Induction of labour: why it’s offered, how it works and your choices

Being offered an induction can feel like a lot to take in. Here’s why it’s offered, how it’s done, and what the NHS says about your choices.

Why it might be offered

The NHS says induction is common when your baby is overdue or there is a risk to your health or your baby’s, such as high blood pressure or poor baby growth. Specific reasons it lists:

Overdue: it is offered if labour hasn’t started naturally by 41 weeks, because the chance of stillbirth or problems for the baby goes up. See past your due date.
Waters broken for over 24 hours before labour: because the risk of infection rises. After 34 weeks you can choose induction or waiting. See how to tell if your waters have broken.
Health conditions such as diabetes, high blood pressure or intrahepatic cholestasis of pregnancy.

How it’s done

Membrane sweep: usually offered after 39 weeks. A finger is swept around your cervix during an internal examination. It can be uncomfortable and you may have cramping and some bleeding afterwards.
Hormones: given as a vaginal pessary or gel, or tablets you swallow. These are usually tried first.
Cervical widening: a balloon catheter or an osmotic dilator.
Breaking your waters and a hormone drip: sometimes needed to speed things up.

Induction always takes place in a hospital maternity unit.

What to expect

The NHS says it usually takes many hours for treatments to work, and you’ll usually stay in the unit, although some people can go home. Induced labour is usually more painful than labour that starts on its own, and you’re more likely to need an assisted delivery with forceps or ventouse. See forceps and ventouse. Induction isn’t always successful, and some people end up having a caesarean. Your options may include another method or reassessing after a few hours. The NHS says you should have access to all the usual pain relief options, such as an epidural or water birth. See pain relief in labour.

It’s your choice

The NHS says it’s your choice whether to have your labour induced, and your doctor and midwife will explain the pros and cons first. If your pregnancy goes beyond 42 weeks and you decline induction, you should be offered increased monitoring of your baby’s wellbeing. For more on going over your due date, see past your due date. Timing and policies can vary slightly between UK nations, so ask your midwife.

Questions people ask

Does a membrane sweep hurt?

The NHS says it can be uncomfortable, and you may have cramping and some bleeding afterwards. Call your midwife if you’re worried or the bleeding is more than a little.

How long does induction take?

The NHS says it usually takes many hours for treatments to work. It can take longer than that.

Can I say no to induction?

Yes. The NHS says it’s your choice, and you should be offered extra monitoring if you decline after 42 weeks.

Can I have an induced water birth?

The NHS says induction doesn’t restrict your pain relief options. A pool may not be advised in some cases, such as with a hormone drip. See water birth.