Induced Labour: 6 Things Expectant Mothers Need To Know About It

Almost a third of pregnant women now have their labour induced.

Almost one in three pregnant women in England now undergo induced labour, up from one in five a decade ago, according to new data released by NHS Digital.

A total of 31.6 per cent of pregnant women had their labour induced in 2017/18, compared to 29.4 per cent in 2016/17. So what’s behind the rise and what do women need to know before choosing this option?

1. Induced Labour Is Offered For A Variety Of Reasons.

Induced labour is offered to women who have passed their due date if they don’t go into labour naturally (or “spontaneously”, as it’s sometimes known) by the time they are 42 weeks pregnant.

The increase in induced labours is thought to be linked to the rising average age of mothers, plus the increase in obesity and other underlying health conditions among pregnant women. Older mothers (aged 40+) are offered induced labour at 40 weeks, as are other women considered at risk of complications.

“The average age of women giving birth is rising all the time,” Pat O’Brien, consultant obstetrician and spokesman for the Royal College of Obstetricians and Gynaecologists, told the BBC.

“They are also more likely to have pre-existing problems, such as type 2 diabetes and high blood pressure, which create complications. And with the rise in obesity, more women are likely to have bigger babies which leads to more inductions.”

2. There Are Different Methods Of Inducing Labour.

The first option for induction of labour is a “membrane sweep”, which is generally considered less invasive than other forms of labour.

“Sweeping the membranes... involves a midwife inserting her finger into the cervix during an internal examination, and moving it in a circular action to separate the membranes of the amniotic sac from the cervix,” NCT explains.

“This helps to release natural prostaglandins which can initiate labour within a few days.”

If the sweep does not induce labour, a woman will be offered a pharmacological induction using synthetic hormones. In the first instance, these are given via a slow-release gel or tablet inserted into the vagina, but if this doesn’t induce labour a woman may receive an alternative dose or hormones via a drip.

Once drugs have enabled the opening of the cervix, a doctor will ask if they can break the waters surrounding the baby. Other drugs can be used to stimulate contractions if needed.

3. Labour Can Happen At Different Speeds After Induction.

While some women may go into labour soon after, or hours after, a membrane sweep, for others it may take a couple of days. Occasionally, where induction does not kick-start labour, women may be offered a caesarean instead.

4. It Can Reduce The Risk Of Still Birth (But The Figures Are Small).

There’s a higher risk of stillbirth or problems for the baby if a woman goes over 42 weeks pregnant and data shows instances of stillbirth are reduced if a woman has an induced labour after reaching 41 weeks, compared to when she decides to continue the pregnancy naturally.

However, the numbers for still birth occurrence are still very low for both.

The risk of a baby dying is between one and two in every 1,000 births (or 0.16 pre cent) if a woman continues with natural labour after 41 weeks, according to the NHS. In contrast, the risk of the baby dying is less than one in every 1,000 births (or 0.07 per cent) with an induced labour.

Research has suggested inducing labour may be particularly effective in reducing stillbirth and neonatal deaths for women over the age of 35, for whom there is slightly higher risk than for the general population.

A study of nearly 80,000 UK women, published in the journal PLOS Medicine, showed that inducing these women one to two weeks earlier (at 40 weeks) was linked to the risk of baby death falling from 26 per 10,000 pregnancies to eight per 10,000 pregnancies.

5. Induced Labour Can Be More Painful Than Spontaneous Labour.

NICE guidelines stipulate that women being offered induction of labour should be informed that induced labour is likely to be more painful than spontaneous labour.

Jessica Prime, who was induced two weeks past her due date, blogged about her experience of this on HuffPost UK, to counteract the “woeful lack of education for women around the realities of birth”.

“I was induced two weeks past my due date, and we would later find out that I was hypersensitive to the hormones used,” she explained. “This meant labour was very intense, with few breaks between contractions. I was in almost constant agony for hours. By the time it came to push, I was exhausted.”

6. You Always Have Choice.

Although it’s common for doctors to recommend induced labour if you’ve passed your due date, it’s entirely your choice whether to have your labour induced or not, and most women will go into labour without inducing by the time they are 42 weeks pregnant.

Abi Wood, head of campaigns and communications at NCT, previously told HuffPost UK: “NICE guidance makes it clear that women’s decisions about whether or not to have an induction should be respected, and that the timing should take into account their preferences and circumstances.”