Under certain circumstances, induction of labour may be recommended, rather than waiting for labour to start naturally.
There may be concerns for the wellbeing of either the mother or the baby, where it becomes necessary to expedite delivery, such as pre-eclampsia in the mother, or poor growth of the baby.
The most common indication for inducing labour is when the baby is overdue. It is well established that pregnancies which go beyond 42 weeks carry higher risk of complications and even higher stillbirth rates. Therefore it is routine to offer induction of labour before this time.
Another common indication is where a mother’s waters break after 34 weeks, but labour does not start. Induction is then recommended as once the waters have broken, there is a risk of bacteria from the vagina reaching the baby and causing infection.
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If the neck of the womb, cervix, has not yet started to soften, shorten and dilate in readiness for labour, a hormone, prostaglandin, is used to facilitate the above changes. This is commonly given as a gel into the vagina. This may need to be repeated at intervals of 6 hours, until it is possible to ‘break the waters’. This is termed A.R.M. or ‘Artificial Rupture of Membranes’. Another hormone, oxytocin may then be given via an intravenous line to ensure there are regular, effective contractions.