Welcome

What is induction and why might you be offered it?

In simple terms, an induced labour is one that's started artificially. And it's fairly common. 

 

Labour can be induced if your baby is thought to be overdue or there's any sort of risk to you or your baby's health. This risk could be if you have a health condition such as high blood pressure, for example, or your baby isn't growing as expected. Other reasons might be that your waters have broken and after 24 hours labour hasn’t progressed so there’s a risk of infection. Gestational diabetes and a mum being over 40 are some other reasons why you may be offered an induction.

 

If it's a controlled medical procedure, why do we hear so many horror stories about it?

I believe this is down to two things: 1) the birthing woman being unprepared or poorly informed about the procedure and experience and 2) the very nature of a more medicalised process and environment isn't conducive to an efficient and comfortable birth so it is much hard for your body to respond positively to the procedure. If a birthing woman is feeling emotions like fear, panic and stress then her body will resist the process making it much more uncomfortable and increasing the likelihood of further intervention.

​

Statistically, there is an increased chance of further intervention if you consent to induction. For example, at my local hospital East Surrey, 38% of first time mums who consent to induction will actually end up birthing their baby via c-section. (source)

 

One of the reasons for this is often the contractions start suddenly and are stronger and more painful than contractions that start naturally. This may mean you need pain relief such as an epidural, which may not have been something you would have needed otherwise or originally wanted to have. Having an epidural then also increases the chance of further interventions.

​

Another big factor is that induced labour can take a long time to be effective. I always suggest my clients prepare to be in hospital for 3 days as they go through the various steps of the process. In my local hospital flyer they state the average stay on the ward is 72 hours.  You will get little quality rest, privacy or food during the process and birthing women are often exhausted before they even reach active labour. Therefore, another factor contributing to the increased likelihood of needing pain relief.

 

How long does induction take? 

This depends on the methods used and how your body responds to them. It can take hours or days depending on your situation. If this isn’t your first baby and you have gone into labour naturally before, your body will generally react faster than if this was your first baby. You’ll have to attend hospital or may even be admitted so you should prepare for this when starting the induction process.

 

How do I decide if it's right for me and my baby?

​

Inductions are usually planned in advance, so you will have the opportunity to discuss the pros and cons with your midwife or doctor. A good question to ask is what happens if you do nothing. If there’s no medical urgency you may choose to wait as most women go into labour naturally (spontaneously) by the time they're 42 weeks pregnant. But then some women are ready to get their babies out and are happy to get things started! If your pregnancy lasts longer than 42 weeks and you decide not to have your labour induced, you’ll likely be offered increased monitoring to check your baby's wellbeing. Ultimately, whether or not you have your labour induced or not is a decision to make with your midwife or doctor but here are some decision making tools to support you to work through it:

​

Tips for avoiding unnecessary medical intervention

Intervention can be life changing and amazing for mum and baby when one or both is at risk. So this is not against situations where there is a serious risk of harm to mum or baby. However, I know that you will likely be aiming to avoid unnecessary medical intervention during your labour.

 

This may be for a variety of reasons but I’ll also share that we know - and I often hear this when talking to mums postnatally - that opting into one form of intervention is more than likely going to lead to a domino effect.  So whilst the intervention being offered to you may sound straight forward, know that it will have an impact on the journey your birth takes from then on. So here are some key questions I always recommend you ask to help you make decisions:

 

• Is this recommendation based on Hospital Policy* or a Medical Recommendation?

• Don't forget to ask how this may affect your birth choices and preferences.

• Can you give me those statistics in numbers not percentages?
  Analyse the language that is used. Often the way information is communicated or presented heavily influences our decision. But you don’t want to make decisions out of fear or just because the person speaking thinks you should.
  For example listen to these statements:

• 24 hours after your waters break the risk of infection to your baby doubles

• 24 hours after your waters break the risk of infection to your baby increases from 0.5% to 1%

• 24 hours after your waters break the risk of your baby not developing an infection changes from 99.5% to 99%

 

How do you feel after hearing these? You see the facts are the same but the way they are presented alters and this alters your decision. So I always suggest asking for risks or benefits in real numbers, not percentages or broad generalisations like ‘doubles’. 

​

* Hospital Policy such as this is their default / routine recommendation for your situation. But that doesn't mean there is a medical risk that the intervention could reduce and therefore improve outcomes.

​​​​

Making Informed Choices: A useful tool for working through these sorts of decisions is the BRAIN thought process:

 

B - what are the benefits? Ask what the benefits are of the action being offered and consider what the benefits would be to you personally.

 

R - what are the risks and repercussions? Are there any repercussions, side-effects or risks that come with this procedure? Ask for the facts and evidence on which they’re based.

 

A - what are the alternatives? Are there other options or courses of action that you could take? Also apply BRAIN to any of those. Ask for a second opinion.

 

I - what does your intuition tell you? Listen to your instincts and tune into your body and your baby. Trust that deep down you know the best course of action for you and your baby. Tell your midwife or doctor what you instinctively feel.

N - what happens if we do nothing? Ask what will happen if you just wait and see what happens. Or if you’re already in labour - ask even for a little time before giving your answer. You may appreciate the time just to reflect and breathe before taking action and it helps you feel more in control.​

​

Only once you have the answers to your questions and information about why your care provider believes the intervention will lead to better outcomes can you decide if induction is right for you and your baby.
 

Trusted Sources of evidence-based information:

​

Dr Sara Wickham, a midwife and academic researcher, analyses research and shares findings in accessible blog posts. For example she analyses the evidence for induction in cases of gestational diabetes, for advanced maternal age, for post due dates. She also has a book dedicated to Induction of Labour. See her resources here.

​