Pregnancy week by week



Induction of labour

When labour is started artificially, it is said to be induced. If there are signs of a problem for you or your baby, your baby may be safer being born, rather than staying in the womb. Labour may be induced under the following conditions:
  • When you are well past your due date that is either in week 41 or 42.
  • You have pre-eclampsia and there are complications which will affect you and your baby.

  • There is placental insufficiency

  • Baby’s growth is slowed down or the baby is not moving well

  • When the contractions slow down in the first stage of labour and it is important to restart labour.

Your doctor will do some tests to be sure baby’s still doing okay in there, such as non- stress tests, contraction stress tests, or biophysical profile to check baby’s heart rate and movement. This will probably help both of you make a decision whether or not to induce. She may also do an ultrasound to determine how much amniotic fluid surrounds the baby. If it looks that the baby’s condition is worsening, or that the amniotic fluid is low, the decision will be made to deliver the baby.  Induced labour is much more painful than the natural one and you may be required to have an epidural, so that you are prepared for a caesarean or an assisted delivery, if necessary.


There are several ways to induce labour.

  • Membrane sweeping: also called artificial rupture of membranes. Your doctor will do an internal examination and try to sweep their finger inside the cervix and loosen the membranes. It is an effective way of inducing labour if the cervix is not sufficiently ripe. This releases prostaglandins which start off labour. This process is painless and successful in starting the labour in majority of cases.
  • Prostaglandins: this method is usually not enough all on its own and is used in combination by with other methods. A pessary /tablet made of prostaglandins is inserted in your vagina. If the cervix is ripe, the pessary stimulates uterine contractions. If the cervix is not ripe, these pessaries will help soften the cervix and open it to the extent that at least ARM can be carried out. This procedure can be repeated several times during the day till a result is achieved. The advantage of this method is that you can be mobile and can eat while waiting for labour to start.

  • Oxytocin (Syntocinon): this is a synthetic form of the hormone your body produces naturally to start off labour. Oxytocin added to your drip to make the contractions stronger and regular. This method is usually combined with ARM. Although very safe, when using oxytocin, contractions may be much more painful, stronger and with shorter interval as compared to those started by natural labour. Once the drip is started, your baby will be monitored continuously with an electronic foetal monitor.


Make sure that you have understood why you are being offered an induction. How will it be carried out, and what will be the likely course of your labour be?


Some women cope with labour using relaxation techniques, breathing and massage. Many others find that they need something to reduce the pain, as the strength of the contractions increases.


1) Gas and air (Entonox): this is
a mixture of oxygen and nitrous oxide gas. You breathe gas in through a mouth-piece or mask. Take several good deep breaths at the very beginning of each contraction. You hold the mask or mouth piece and take as much or as little as you need. The gas takes about 15-20 seconds to work, so you breathe it in just as a contraction begins. It works best if you take slow, deep breaths

Pros: ou are in control.
The oxygen is good for your baby. The gas doesn’t linger in your system. Only affects alertness temporarily as it’s quickly breathed in and out.

Cons: It's only a mild form of pain relief. It may make you feel slightly sick, sleepy, or unable to concentrate. You
may not like the feeling of light-headedness it gives. The gas won’t remove all the pain but it can help reduce it and make it more bearable. If it doesn’t give you enough pain relief, you can ask for an injection s well.

2) Pethidine: this is given by injection, usually into your bottom or thigh. It takes about 20 minutes to be effective and lasts for two to four hours. This can help you to relax, which can lessen the pain. There are new types of pain relief that may be used in your hospital instead of, or as well as, pethidine. Please find with your doctor what is on offer.

Pros: Pethidine may enable you to rest if labour is long and difficult. Some women find it helps “distance” them from the pain. If you are feeling anxious, it may relax you and help contractions be more effective.

Cons: may make you feel dizzy or sick. You may dislike feeling “
detached” from what’s happening. It may make your baby tired and slow to respond. It affects your digestive system, which may be a problem if you need a general anaesthesia. If it hasn’t worn off towards the end of labour, it can make it difficult to push. If the drug is given to close to the time of delivery, it may affect the baby’s breathing.

3) Epidural: this injection into your lower back numbs your body from waist down so you don’t feel the contractions. It takes 20 minutes to set up and has an immediate effect.

Pros: it can mean you feel no pain during labour. It is a very effective form of pain relief in labour. It can be helpful for women who are having a long and particularly painful labour, or who are becoming distressed.

it may have a patchy effect. It increases the length of labour as you can no longer feel your contractions.  It may cause sudden fall in blood pressure. It may cause headache after delivery. Some women say it causes short-term backache. You are more likely to need an assisted delivery (forceps, ventouse or caesarean)

4) TENS: stands for transcutaneous electrical nerve stimulation. A small machine with pads that stick onto your back and stimulate your nerves with small, safe amounts of electric current. You can turn the current up and down as needed. Best used from very early labour.

Pros: useful for backache during labour. You are in control. It can be used at home before going to hospital. It has no adverse effects on your baby.

Cons: you may need more pain relief than TENS can provide. It may not help with the pain for some women. You need to hire one as few hospitals have them.

5) Hydrotherapy: Some women find that getting into a pool of warm water is a good way to relax in labour. Women who use pools tend to need less pain relief, and may have shorter labours. If your hospital has a birth pool, there will be guidelines about using it. Usually, only women who have reached full term, and with a single baby whose head is downwards are allowed to use the pool. Talk to your doctor to find what guidelines apply to your hospital.


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