Induction of Labour

Sometimes a pregnancy goes past the "due date". When the pregnancy goes past 41 weeks and labour does not set in naturally, then your obstetrician may decide to induce labour.

What is induced labour?

When labour is started artificially, it is said to be induced. It is always planned in advance and you will be able to discuss advantages and disadvantages with your doctor. Labour is induced when there is danger to the baby or mother. It may be induced under the following conditions:

• When you are well past your due date
• You have pre-eclampsia and there are complications which will affect you and 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

One thing that needs to be considered is that induced labour is much more painful than the natural one and you may require to have an epidural so that you are prepared for a caesarean or an assisted delivery, if necessary.

Is it true that making love can induce labour?

It is true that sex can help to induce labour but only when the term is almost complete or you are overdue. Semen contains prostaglandins which soften the cervix and stimulate uterine contractions. Lovemaking also stimulates the cells of the cervix to secrete their own prostaglandins.

How does breast stimulation affect labour?

Stimulation of breasts can produce very strong contractions. Hence, it is not advisable to practice it to initiate labour unless asked by the doctor to do so. Nipple stimulation can even reactivate a halted labour.

What will happen when I arrive at the hospital?

When you arrive at the hospital you will have to come to the Labour Ward. The doctor will then give you a full examination, which will include taking your blood pressure, pulse, examining your abdomen, and doing an internal examination. Your baby's heartbeat will also be monitored for a short while. The doctor will then decide the best way to induce labour.

Ways to induce labour

Using Pessaries

A pessary/tablet or gel made of prostaglandins is inserted in your vagina. Prostaglandins help in softening the cervix and stimulating uterine contractions. The first dose is usually given at midnight. This procedure may be repeated until the desired result is achieved. Gels may also be used. Advantage: you can be mobile and eat while waiting for labour to start. Usually combined with other methods.

Using ARM (Artificial Rupture of Membranes)

Also called breaking of waters. Your doctor will break the membranes using an Amnion hook. This is painless and usually effective in starting labour. Once membranes are broken, contractions become stronger. If necessary, Oxytocin may be given.

Using Oxytocin

Oxytocin makes contractions strong and regular. It is usually combined with ARM. Contractions are stronger and closer together, which may require pain relief. Oxytocin is given intravenously, restricting mobility, and careful monitoring is required.

Safety of baby during induction

Your baby's heartbeat will be monitored at regular intervals once labour is induced.

If labour starts at night or fails

Occasionally labour may start during the night. The hospital will manage it as normal labour. If labour does not start, the doctor will discuss your progress and may try again the next day. Further treatment depends on your specific case.