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This leaflet gives information about induction of labour for pregnant women and their families. It helps you understand what induction is and make choices. It is based on a national and evidence-based guidance. The risks listed are not all the possible risks.
Induction of labour means starting labour using medicine or other methods, instead of waiting for it to start naturally.
Most babies are born between 37 and 42 weeks when labour starts on its own. Your midwife or doctor may suggest induction if it is safer for you or your baby to be born sooner. On average, about 1 in 3 labours are induced.
The most common reason is being 7–14 days past your due date, because risks increase after this time.
Other reasons include:
- gestational diabetes
- concerns about your baby’s growth
- your baby moving less
- high blood pressure
- your waters breaking but labour not starting
Most women start induction on the antenatal ward unless told to go to the labour ward.
- One birth partner can stay with you from 06:00 to 23:00.
- Visiting is 14:00 to 20:00 (max two visitors).
- No overnight sleeping facilities for partners.
- If you have special needs, talk to your midwife before.
When you move to labour ward, you can have two birth partners.
Sometimes induction may be delayed if the maternity unit is very busy.
If this happens:
- you will get a call on the morning of your planned induction.
- we will explain why and keep you updated.
- most delays are only for a few hours.
If the labour ward is full, moving from the antenatal ward may also be delayed. We will always explain and support you. Transfers are based on clinical need.
There are different ways to start labour. Your midwife or doctor will choose the best method for you. Sometimes you may have more than one method.
A membrane sweep is when your midwife or doctor puts a finger just inside your cervix and moves it in a circle. This helps separate the bag of waters from the cervix.
- It can be done at home, in clinic, or in hospital.
- It can help labour start naturally within 48 hours and reduce the need for other methods.
- You may feel some discomfort or see a little blood, but it will not harm your baby.
- It is not done if your waters have already broken.
- You may need more than one sweep.
If you are overdue and low risk, you may be offered a post-dates clinic for a sweep and other therapies.
Prostaglandins are medicines used to help start labour. They work by softening and opening the cervix (the neck of the womb), which helps contractions begin. For most women, prostaglandins are the recommended way to induce labour.
How Are Prostaglandins Given?
Prostaglandins are given in hospital, usually on the antenatal ward, in one of two ways:
- Propess pessary – a slow-release pessary (like a small tampon) placed in the vagina behind the cervix
- Prostin gel – a gel placed behind the cervix
The choice depends on your individual situation and how ready your cervix is.
- The pessary stays in place until labour starts or for up to 24 hours
- If labour has not started after 24 hours, you will be examined to see if your waters can be broken
Some women may be able to go home after the pessary is inserted if they are being induced for certain reasons and have no other risk factors. You will be advised if this applies to you. If labour does not start, you will return to hospital within 24 hours.
- Up to three doses may be needed
- Each dose works over about 6 hours
- You will stay in hospital
- After each dose, you will be examined to see if your waters can be broken
If labour starts or your waters break, you will be transferred to the labour ward.
- Your baby’s heartbeat will be checked before prostaglandins are given
- Monitoring continues for 30–60 minutes afterwards
- While you are in hospital, checks are repeated every 6–8 hours
- If contractions become regular or pain relief is needed, monitoring will be increased
If there are any concerns, you may be moved to the labour ward for continuous monitoring.
Occasionally, prostaglandins can cause contractions to be too strong or too frequent. If this happens:
- the pessary can be removed
- you may be asked to change position
- medication may be given to relax the uterus
- a doctor will review you, and closer monitoring may be needed
A balloon catheter is a method of induction used to soften and open your cervix, so your membranes can be broken. It involves a soft tube (catheter) with a balloon at the tip, being inserted into your cervix.
- The balloon is filled with salty water and gently stretches the cervix.
- This helps your body make prostaglandins and start labour.
- You will stay in hospital but can move around.
- Your baby’s heartbeat will be checked regularly.
- After 12–24 hours, or if the balloon falls out, you will be checked and the next step planned.
If induction works, you may:
- go into labour or have your waters broken (the next step in induction).
- have a vaginal birth instead of a caesarean section.
- avoid the risks that come with a caesarean.
- leave hospital sooner.
The balloon is made of soft, clear plastic called silicone. It will not harm your baby.
Problems are very rare - less than 1 in 1,000.
Possible risks:
- Your waters might break while the balloon is put in. This does not stop the balloon working, but your doctor may suggest using a drip called Syntocinon instead.
- Some women feel faint while the balloon is being filled. If this happens, the procedure will stop and can be done more slowly.
- There is a very small risk of infection because the balloon goes inside your body. If an infection is suspected, your baby will need to be born quickly (not always by caesarean).
- The balloon might not work if your cervix does not open. If this happens, you will talk to a doctor about what to do next.
If your cervix has opened enough and your waters haven’t broken on their own, your midwife or doctor may suggest breaking your waters. This is called an amniotomy.
- It is done on the labour ward.
- Your midwife or doctor uses a small plastic tool to make a hole in the bag of waters.
- You may feel some discomfort during the vaginal examination, but your midwife will support you.
- After your waters break, your baby’s heartbeat will be checked.
- You will be encouraged to move around or walk.
If contractions don’t start after 2–4 hours, you may be offered a drip called oxytocin.
Oxytocin is a drug that encourages stronger contractions, in length and frequency.
- It is given through a drip in your arm.
- The amount is adjusted so contractions come every 2–3 minutes.
- You will stay in the delivery room on the labour ward.
- You can sit, kneel, or stand, but you cannot move from room to room or have a bath.
Your baby’s heartbeat will be checked all the time using a CTG monitor.
If contractions become too strong, the drip will be slowed or stopped, and sometimes another medicine is given to relax the uterus.
Induction can cause early labour pains, which may make you feel tired and make labour seem more painful. There are many pain relief options to help you. Check your MyFrimleyHealth Record and managing pain in labour for more details.
It is hard to say how long labour will take. Induction can take up to 3 days for your cervix to open enough or for labour to start.
- Everyone responds differently.
- It usually takes longer if it’s your first baby or if induction is earlier in pregnancy. Plan to stay in hospital for a few days. Your midwife will keep you updated.
Yes! In early labour, you can walk around, use your bed space, or go to special rooms like the Poppy Room or Bubble Room with dim lights and bean bags.
If your baby needs continuous monitoring or you have an oxytocin drip, moving around is harder, but you can still sit on a chair or birthing ball.
Wireless monitors (telemetry) are available on labour ward to help you move more freely.
Induction can cause strong contractions, which may stress your baby.
Your contractions and your baby’s heartbeat will be checked often.
If contractions are too strong or too close together, you may be given medicine to slow them down.
If this is not treated, it can cause problems for your baby or, very rarely, a tear in the womb.
Induction aims to help you have a normal birth, but there is a higher chance of:
- assisted birth (using forceps or ventouse)
- caesarean section
Sometimes induction does not start labour. If this happens, your doctor and midwife will talk to you about options:
- waiting longer for labour to start naturally
- trying induction again
- using a different method
- having a caesarean section
If your midwife or doctor suggests induction but you do not want it:
- you will have an appointment with a senior doctor to talk about the risks and benefits.
- if you still choose not to have induction, you will have more check-ups with scans and heartbeat monitoring.
Extra monitoring cannot always prevent serious problems for you or your baby.
The choice is yours. Midwives and doctors are here to help you make the best decision.
If you have questions, call:
- Frimley Park Hospital: 0300 613 4231
- Wexham Park Hospital: 0300 615 4516
Contact us
If you have any queries relating to this information, please contact the Maternity service.
About this information
Service:
Maternity
Reference:
M/029
Approval date:
1 March 2026
Review date:
1 March 2029
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.