A baby is considered overdue if pregnancy carries on longer than 37 weeks. Around the 38-42 week mark, you may be exploring your labour induction options. Some natural or medical induction methods may be helpful.
As of 2019, between one-quarter to one-third of women were induced into labour. Medical induction can involve stimulating contractions with medicine, opening the cervix with forceps, or medically breaking water.
Medical induction is generally more painful than natural labour. The good news is you’re still able to receive the full extent of pain relief available. Induced labours are monitored closely, and mum’s movement will likely be restricted.
You may need to explore medical induction with your doctor if:
- Your due date has been and gone
- There is concern around the positioning of your placenta
- You have existing health conditions such as diabetes or high blood pressure
- Your water has broken, but contractions have not started after a long time
- You are expecting twins
- Your baby is moving around in the womb less than usual. If you notice this happening, alert your doctor.
Medical Labour Induction Methods
Breaking your waters
A small instrument is inserted into the vagina to rupture the membrane sac and release fluid; called Artificial Rupture of Membranes (ARM). The vaginal examination may be slightly uncomfortable, but the procedure itself shouldn’t hurt. Sometimes ARM is enough to induce labour, but it is often paired with oxytocin.
Oxytocin is a hormone that causes contractions. If your water has broken, but contractions are taking too long to begin, oxytocin will be administered through a drip in your arm. Contractions can be kept regular by adjusting the drip rate. Your baby’s heart rate will be monitored the whole time.
Prostaglandin is a hormone that can soften up and open the cervix. It is naturally present in semen. Artificial prostaglandin comes in gel and pessary form, either of which will be inserted into the vagina should the cervix need help opening or ‘ripening’. Once prostaglandin has been administered, you will likely be asked to lie down for a while.
Cervical Ripening Balloon Catheter
Sometimes used as an alternative to prostaglandin. A ‘balloon’ is inserted via a tube into the vagina. The balloon is filled with saline so it applies gentle pressure to the cervix, which can soften and open it. After 12-15 hours or when the balloon falls out – whichever comes first – your cervix will be re-assessed to determine the next step.
When deciding whether or not to induce labour, there are a few things to consider. The ‘wait and see’ option is a matter of patience, comfort and safety. You may prefer to wait as long as possible for natural labour to start. Listen to your doctor’s advice, as sometimes induction is the safer approach.
Not all inductions work. Some women require multiple methods of induction before labour begins, or a caesarean is performed instead. If your pregnancy circumstances indicate you may need to be induced, talk thoroughly to your birth team professionals to reach a decision that is both safe and appropriate for you.