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.
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