Are there national clinical guidelines for Induction of Labour?
Yes, NICE (National Institute for Health & Care Excellence) publishes national guidelines for clinical care. To access the guidelines on induction of labour, visit the NICE website at www.nice.org.uk.
Will I be able to go home with the balloon (Cervical Ripening Balloon)?
Yes, it is usually safe to go home with a balloon in place for most inductions, including when:
– You are past your due date
– You have Gestational Diabetes (GDM)
– You have Pelvic Girdle Pain / Symphysis Pubis Dysfunction (SPD)
– You had a previous caesarean section.
The benefit of having an outpatient induction is that being in your own home environment allows you to relax
and keep mobile which encourages your body to produce hormones to help dilate your cervix.
Will I be able to go home with the pessary (Propess)?
Because this method uses artificial hormones and we recommend monitoring how your body will react to them, we only advise going home if you have had a low risk pregnancy, with no complications, and are between 41 and 42 weeks pregnant.
Can my partner stay with me for inpatient induction?
Yes, one birth partner is welcome to stay with you throughout the induction process. However we are unable to provide meals or a bed for them. On some wards there are cozy chairs for the birth partners who wish to stay overnight. We ask that your birth partner does not share your bed as this may cause it to break (there are safe weight limits for each bed); and sharing your bedspace in hospital can increase your chance of developing an infection.
Can I use the Birth Centre?
Most women having an induction may need medications and monitoring that are only available in the labour ward. However, it is possible to use the Birth Centre if your pregnancy is considered low risk and your induction helps labour to establish within 24 hours of it being commenced. ‘Established labour’ means that your body has taken over the physiological process of having contractions and your cervix is more than 4cm dilated and progressing. If you are not in established labour, we would recommend you attend the labour ward to be offered artificial rupture of membranes and given medication to help your labour progress. Speak to the midwife discussing induction with you to ask what would be recommended for you.
What are the risks of each method?
Please see (What happens during an induction) page for the advantages and disadvantages of each method.
How many rounds of induction will I be offered (when not successful)?
This depends on your personal circumstances. You will be offered a medical assessment at each step. Your midwife or doctor will discuss your options, which could be to have a rest before trying again or to go on to a different method.
Can I stop the process at any time (e.g., after an unsuccessful balloon try can I decide to wait rather than go to next method)?
After each step your personal and medical circumstances will be reviewed and the midwife or doctor will discuss your options. Thinking BRAIN will help you talk through your options with them (BRAIN= Benefits, Risks, Alternatives, Intuition and doing Nothing).
How many inductions go to unplanned caesarean?
In NHS Lothian around 30% of inductions (1 in 3) go to an unplanned caesarean birth, 50% of inductions (1 in 2) go to a vaginal birth and 20% of inductions (1 in 5) go to an assisted birth (ventouse or forceps).
I have heard that an induced labour is more painful – is that true?
Yes. This is because your body does not produce natural pain killers in the same way as when labour starts by itself, so the contractions can feel more painful.
At home, there are several pain relief options you could try:
- Keep mobile and use active, upright positions to help your baby into an ideal position for birth
- Heat packs, hot water bottles or massage on your lower back may help relieve any cramping
- Warm bath or shower
- TENS machine
- You can take 1000mg paracetamol every 4-6 hours (maximum four doses in 24 hours).
On the antenatal ward
On the antenatal ward, oral pain relief such as paracetamol and dihydrocodeine will be offered to you.
If you are in a single room, aromatherapy can be used. A specially trained midwife can advise you and guide you to do this safely. Unfortunately aromatherapy oils cannot be used in a four bedded bay as they might not be suitable for other people in the bay.
In the labour ward
When you have moved to the labour ward you may use any and all forms of pain relief available as described on the website.
Your pain relief options in NHS Lothian – Maternity Services
Will I still be able to remain mobile / use positions for labour?
We encourage you to keep mobile and upright as much as possible. Your movements may be restricted if you or your baby are being monitored but your midwife will be able to show you positions that are safe and can help your labour to progress.
Can I refuse induction and request an elective caesarean?
The decision to have an induction – or not – is yours and will be respected. We recommend you talk to your midwife or doctor about the reasons why an induction is being offered and to discuss all your options with them. For example, it may be possible to make a plan to monitor your baby while you wait a little longer.
