🔊 Pagina beluisteren Induced labour

Your labour will be induced in the near future. This means that labour will start artificially. This involves breaking your waters and giving you medication to induce contractions. An induced labour always takes place in hospital. A clinical obstetrician or doctor and a nurse will accompany you, under the responsibility of a gynaecologist. Once you are discharged from hospital, your own midwife will assume your care.

Informative video and leaflet

You can also watch informative videos about induction on the gynaecologist’s website. You can read the full leaflet here (Dutch only).

Why is labour induced?

Induction of labour is generally advised if the gynaecologist and/or midwife thinks that the situation for your child outside the womb is more favourable than in the womb.

Labour is induced when your child’s condition is still good and it is expected to endure a normal delivery. Any severe symptoms affecting you may also be a reason for inducing labour.

Some common reasons for induction include:

• hypertension,
• growth deceleration in your child,
• deterioration of the function of the placenta,
• (gestational) diabetes
• Cholestasis of pregnancy

• Planning to stop or adjust medication of the expectant mother
• Severe medical complaints affecting the expectant mother
• prolonged ruptured waters,
• gestational age 41-42 weeks.

If you have had a caesarean section before, we are cautious. An induction can be done but the risk of tearing the uterine scar (uterine rupture) may be slightly higher when inducing labour.

When is induction possible?

To assess whether labour can be induced, an internal examination takes place. An induction is possible as soon as the cervix is (slightly) open and dilated. Midwives and gynaecologists refer to this as ‘ripening’. If the cervix is unripe, the decision can be made to ‘ripen’ the cervix (priming).

The cervix is unripe

If the cervix is not yet ripe while there is an indication to induce labour, the decision may be made to prime the cervix.

Cervical priming can be done in two ways: with a balloon catheter or with hormones. A balloon catheter is the preferred method. Read more in the leaflet on induction (Dutch only).

The cervix is ripe

If the cervix is sufficiently ripe (spontaneously, due to the balloon catheter or the tablets), the waters can be broken and the contractions induced.

1. the waters are broken

When you are sufficiently dilated and the baby’s head has descended, the midwife or doctor will puncture the amniotic sac. You will feel warm amniotic fluid flowing out through the vagina. Rupturing the amniotic sac is not painful. Once the waters have broken, contractions may begin on their own, but an intravenous drip with medication is often needed.

If the baby’s head or tailbone is not properly descended, the midwife or gynaecologist is not always able to break your waters. 

The midwife or obstetrician will discuss the possible next steps with you.

2. contractions are induced

To induce contractions, you will be given intravenous medication. A thin tube/IV is inserted into a blood vessel in your hand or forearm. An intravenous tube is then connected to this. A pump system is used to administer the medication oxytocin to induce contractions. The dose is very low and is gradually increased. Contractions will progressively begin. In some women, oxytocin can be tapered off/stopped once the contractions are well underway.

How labour proceeds

When labour is induced, there will first be painful hard abdominal contractions and these will then become dilation contractions. Every birth is different. An induced labour is not necessarily more painful than a normal labour.

After the contractions start, labour progresses essentially the same as with spontaneous labour. The contractions become more intense and painful. You can manage the contractions in your preferred way.

• Sitting in a chair,
• standing next to the bed,
• lying down or sitting in bed or
• under the shower

It is beneficial to change position regularly, as this promotes dilation. Sometimes the oxytocin drip can be reduced or stopped if your body generates sufficient contractions on its own.

If the dilation contractions are too painful, you can ask about the options for pain relief. Read about this in the brochure Pain relief during labour and in the brochure Bevallen in Deventer (Dutch only).

The expulsion (the pushing), the birth of the baby and the birth of the placenta are no different from spontaneous labour. In most cases, the baby is born within 24 hours of the induction. The delivery of a second child generally goes more smoothly than the first.

Monitoring your child and the contractions

Your baby’s condition is monitored with a CTG or heart monitor. This is done externally, via the abdomen, but if necessary, via a wire (scalp electrode) on your baby’s head. This electrode is applied during an internal examination. A dial on your abdomen registers contractions. In some cases, a thin tube (pressure catheter) is inserted into your uterus to monitor contractions internally.

Who is present during labour?

You will usually be accompanied by a clinical obstetrician or junior doctor/gynaecologist and a nurse. They work under the responsibility of the gynaecologist and consult regularly with the gynaecologist. Deventer Hospital is a training hospital. Co-assistants (medical students), trainee midwives and trainee nurses work at various stages of their studies.

After childbirth

After birth, your child will be examined by the midwife, doctor or, if there is reason to do so, by the paediatrician. Depending on the reason you were induced, you may be allowed to go home a few hours after giving birth or you may have to stay for a few more hours or days.

Risks and complications

Complications can occur with any birth regardless of whether it is induced. Examples include prolonged labour, a prolapsed umbilical cord or overstimulation. Read more in the leaflet

Most inductions go without complications. However, an induction should take place under proper supervision with continuous monitoring in the hospital.

A common belief is that an induced delivery is more painful than a spontaneous one. Whether this is so is difficult to determine, as no two births are the same.

Alternatives

If you object to an induction, discuss this with your obstetrician or gynaecologist. Sometimes there are alternatives, such as closely monitoring your baby’s condition while you wait for labour to start on its own.

Conclusion

If the information in this leaflet has left you with any questions, do not hesitate to ask your midwife or gynaecologist.

If the Obstetric Department is very busy, you may be called early in the morning the day before or on the day of the planned date to inform you that your induction will be postponed for a few hours or a day.