Induction


We aim for a spontaneous onset of labour at term, but there are many situations where it is safer for mother and baby if labour is induced. Over all at France Perry House about 20 percent of labours are induced. Recent evidence is showing that at term this actually decreases  the risk of caesarean section for post date pregnancies.

Common reasons for induction include dates (usually 10-12 days over your due date, but in practice any time after 41 weeks is acceptable) or pre labour rupture of membranes (greater than 24 hours without contractions starting). Then there are many medical reasons such as blood pressure, diabetes, poor fetal growth, previous difficult delivery, and less common maternal symptoms or social timing issues.

The usual process for induction requires rupture of the membranes to allow an infusion of oxytocin to be started and increased in a stepwise fashion until contractions are strong and regular. In practice many times we are unable to “break the waters” initially as the cervix is closed and so women spend an afternoon and evening in Labour Ward at Frances Perry having a dose of Prostin gel inserted vaginally, with pre and post electronic fetal heart rate monitoring (CTG) traces to ensure the baby is happy before and in response to the gel. Most times after this it is possible to go home to sleep, and return if labour starts or else arrive early the next morning in preparation for the oxytocin drip.

Once contractions begin we use continues CTG monitoring until the baby is delivered. Induction is neither more nor less painful than spontaneous labour. Often this myth is perpetuated by comparing a first, induced pregnancy to a second, spontaneous labour, where the real difference is a second labour is overall much quicker and easier than a first! Induction may speed up the latent phase of labour and so appear to come on more quickly sometimes, but this therefore decreases the over length of labour.

If your labour needs to be induced you will have plenty of time to ask questions about the process and the reasons in your case.


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