Induction of Labour
What is induction of labour?
Induction of labour is the medical process by which a combination of methods can be used to initiate and continue labour until the birth of your baby. Locally, induction of labour most commonly occurs when low-risk clients are still pregnant at 41+3 weeks gestation. However, some clients may be offered induction prior to this time based on increased risk factors occurring in their pregnancy.
Other indications for induction:
- Severe maternal illness
- Uterine infection
- Twin pregnancy (after 38 weeks)
- Poorly controlled Gestational Diabetes Mellitus
- Poor growth of baby
- Gestational hypertension
- Rupture of membranes and no labour
- Rupture of membranes and client is GBS positive
What method of induction will be used for my birth?
- Prostaglandin: Products (gel, tablet or insert) that are placed on/in the cervix to help it soften and thin. Prostaglandin can sometimes also start contractions.
- Mechanical dilation of the cervix: a deflated balloon catheter is inserted through the cervix, and is then filled with a predetermined amount of fluid putting pressure on the cervix and causing it to dilate.
- Oxytocin: Oxytocin used for induction is a synthetic form of the naturally occurring oxytocin already present in the body. Oxytocin is administered through an IV, started at a very low rate and increased until an adequate number of contractions are present. Oxytocin causes the contractions to keep occurring and the contractions enable the cervix to dilate (open). Oxytocin is generally continued until the baby has been born. As oxytocin can cause strong contractions, your baby’s heart rate will be monitored for the duration of your labour.
- Artificial Rupture of Membranes (ARM): After your cervix is dilated enough to reach the amniotic sac inside the uterus, a small hole can be made in the amniotic sac, breaking the waters. This may cause the uterus to begin contracting. Occasionally, ARM is enough to start labour on its own, mostly it is used in conjunction with the other methods listed.
The best method/s for your induction will be determined by your healthcare team. Which method/s used will be based on your body’s readiness for labour. Not all inductions of labour are successful, if a baby can not be born through induction, a c-section is generally performed to birth the baby.
Locally, all inductions of labour occur at the hospital. At this time at GRH, induction is a transfer of care from the midwife to the obstetric team. However, your midwife will be present for labour support when you are pushing and for the birth of your baby. You will still receive the standard midwifery postpartum care for 6 weeks after having your baby.
Feel free to review the additional resources below for more information or speak to your midwife.