Induction of labour

Induction of labour

Hi, my name is Charlotte. I’m a midwife over at North Tees and I’m here to talk to you about induction of labour.

As you approach term, your midwife in community will offer you a membrane sweep. A membrane sweep is not designed to put you into labour, but if you are on the cusp of starting to labour yourself, a membrane sweep can definitely help.

Your community midwife will ensure that your placenta is in the right location. She will then offer to do an internal examination where she pops two fingers just inside of your vagina and attempts to find your cervix.

Our cervixes are naturally about 3 cm long and very tubular and very tightly closed. As we get towards term, pressure from baby’s head will move your cervix forward, start to soften it, and start to open it.

Your community midwife will try and pop two fingers just inside of your cervix and make a sweeping motion with them. The hope is that this will stir up a lot of hormones and will hopefully push you into labour if your body is ready to do so.

National guidance is now that at 7 days past your due date, you will be offered an induction. Your local trust will invite you in, they will ensure that you are well and baby as well and they will monitor baby.

They will then insert what is called a cervical ripening balloon. This is done by using a foley’s catheter. It is very soft and very stretchy, that goes inside your cervix and is then inflated with 30mls of water. It forms a large water balloon on the end.

This is then left to hang from your vagina and is often taped to your inner thigh. The pressure from the balloon then adds pressure to your cervix which hopefully will increase dilatation.

You will then be given a time to go back into hospital to have this balloon removed. Hopefully, while you are at home, the pressure from the balloon will help to dilate your cervix so much that the catheter just falls out naturally itself. If this does occur, then you would ring your chosen trust and go back in earlier.

Once your catheter has been removed, the next stage of induction is to break your waters. We do this with an Amnihook. It is a small plastic hook with a tiny little spike on the end.

This is then popped inside your vagina. It shouldn’t be painful for you and it shouldn’t be painful for baby. We then use it to nick your bag of membranes around baby and release the water from there.

Following that, you will be left alone for a couple of hours for your contractions to start naturally.

The final stage of induction is when we pop a canula into the back of your hand and we start an oxytocin drip. This will be turned up very very slowly in little increments until you are contracting regularly and the doctors are happy with your progress.

So you can opt to decline induction at term plus 7. We would recommend that you have a discussion with your midwife and a consultant if you are registered with one so that further plans can be put into place.

We will not break your waters until there is a midwife available to do so as after we break your waters you will get one to one care from a midwife on delivery suite. This therefore may delay your induction ever so slightly until the situation on delivery suite ensures that we have one-to-one care available.