Induction of labour

A comprehensive guide

Induction of labour (IOL) is the attempt to bring on labour when a woman is not showing any signs of being in labour, it is now a commonly used intervention, with 1 in 3 women experiencing it.  As with any intervention offered in pregnancy and birth, you, as the mother have the option to accept or decline. In order to make that decision you will need up-to-date, evidence-based information about that topic. We want all women to have the same information and to empower you to make the right decision for you, your baby and your family.

(NICE guidelines recommend that all women have the above information before consenting or declining an IOL).

As you read about the reasons for being offered an induction, please always bear in mind that everyone is different and what is right for one person may not be right for you. Please take your time to read all of this information before deciding whether IOL is the pathway you wish to follow.

This page includes the following:

• Membrane sweeping
• The process of induction
• The risks associated with induction
• Reasons why you might be offered an induction
• Comfort measures during an induction
• A framework to help you make the decision
• If you decide to decline Induction birth stories and experiences
• What to bring with you to your induction
• Further reading and references

Induction of labour video

This is a helpful and informative video that has been produced for patients in Herefordshire and Worcestershire, in partnership with the Local Maternity and Neonatal Service and Maternity and Neonatal Voices Partnerships.

Induction of labour birth stories 

‘Maddie’s’ story

My waters had gone at around 11pm, my partner and I were in bed and I was actually eating profiteroles rolls before going to sleep at the time! It was strange that day…as we had put the car seat into the car, I had sorted all of the babies bottles and had literally got everything ready. After I had realised my waters had gone I phoned maternity triage, the midwife was very helpful and reassured me as I started to get very nervous. I thought I was going to go over my due date. She advised me to come in and just clarify my waters had gone, I did just that and was told if I didn’t start getting contractions, to come back at 5pm the next day to be induced. Our baby didn’t want to come! So we went in at 5pm and the induction was started. Every midwife was so lovely and reassuring. I had a pessary and was then advised I would be checked within 6 hours to see if anything had happened. Nothing had happened and I was still only 1cm. In that time my partner had left the department (due to COVID) and the pain started to get intense in my lower abdomen. I was nervous to press my buzzer to start with, but in the end I knew I needed too. The midwife that saw me that evening was lovely and she could see I had started to get quite upset. She sat on my bed and made me feel so much better. I then had some codeine, it didn’t help my pain, so a short while after I had a pethidine injection to try and get some sleep, as I hadn’t slept in a few days by this time! A few hours passed and I still wasn’t dilating how I should of been. The maternity support workers and midwives kept checking on me as I was in a side room on my own, but I really wouldn’t of been able to do it without them!

As I wasn’t dilating I was advised I was going to be put on a synthetic drip to try and start dilating. I was also advised a lot of women have an epidural with the drip as it can be quite painful. At this point I just agreed! Anything to help. By this time it was about 4am, two lovely midwives came and got me and took me down to the delivery suite, I was told to give my partner a call to come in. This put me at ease quite a bit after he came. I had the drip put in and also the epidural (something I’d never thought I’d have!) I was fine for a few hours. Couldn’t feel anything. Had a bit of sleep. The hours went on… I still wasn’t dilating how I should of been. Then all of a sudden I had this intense pain in my pelvic region. Our babies head was on a nerve in my pelvis and I was dilating! It was very intense and I will never forget that pain. I also had gas and air during this time. But we had the most amazing midwife and doctors with us the whole time. Our midwife didn’t even have a lunch break. She was absolutely amazing and I felt so comfortable! I was examined by the doctor who said “well done you are 10cm dilated” within 20 minutes of pushing, Connie was born at 14:14pm on 10th May 2021 weighing a healthy 7lb 12oz. We were absolutely besotted with her and we are both so grateful for each and everyone of the member of staff in the whole of the maternity/delivery department. I wouldn’t of changed anything about being induced. I expected the worst as a first time mum, but it really was a day to remember and that was also down to being cared for in the way we were. 

‘Sarah’s story’

My second pregnancy, (first resulted in a missed miscarriage so my first live birth), I was monitored throughout, due to multiple episodes of reduced fetal movements (RFM) and high PI readings (high result on umbilical artery doppler scan). I had gone in at 37 weeks for a growth scan and my son had hardly grown at all since the previous scan, so induction of labour was booked in for the weekend. That evening, I’d had another episode of RFM so went into triage where they kept me in overnight for observation. In the morning, they discussed doing IOL there and then, to which I agreed. I was checked before the pessary was inserted and I was 2cm dilated. I was left with the first pessary in place until Friday evening, so Wednesday morning until Friday evening. When it was removed, I hadn’t dilated any further. I asked for a caesarean section, as I’d been examined so many times by this point that I was having gas and air just to be able to stand the pain of the examinations. I was repeatedly told I couldn’t have a section and I didn’t need it etc and felt my opinion was being ignored. I had yet another pessary inserted reluctantly, and Saturday morning I was in so much pain from the pessary I had it removed and said I wouldn’t be continuing with induction. At this point I was given pethidine and from there my labour was so quick that I didn’t go to delivery suite until I was 8cm. I am fortunate that this was before Covid hit and my husband could be with me the whole day or he would definitely have missed the birth of our son. 

My second baby was born in February of 2021. Again I had complications during pregnancy so had lots of scans and appointments, one of the concerns with my daughter was her size. Again like with my son, I went in for a growth scan and she hadn’t grown so IOL was booked for that day. As covid restrictions meant my husband couldn’t be with me, and with my previous horrible experience of IOL, I wasn’t happy with being induced again but agreed for the safety of my daughter. Induction was started about 6pm that evening. Around lunch time the following day I had very intense contractions, however when my midwife came to check me, she had to pull my cervix forward to even check me and I wasn’t even 1cm. Again I was pushed towards a second pessary, however I refused and had an emergency caesarean section instead. In my experience, IOL has been a horrible, long drawn out experience and never again would I agree to have one. My emergency section was far less stressful and especially given the circumstances with the covid restrictions, I felt that an IOL could mean I would potentially be away from my son for 4/5 days just waiting to go into labour as I was the first time, wasn’t an option. The birth of both of my children could have been so much more enjoyable and less stressful had a c-section been more readily available and my concerns taken on board.