Induction of labour
In most pregnancies, labour will begin spontaneously between 37 and 42 weeks. If your labour has not commenced by this time, or if there is any risk to you, or to your baby’s health, your doctor may suggest that labour is induced. This means that the process of labour is encouraged to start artificially.
Your doctor or midwife will explain to you and your partner why induction of labour is recommended for you; the risks and benefits of induction of labour; 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 prostaglandin gel into your vagina
- breaking your waters
- giving you a synthetic hormone called Syntocinon via a drip (IV) into your arm
- a combination of the above methods.
Your induction of labour - evening
Prostaglandin, in a gel form, when inserted deep into your vagina assists your cervix to prepare for labour. The gel is usually administered to you in the evening, allowing your cervix time to respond to the gel overnight, so that the next stage of the induction process can proceed. This increases the chance of the induction process being successful.
You will be asked to come to main reception, level 5, Mater Mothers’ Hospital at approximately 6 pm on the day of your booking, or as otherwise advised. You may need to wait in the reception area for a brief period, as a room for your induction is allocated. Once this has been finalised, you will be escorted to your room where your midwife will assess you by taking your pulse, temperature, blood pressure and checking your pregnancy history. Your midwife will assess your baby by feeling your abdomen to determine the position and use a cardiotocograph machine (CTG) to monitor your baby’s heart rate, which may take approximately 20 to 30 minutes. Your midwife will also perform a vaginal examination to assess your cervix.
Your midwife will then insert the prostaglandin gel in your vagina, next to your cervix. You will continue to rest in a lying position and your baby will be monitored by CTG for another hour. If the outcome of the CTG shows anything which may be a concern, you may be transferred to a room within Birth Suite for closer monitoring.
Some women may feel some contraction-like pains, after insertion of the gel, while others feel none; both are normal. After this procedure most women are comfortable, and should be able to rest. However, if you leak any water from your vagina, have any bleeding, need pain relief or have any other concerns, please let your midwife know.
Some women who have had a previous caesarean birth may require a different method to ripen their cervix, which avoids using the gel. This would be discussed with you in more detail if required.
Your cervix may have started to dilate on its own prior to coming hospital. If this has occurred, the gel may not be used. You may be able to go home and return to hospital in the morning for your induction of labour.
If you have received the gel in the evening, you will be required to stay in hospital overnight. Early the following morning, you will be taken to a room within Birth Suite where a midwife or doctor will re-examine you and attempt to break the bag of waters surrounding your baby. Although uncommon, a second dose of prostaglandin gel may be necessary if your cervix is not open enough and your waters are unable to be broken.
If your cervix does not respond to the first dose of prostaglandin gel you may require further doses to allow your cervix to become ready for labour.
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.
When you arrive you will be taken to a room within Birth Suite. Your midwife will assess you by taking your pulse, temperature, blood pressure, checking your pregnancy history and then assess your baby by listening to their heart beat and 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 commence electronic monitoring of your baby’s heart rate, using the CTG machine. This monitoring will be continuous throughout your labour until your baby is born.
After breaking the waters around your baby, whether you were induced in the evening or morning, a small needle will be inserted into the back of your hand and Syntocinon will be given through this needle to stimulate your uterus to begin contracting. Sometimes, this process may take several hours to begin working. Your midwife will adjust the drip rate until you are having regular effective contractions and monitor your baby’s heart rate.
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. You will need to discuss this option with your doctor prior to your admission to hospital and prior to the commencement of your induction of labour regardless whether it is in the evening or in the morning.
Most women will find labour painful, however some women may find labour resulting from an induction of labour more painful and may choose to have pain relief earlier than usual. If you choose an epidural as your pain relief option you should be aware of the risks and benefits of epidurals. Please refer to the Mater Mothers’ Hospitals brochure Epidural for further information regarding epidural pain relief.
A small number of women may find that their labour does not become established or progress. A caesarean birth may then be recommended.
Please phone the Mater Mothers’ Hospital Birth Suite Team Leader on 07 3163 6580 at least one hour prior to coming to hospital as the hospital can become unexpectedly busy and your admission may need to be delayed for a short period of time. Please be assured that we will always try to contact you as early as possible if we need to postpone your admission.
© 2010 Mater Misericordiae Ltd. ACN 096 708 922
Mater acknowledges consumer consultation in the development of this patient information.
Last modified 11/11/2015.