What happens during induction?

Advice on what to expect if your pregnancy is overdue and labour needs to be induced, including information on prostin and ARM methods of induction.

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There are situations that arise when the doctors and midwives caring for you recommend that your labour be induced. Labour can be induced by using Prostin gel or breaking the waters (known as Artificial Rupture of Membranes or ARM for short).

Prostin gel:

This is used to soften the neck of the womb (cervix ). This is insertedinto the vagina during a vaginal examination. This is usually done on the ante-natal ward.

If you need to have prostin gel you will normally be asked to go to the hospital first thing on the date given. A midwife will care for you during the morning and will show you where things are on the ward. When you are admitted the midwife will want to obtain a tracing of the baby's heart rate ( CTG ) and take your pulse and blood pressure.

Prostin gel comes in a slim plastic tube, similar to the size and shape of a tampon. To be able to insert the gel the midwife or doctor will need to do a vaginal examination.

It varies how many doses are needed with each woman, on average you will probably need 2-3 doses of prostin but some women may need more. If the first dose of prostin does not work a second dose will be given approximately 6 hours after the first dose was given. It is sometimes necessary to give a 3rd and 4th dose on the following day but this is unusual.

You may have period like pains after the prostin and in some cases you may have tightenings and/or contractions which may or may not be painful. If you do find it painful then do ask your midwife for advice. Ask your midwife when you feel the need for pain relief. Pain relief options include: warm baths, massage, changing position, relaxation, paracetamol, co-proxamol, TENS machine, entonox, and for severe pain, pethidine.

After you have had the prostin you will need to stay on your bed for 1 hour to have the baby's heart rate monitored and to prevent the gel from running out. You will then be able to walk about once the CTG has been discontinued and providing you have not been given pethidine for pain relief.

Whilst you are on the ward and providing you are not feeling sick or vomiting then it is generally OK to eat and drink, but check with the midwife first.

ARM :

This lets some of the fluid around the baby out and may start contractions. After this it may be necessary to give you a drug, called Syntocinon, through a drip in your arm to start your contractions. This will be done on delivery suite.

It would be impossible to say how long it will take from the time you are induced until you have your baby. For some women it may take less than 24 hours but for a small number of women it may take longer.