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Will I be offered induction of labour?

If you are pregnant, you have probably heard of induction of labour. But what exactly is induction and what is the likelihood of you having one?

What is induction of labour?

Induction of labour is the aritificial initiation of labour. Any method where you are actively trying to get labour started, whether at home or in a medical setting, can be called induction.

Non-medical induction of labour methods include:

Nipple or clitoral stimulation

Eating dates in the last weeks of pregnancy

Acupuncture or accupressure

Sex

Eating spicy food such as curry

Hypnotherapy

Homeopathy

Aromatherapy (such as clary sage)

Reflexology

Raspberry leaf tea

It is important to note that there has been very little research in to the effectiveness or safety of these methods and most of the studies done have been small.

Medical induction of labour methods include:

Membrane sweeping

Artificial rupture of membranes (breaking of the waters)

Synthetic prostaglandin inserted into the vagina via a pessary, tablet or gel to soften, or ripen, the cervix

Some hospitals also use mechanical methods of induction including rods and balloons which aim to open the cervix over a number of hours

Intravenous synthetic oxytocin drip (also used when care providers feel that labour needs to be sped up, called augmentation of labour)

How likely are you to have an induction?

A pregnant woman is reclining on a hospital bed. Her male birth partner is supporting her while a doctor performs an vaginal examination in preparation for induction of labour

The most recent NHS England maternity statistics were published in December 2024 and cover data from 2023 to 2024. There are two different datasets that are used to provide information about births – the Maternity Services Data Set (MSDS) and the Hospital Episode Satistics (HES). The HES dataset records slightly more of the total births in NHS England. It is important to note that membrane sweeping is not included in these statistics as a method of induction. These numbers also do not show how many women were offered an induction but declined it.

Based on these statistics, across England you have a 23.8% (HES) to 28.8% (MSDS) chance of undergoing a medical induction at the onset of labour. So if you take my group hypnobirthing course, the likelihood is that one of you in a class of four couples will be induced.

At a regional level, the North East and Yorkshire region has slightly higher levels of induction than the national average. Between 27.8% (HES) and 30.8% (MSDS) of women in this region had their labour started by induction.

And if we look at the local level, women birthing in the Leeds University NHS Trust have a 25.5% (HES) to 26.6% (MSDS) chance of being induced. At Harrogate and District NHS Foundation Trusts the rate of induction at onset of labour is 25.3% (MSDS). And at Bradford Teaching Hospitals NHS Foundation Trust, induction rates at onset of labour are significantly higher at between 32.3% (MSDS) and 32.5% (HES). So if you give birth in this trust, you have approximately a 1 in 3 chance of having an induction.

Why might you be offered an induction?

There are many reasons why you may be offered an induction. Some of the most common reasons are:

Going past your estimated due date. NICE guidelines recommend that women are offered induction when they reach 41 weeks of pregnancy.

Your waters breaking and contractions not starting spontaneously. NICE guidelines (see points 1.2.13 – 1.2.16) recommend that women whose waters break after 37 weeks of pregnancy should be offered expectant management for up to 24 hours, or induction of labour as soon as possible

Having a baby that is estimated to be large via ultrasound (suspected foetal macrosomia) (see NICE guidelines, point 1.2.24)

NICE guidelines recommend that all women are offered a membrane sweep from 39 weeks

Reduction of baby’s movements

Medical conditions affecting the mother, such as pre-eclampsia, diabetes or cholestasis

Medical conditions or health problems affecting the baby

Does induction of labour carry risks?

A close up photograph of the feet of a newborn baby

Like all medical interventions, induction carries risks. The risks vary according to the method used and you should ensure that you are fully informed of the specific risks to you and your baby. Some risks are listed in the NICE guidelines (point 11.3) on induction of labour and include:

Contractions may be more painful than in spontaneous labour

You may have limited options as to where you can give birth

There is a risk of assisted / instrumental birth (the use of forceps or ventouse)

You may have to stay in hospital for longer than if you went into labour spontaneously

Some methods of induction carry a heightened risk of hyperstimulation of the uterus which can cause the baby to become distressed and can affect their heartrate

Should you have an induction?

The responsibility for accepting an offer of induction lies with you. So ensure that you are fully informed before making your decision.

If you are offered an induction:

Ask your care provider what are the specific risks to you and your baby for the induction method being offered based on your medical history and experience of pregnancy

Ensure that you understand why you have been offered an induction

Find out what your care provider believes the risks to be if you decline an induction

Ask about whether there are any alternatives

Take time to make your decision (inductions can often take many hours and even days, so take at least a few hours to think over your decision)

Follow your intuition and listen to your gut

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