Induction of Labour: What You Need to Know

Induction of labour (IOL) is one of the most common interventions in maternity care. In Northern Ireland, nearly 50% of births are induced. While induction can be life-saving in certain situations, it’s not without challenges and there is a lot of negativity surrounding IOL.

Understanding the process, risks, and your options can help you feel more in control and make this experience as positive as possible.

Types of Induction

There are several methods used to encourage your body to start labour:

1. Membrane sweep/sweeping the cervix – A gentle method your midwife may offer during a routine appointment. It can help release natural prostaglandins (hormones) to start labour.

2. Prostaglandin pessary or gel – Inserted into the vagina to soften and dilate the cervix.

3. Balloon catheter (Foley or Cook catheter) – A small balloon is inserted into the cervix and inflated to encourage dilation and release of prostaglandins.

4. Artificial rupture of membranes (ARM) – “Breaking your waters” to stimulate contractions.

5. Syntocinon infusion – IV drip to strengthen contractions once the cervix is ready.

Each method may be used alone or in combination depending on your situation. Your midwife or obstetrician should explain the reasons and expected timeline for each.

Stages of Induction

Once an induction date is given it is important to understand that this may change depending on the beds available in the hospital setting and often this date wont be confirmed until the day before of the day of induction.

Induction is a process rather than a single event. It can take hours or even days and each person will react differently at each stage:

1. Cervical Ripening – Using a pessary, gel, or balloon to prepare the cervix.

2. Artificial Rupture of Membranes - Breaking of waters

3. Labour Onset – Contractions start naturally or are triggered with oxytocin.

4. Active Labour – Labour progresses as contractions intensify.

5. Birth – The final stage, supported by your care team.

(It’s important to remember that every body responds differently, and timelines can vary. Some women wont need every intervention and may go into labour themselves prior to needing IV Syntocinon, if this is the case depending on hospital guidelines and policies you may be able to have a water birth if you choose)

Risks and Considerations with Induction

While induction is generally safe, research and guidelines (NICE 2021; AIMS 2022) highlight some important considerations:

• Increased interventions – Slightly higher likelihood of instrumental birth (forceps/vaccum) and caesarean, particularly for first-time parents.

• Continuous monitoring – Syntocinon infusions require continuous fetal monitoring. This can limit mobility, making upright or active positions harder, and sometimes hindering the baby’s descent.

• More intense pain – Induced contractions are often stronger and closer together, as they are chemically driven rather than guided by your body’s natural oxytocin. This can inhibit your natural endorphins, meaning labour may feel more painful.

• Stronger pain relief often needed – Options such as epidural are more commonly requested during induced labours.

• Impact on breastfeeding – High doses of Syntocinon during labour can sometimes affect the body’s oxytocin pathways, which may influence early breastfeeding and bonding. Skin-to-skin contact and additional support can help restore this balance.

Alternative Options

If you are offered induction but would prefer to wait the hospital should support your decision, there are guidelines which recommend:

• Continue monitoring – Your care team can offer close monitoring if you choose to wait for spontaneous labour.

• Lifestyle measures – Walking, relaxation, and acupuncture are sometimes suggested, depending on your situation.

• Shared decision-making – You have the right to ask questions, request a second opinion, or decline induction when medically safe to do so.

• Using BRAINS acronym - to weigh up your benefits and risks to aid your decision making.

How Hypnobirthing Can Help

Hypnobirthing techniques are designed to help you feel calm, empowered, and in control during all types of birth, including induction:

• Breathing and relaxation techniques reduce tension and pain perception

• Visualisation and positive affirmations help you feel in control of each stage

• Partner involvement ensures support throughout the induction process

• Mindset preparation allows you to navigate medical interventions with confidence

• Stimulating your Senses - hypnobirthing teaches you tricks to utilise all of your senses to help you feel calm and relaxed

Even if labour is medically induced, hypnobirthing can make your experience more positive and less stressful.

Final Thoughts

Induction of labour is common and sometimes necessary, but you always have options and a voice in your care. Being informed, asking questions, and using relaxation and hypnobirthing strategies can help you approach induction with confidence and calm.

💜 If you’d like to prepare for all birth pathways, including induction, my Hypnobirthing Course will give you the tools, knowledge, and confidence to create a positive birth experience.

References:

• NICE Guidelines: Induction of Labour, 2021

• AIMS (Association for Improvements in the Maternity Services), 2022

• Wickham, S. (2018). Inducing Labour: Making Informed Decisions