What happens if my baby is late?

Your due date is just an estimate of when your baby will arrive, and most babies make an appearance between 37 weeks and 42 weeks. If your baby has not arrived by 41 weeks, your midwife can offer you a membrane sweep. If your baby hasn’t arrived by 10 -14 days after your due date, your midwife will discuss the option of induction with you.

What can I do to help bring my labour on?

There are many myths around kickstarting labour, but unfortunately there are no medically proven ways to bring labour on at home. However, here are few of the many myths that you may like to try:

Exercise produces endorphins, which can help you to relax. Walking will also encourage your baby to move down on to your cervix.

Movements that encourage your pelvis to open, such as siting on a birthing ball, walking, using the stairs or crouching/squatting can help your baby to get into the right positions – but only do this if it is comfortable to do so.

These include massage, acupuncture, reflexology and aromatherapy. Many complementary therapists will offer therapies for women who are overdue. These can be a nice relaxing treat but will have a cost associated with them as this is not offered by the National Health Service (NHS).

Sex can encourage the release of the ‘love hormone’ oxytocin. Oxytocin is also the hormone necessary for labour and will encourage contractions to begin. Semen also contains a hormone similar to prostaglandins which can help soften the cervix so this could help to get labour started. Please do not have sex once your waters have gone, due to the risk of infection.

The theory behind this is that stimulating your nipples could help release the ‘love hormone’ oxytocin into your body, which could help you go into labour naturally. However, it is thought you would need to do lot nipple stimulation for this to help! Please don’t try until after you are 37 weeks.

The theory is that eating spicy foods will stimulate bowel movement, which could encourage your uterus to start contracting.

Pineapple contains an enzyme called bromelain, which is thought to soften the cervix. However, it is thought that you would need to eat quite a few pineapples for this to happen!

What happens if I go over my due date?

Membrane Sweep

A membrane sweep is a vaginal examination, which is offered to all women once they reach 41 weeks, to help encourage labour to start naturally. The midwife will insert a finger into your vagina and reach for the cervix. Once she has reached the cervix she will do a circular ‘sweeping’ motion around the cervix to help separate the sac from the cervix. This can release hormones in the body that will help your body to go into labour. This will normally work within 24hrs and there’s around a 50% chance of labour happening naturally. It is possible to have more than one membrane sweep, so please discuss this with your midwife.

Membrane sweeps can be uncomfortable, and you may have a small amount of bleeding afterwards.

Inductions

In the UK around 20% of labours are induced, mainly due to women who have gone past their due date. Induction of labour is the process of starting labour artificially. If your baby has not made an appearance by 41 weeks and 3-6 days, you will be advised to have an induction. This is recommended by the obstetricians, but you may do some research and feel that you would prefer to wait a few more days to allow your body to go into labour. You can discuss the risks and benefits with your midwife, so that they can organise a plan of care for you. You may also need an induction earlier if recommended by the obstetricians for various medical reasons.

Inductions will take place in your local hospital: Dorset County Hospital in Dorchester, or St. Mary’s Maternity Unit in Poole. Select the location below to find out more about the induction process.

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).

Hormone gel (Dinoprostone)

During the examination if your cervix is not open enough to break your waters, the midwife will put a gel, which contains a hormone into your vagina next to your cervix, to help it soften and open enough to have your waters broken. Your baby’s heartbeat will be monitored for a further 20 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 every 6 hours.

You will have a vaginal assessment by the midwife again 6 hours later. If the cervix is still not open enough to break your waters, it will be necessary to have a second dose of the hormone gel. If however your waters can be broken, you will be transferred to Labour Ward as soon as possible

Cervical Ripening Balloon catheter

The cervical ripening balloon catheter is used to open the cervix so that we can break your waters.

On vaginal examination, the hormone-free catheter is passed through your cervix and is left in place for approximately 24 hours.

The presence and pressure of the balloon should encourage you’re cervix to open enough to have your waters broken. If the balloon does not fall out within 24 hours it will be deflated and removed.

You will then have a vaginal assessment and if your waters can be broken you will be transferred to Labour ward to have this performed when it is clinically safe to do so. If they can’t be broken at this time you may be offered to have the hormone gel induction.

Outpatient Induction

An outpatient induction means that the process will be started in the hospital, using the balloon catheter and then you can go home for a while. You may be offered 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

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 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 hormone gel 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 temporarily 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

On arrival to the maternity unit you will have an antenatal check, which will include your blood pressure, pulse and temperature. You will then have CTG monitoring to ensure that your baby is doing well before starting the induction process and a quick presentation scan to make sure baby is facing “head down”.

Hormone Pessary (Dinoprostone)

Once the observations have been completed and the midwife is happy, she will ask if it is 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 dissolve in your vagina in the next 6 hours. Your baby’s heartbeat will continue to be monitored for a further 30 minutes to ensure they are coping well. You will then be able to move around the ward. This process of monitoring your baby’s heartbeat and wellbeing, and being offered a vaginal examination, occurs every 6 hours, with a maximum of two pessaries per cycle.

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. There may sometimes be a delay in breaking your waters if the maternity unit is busy – the staff will explain this to you. If your cervix is not dilated enough for your waters to be broken, you will be ‘rested’ for 24 hours and the pessary cycle can be commenced again.

Cervical Ripening Balloon catheter

The cervical ripening balloon catheter is used to open the cervix so that we can break your waters.

On vaginal examination, the hormone-free catheter is passed through your cervix and is left in place for approximately 24 hours.

The presence and pressure of the balloon should encourage you’re cervix to open enough to have your waters broken. If the balloon does not fall out within 24 hours it will be deflated and removed.

You will then have a vaginal assessment and if your waters can be broken you will be transferred into a labour room to have this performed when it is clinically safe to do so. If they can’t be broken at this time you may be offered to have the hormone pessary induction.

Once your waters have been broken, your baby’s heartbeat will be monitored continuously using the CTG monitor.

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, temporarily, 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.

What if I don’t want to be induced?

You might decide that you don’t want an induction of labour. If you feel that you would prefer to wait for a few more days to allow your body to go into labour naturally, please discuss this with your midwife. They can organise an individual care plan for you, and arrange for you to be seen by an obstetrician to discuss the risks and advantages of delaying induction.