If you are pregnant, the likelihood is you have heard induction of labour is on the rise. In fact, according to the latest maternity statistics (2023-2024), around a third of birthing people have their labours induced, which is a 10% increase from a decade ago. This doesn’t include membrane sweeps as the NHS do not consider this procedure to be a form of induction, so the number of labours which begin with some sort of induction or intervention is likely to be much higher.

Induction of labour appears to be a normal part of birth in the UK these days and the majority of people could tell you what an induction is and perhaps why they are recommended. For clarity, let’s have a look.

What is an induction?

It is an attempt to start labour which hasn’t yet begun spontaneously. This can include ‘natural’ forms of induction which may include acupuncture or acupressure, walking, sex and nipple stimulation, drinking raspberry leaf tea or eating spicy food. If you are trying anything to bring on labour, you are trying to induce your labour.

For the purposes of this blog, I’ll specifically look at mechanical and medical forms of induction. The decision making surrounding induction is often not simple, even if the processes can appear to be.

Why is an induction being offered to me?

Reasons range from going ‘beyond your due date’’ to a genuine medical emergency which means your baby needs to be born very quickly. Some of the most common reasons for recommending an induction include:

• Being considered ‘overdue’ or a concern that you will become ‘overdue’.
• When your waters have broken but contractions and labour have not yet begun. Depending on the Trust, an induction will be recommended 24-72 hours after your waters have broken, due to risk of infection.
• Where infection is present or suspected.
• High blood pressure.
• Diabetes.

•Any other medical condition or situation where you or your baby are considered to be ‘at risk’ by your care team.

For all of the above situations, your healthcare team should offer you information (including evidence) and support to help you decide whether or not you wish to accept the offer of the induction.

How is it done?

There are a number of ways in which labour can be induced and as with all interventions, they come with benefits and risks. These should always be discussed with your healthcare team but it is well worth doing your own research so you feel prepared when discussing this. Your informed consent should always be sought before any intervention or procedure occurs.

The forms of induction which will be offered will depend on your hospital (for example, some hospital don’t use balloon catheters or cervical rods) but in general, types of induction are as follows:

- A stretch and sweep - this is a vaginal examination where a midwife or doctor will insert a finger around or inside the cervix in an attempt to stimulate contractions. The NHS website states this is not a form of induction but as it is an intervention, I strongly believe this is the first stage of induction in a medical environment.

- Synthetic prostaglandin gel or pessary - The insertion of pharmacological prostaglandins in gel form or a pessary with the aim to soften the cervix.

- Balloon catheter or cervical rods - These devices are inserted into the vagina. Their purpose is to encourage the cervix to open physically rather than using pharmacological methods of cervical ripening.

- Rupture of membranes (or breaking of waters) - Performed during a vaginal examination, this procedure involves the breaking of the amniotic sac using an amnihook (a long, flattened hook). This can help bring on contractions.

- Synthetic oxytocin drip - A synthetic form of the hormone oxytocin, Syntocinon, is delivered via IV drip to induce and sustain contractions.

It’s important to note, not all inductions include all of the above. You may be offered only one of these and that may result in your labour beginning. Alternatively, the initial attempt to induce labour may not bring on contractions so another method may be offered to you.

All of these procedures have their own benefits and risks to consider and weigh up as part of your decision making and I encourage you to research these and have them clear in your head.

Most importantly though, having a good understanding of induction will (hopefully) help you if you experience an induced labour. How you feel about it afterwards will stay with you forever, so it’s not just what happens that matters but also how you feel about it.

Experiencing induction of labour

It’s important to recognise that a labour which is started artificially may be a very different experience to a labour and birth which starts spontaneously and has no or minimal intervention.

Of course, there’s no real way of knowing what an induction will feel like or how it will unfold, even if you have been induced before as every birth is different and unique in its own way. You may only be offered the first stage of induction, resulting in your labour progressing quickly and your baby being born soon after. On the flip side, it could take a long time (perhaps days) with several forms of induction being offered along the way. Until you are there, it’s difficult to know which way it will go. If it’s fast, it can feel overwhelming and very intense. If it takes a long time, it can be utterly exhausting and mentally draining.

With some forms of induction there will be some additional measures put in place to monitor your progress and the way in which you and your baby are coping. The drugs used in induction are powerful and require effective monitoring for safety. This includes continuous or regular monitoring which can restrict or reduce your ability to be mobile during labour.

Some of the drugs used during induction can interfere with or suppress the production of the birthing person’s natural hormones, especially oxytocin. This disruption can have a cascading effect on other hormones involved in a physiological labour and birth, potentially affecting not only the birth itself but also the early postnatal period, with possible implications for breastfeeding.

Is there anything I can do to prepare?

Some people choose to be induced whilst for others it is medically necessary (although this is less common than you may think). But for many people, it can be something they were not planning on and they ‘end up with.’ This inevitably can create dissatisfaction with their birth experience or even birth trauma as they didn’t want an induction or didn’t feel prepared for it and it’s something that ‘just happened to them’.

Even if you are hoping to avoid an induction, I strongly believe it’s important to prepare for and explore what an induction can look like and what your options are. Preparation can make all the difference in how you feel about it before, during and afterwards and can help you to form ideas of what support you may want and the tools you can use during an induction.

Finally...

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Induction of labour is a medical procedure, and like all procedures, it requires your clear and informed consent. You might hear some people say, "They can’t do it without your consent, just say no," and while that sounds simple, the reality can be a bit more complex. It's absolutely your right to say "no" to any part of your care, but just knowing that you have that right doesn’t always make it feel easier when it comes to it.

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As a doula, I’m not here to make decisions for you or tell you what I think you should do. I won’t tell you whether or not I think you should go for an induction. My main role is to support you, help you feel informed and in turn, feel confident in the decisions you make. I’ll help create space for you to explore your feelings and trust your intuition, so no matter how your birth unfolds, you feel safe, respected, and empowered.​

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February 2025