Your induction will be started on the antenatal ward. When you arrive you will have an antenatal check, which will include your blood pressure, pulse and temperature. You will then have cardiotocography (CTG) monitoring to ensure baby’s heartbeat is within normal range. Once the observations have been completed and the midwife is happy, she will ask if it’s okay to perform a vaginal examination to check the neck of the womb (cervix).
If the cervix is closed then you will have a pessary (like a small flat tampon) inserted into your vagina, which contains a prostaglandin. This will stay in your vagina for 24-30hrs. Your baby’s heartbeat will be monitored for a further 30 minutes to ensure everything is going well. You will then be able to walk around the ward. You will have your baby’s heart monitored on the CTG at regular intervals. In some cases, you may be able to go home – this is called an outpatient induction (see below). You will need to return at regular intervals to have your baby’s heart rate monitored.
The pessary alone will start labour for some women. If labour hasn’t started after 24-30 hours, the pessary will be removed, and you will be offered another vaginal examination to assess the neck of the womb (cervix). Hopefully the pessary will have helped to soften your cervix. If so, your cervix may have dilated (opened) enough for your waters to be broken.
Cervical Ripening Balloon catheter
This is another method that can be used to induce labour. The cervical ripening balloon catheter is inserted through the cervix. Sometime your legs will need to be put in stirrups to insert the balloon catheter. A speculum is inserted in the vagina and the cervix is cleaned. The catheter is inserted through the cervix and the balloons are inflated with fluid carefully so that they apply pressure to the cervix. The speculum is removed and the catheter is loosely taped to the thigh. The balloon is left in place for around 12-24 hrs.
If the labour begins then the balloon will fall out. If labour does not begin, it will be deflated and removed after 12-24 hours so that your waters can be broken.
An outpatient induction means that the process will be started in the hospital, using one of the methods listed above, and then you can go home for a while. You may be offered of an outpatient induction if:
- You are under Midwife-led care
- You have no medical or obstetric problems
- You have not had any gynaecological surgery
- You have a relative or someone who can stay with you at home on that day
- You have transport to bring you into the hospital
- You live within 30 minutes’ drive of Poole hospital
You will need to come back to the hospital at regular intervals so that you and the baby can be monitored. Your midwife will tell you if you meet the criteria for an outpatient induction.
What happens next?
The aim of these methods is to dilate your cervix so that your waters break or can be broken by your midwife. This will take place on the Central Delivery Suite (labour ward). There may sometimes be a delay in transferring you if the labour ward is busy. The staff will explain this to you.
Most women will require an oxytocin (hormone) drip to strengthen contractions. The progress of your labour will be monitored regularly by vaginal examinations until your baby is born.
Occasionally the pessary or the oxytocin drip used for induction of labour can cause your womb to contract too much and cause your baby some distress. In these cases, we can stop the contractions with medication.
Please ask your midwife if you require further information. Each step will be explained to you when you are in hospital and your pain relief options will be discussed with you.
Induction of Labour