If you have been offered an induction of labour, you may be wondering what will happen and how long it will take. Induction means using a treatment to help labour begin. The steps depend on your pregnancy, how ready your cervix is for labour and how your body responds.

Your midwife or doctor should explain why they are recommending induction and talk through the benefits and disadvantages with you. It is your choice whether to have your labour induced.
Why might induction be offered:

Induction may be recommended if:
• Your baby is overdue.
• Your waters have broken but labour has not started.
• There is a concern about your health or your baby’s health.
Ask your care team why they are recommending induction in your circumstances, and whether there are other options.

What happens during induction?
You may need only some of the steps below. Your team will explain which method they recommend and assess how you and your baby are doing as the process continues.
1. You may be offered a membrane sweep
During a vaginal examination, a doctor may offer to stimulate the cervix, which is the neck of the womb. This is called a membrane sweep. It aims to encourage your body to release hormones that may start labour.
A sweep is usually done at an outpatient appointment, so you generally go home afterwards. A sweep does not always start labour.
2. The cervix may need time to soften and open
If labour has not started, your team may recommend a treatment to prepare your cervix. Options include:
• A Propess pessary: A small vaginal pessary that slowly releases a hormone called prostaglandin. It may be left in place for up to 24 hours.
• Prostaglandin gel: A hormone gel placed in the vagina. It may need to be given more than once and can take up to 72 hours to work.
• A balloon: A small balloon placed in the cervix to help it open. Your obstetrician may recommend this in certain circumstances, including after one previous caesarean birth.
These treatments may start labour or open the cervix enough for the next step. Your team will tell you which option is suitable for you.
3. Your waters may be broken
If the cervix has opened enough but labour has not started, a midwife or doctor may offer to break the waters. This is called an amniotomy or artificial rupture of membranes.
Your team should explain what they plan to do and what may happen next.
4. You may need an oxytocin drip
Sometimes contractions need help to start or become regular. In that case, you may be offered synthetic oxytocin through a drip.
This is usually given after the waters have broken and takes place in the labour ward.
The drip is started slowly and adjusted as needed. Hospital staff monitor your response to avoid contractions happening too close together.
How long does induction take?
There is no single timetable. Some people go into labour after an early step, while others need further treatment. Preparing the cervix can take time: a Propess pessary may be in place for 24 hours, while prostaglandin gel can take up to 72 hours to work and may need to be repeated.
It can help to think of the start of induction and the start of established labour as two separate points. Ask your maternity team what to expect from the method they recommend, where you will spend each stage and when they will reassess you.
You do not have to remember everything at once. Ask your team to explain each step again whenever you need to.
The key thing to remember: induction is a process, and your experience may differ from someone else’s. Your maternity team can explain the recommendation, the next step and your choices based on your individual pregnancy.
Watch our video on induction of labour

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