synthetic hormone called syntocinon via an intravenous drip (IV) into your hand
- a combination of the above methods.
Your induction of labour—evening
You will be asked to come to main reception, level 5, Mater Mothers’ Hospital at the day and time advised. Please have a meal before coming to the hospital. You are also welcome to bring some light snacks with you for you and your support person.
Your midwife will take your pulse, temperature, blood pressure and review your pregnancy history. Your midwife will also assess your baby by feeling your abdomen to determine your baby’s position and use a cardiotocograph machine (CTG) to monitor your baby’s heart rate, which may take approximately 20 to 30 minutes.
For women commencing their induction with a balloon catheter will be inserted by a doctor or midwife during a vaginal examination. Once it is in place, a small quantity of water will be added, inflating balloons on either side of your cervix. The balloons place continuous gentle pressure on your cervix encouraging it to gradually soften, shorten and dilate. The balloon catheter may fall out by its self as your cervix opens. If not, it will be removed by the doctor or midwife before you have your waters broken the following morning. Once the balloon catheter is in place, you will remain in hospital overnight.
For women commencing their induction with prostaglandin gel your midwife will perform a vaginal examination to assess your cervix, and then insert the prostaglandin gel in your vagina. You will continue to rest in a lying position, and your baby will again be monitored by CTG for about one hour. Prostaglandin gel is usually administered to you in the evening, allowing your cervix time to respond to the gel overnight. Once the prostaglandin gel has been administered, you will remain in hospital overnight.
Some women may feel some contraction-like pains after insertion of the gel, while this is less likely following insertion of the balloon catheter. After the balloon or prostaglandin gel, most women are comfortable and should be able to rest. However, if you leak any fluid from your vagina, have any bleeding, need pain relief or have any other concerns, please let your midwife know.
- If prostaglandin gel is used and your cervix does not respond to the first dose, you may require further doses to allow your cervix to become ready for labour.
- A uterine scar, usually from a previous caesarean birth, is a contraindication for the use of prostaglandins; a different method, such as the balloon catheter is required to ripen the cervix. This would be discussed with you in more detail, if required.
- Your cervix may have started to dilate on its own prior to coming to hospital. If this has occurred, we may not need to use the balloon catheter or the gel, you may be able to go home and return in the morning to have your waters broken and start a synotocinon drip to help with your IOL.
Your induction of labour—morning
Please come to main reception, level 5, Mater Mothers’ Hospital at 5 am on the day of your booking, or as otherwise advised.
You will be taken to a room within Birth Suite. Your midwife will record your pulse, temperature, blood pressure, review your pregnancy history; assess your baby by listening to their heart beat and then discuss your plans for labour and birth with you. Your midwife or doctor will break the bag of waters surrounding your baby, during a vaginal examination. Once your waters are broken, your midwife will monitor your baby’s heart rate continuously, using the CTG machine, until your baby is born.
An intravenour drip will then be inserted into the back of your hand and syntocinon given through this needle to stimulate your uterus to begin contracting. Sometimes, this process may take several hours to take effect. Your midwife will adjust the rate at which you receive the syntocinon, until you are having regular, effective contractions.
Some women may wish to delay starting, or avoid the use of syntocinon. However delaying this after your waters are broken may prolong the onset of your labour. Please discuss this option with your doctor prior to your admission to hospital and prior to the commencement of your induction of labour.
A small number of women may find that their labour does not establish or progress. A caesarean birth may then be recommended.
Booking details for your induction of labour
Please telephone Mater Mothers’ Hospital’s Birth Suite on 07 3163 1916 if you have any questions regarding your IOL booking. Please be assured that we will always try to contact you, as early as possible, if we need to postpone your admission.
For more comprehensive information about IOL please refer the following publications:
1. Induction of labour
2. Having your baby in Queensland. Choosing how your labour will start: a decision aid for women with a prolonged pregnancy. 2010; 81–95
© 2014 Mater Misericordiae Ltd. ACN 096 708 922
Mater acknowledges consumer consultation in the development of this patient information.
Last modified 01/11/2016.