When we induce your labour, BC Women’s Hospital care providers use medication or other methods to start (induce) labour.
We recommend inducing labour when your care provider believes delivering your baby will improve yours and/or your baby’s health.
In BC, about one in five pregnancies require an induction of labour. Some common reasons why include:
- Your pregnancy is 10 days or more past your due date
- Your water has broken but labour has not started on its own
- You have health issues such as high blood pressure, diabetes or kidney disease
- Your baby’s growth is less than expected
- The level of the water around your baby is low but your water has not broken
It is normal for the induction process to take from one to three days, depending on how care providers induce your labour.
Inducing labour usually involves one or two processes. The first step is getting your cervix ready for labour. The second is starting contractions. Medications for inducing labour either soften the cervix or cause the uterus to contract. In some cases, medications do both.
We can use Cervidil (dinoprostone), prostaglandin gel or a Foley catheter to get your cervix ready for labour. Your maternity care provider will choose the method for your induction based on how ready your cervix is for labour, as well as other factors.
You and your maternity care provider will discuss the reasons for induction, the method to be used and the advantages and disadvantages. In many cases, your maternity care provider will continue to manage your care after the induction has begun. An obstetrician may be part of some of your discussions and may remain involved in your care to monitor your health, the progress of labour and your baby. Talk with your care provider if you have questions.
Cervidil (dinoprostone)
Your care provider inserts a small ribbon containing prostaglandin into your vagina and places it near your cervix. The end of the ribbon is reachable at the entrance to the vagina.
We use prostaglandin to soften, shorten and open your cervix.
You will stay in the hospital for monitoring for at least one hour to see how you and your baby respond to the prostaglandin.
The ribbon usually needs to be replaced after 12 to 24 hours, if you have not gone into labour.
If you have had a previous Cesarean section, we will not use Cervadil to induce your labour.
Prostaglandin gel
Your care provider inserts a gel containing prostaglandin into your vagina to soften, shorten and open your cervix.
You will stay in the hospital for monitoring for at least one hour to see how you and your baby respond to the prostaglandin. You will usually need more than one dose of gel to get your cervix ready for labour. We usually give these doses about 6 hours apart, so you might go home between doses.
If you have had a previous Cesarean section, we will not use prostaglandin gel to induce your labour.
Misoprostol
This is a tablet that you either swallow or have placed in your vagina every 4 hours to start your labour. You will remain in hospital during this process.
Foley catheter
We insert a thin tube (catheter) through your cervix. We slowly inflate the balloon-tip of the catheter with water to put pressure on your cervix and help get your labour started.
We pull the other end of the tube tight and tape it to your leg while the catheter is in place. It can be uncomfortable but is usually not painful.
Foley catheters are a safe way to induce labour if you have had a previous Cesarean section.
You will usually go home after we start these methods, with directions on when to return to hospital. However, you may need to stay in hospital if the baby needs more regular monitoring or if there are other medical concerns.
If you go home, we recommend that you have someone drive you. You may start to feel contractions within a few hours, or not notice anything different at all.
When at home, contact your care provider or come to hospital if any of the following things happen:
- Painful contractions coming regularly every 5 minutes
- Painful contractions that last more than 2 minutes each
- Leak or gush of fluid from the vagina (water breaking)
- Bleeding from the vagina
- Less than 6 movements of your baby in 2 hours
- The Cervidil ribbon falls out
When your cervix is ready for labour, you may need help to start your contractions. We may use methods such as using oxytocin and/or breaking your water. You will stay in hospital if we use either of these methods.
Oxytocin
A hormone that causes contractions of the uterus.
We give oxytocin through an IV (intravenous) tube to start or increase labour contractions. We give a small amount and increase slowly until your contractions become regular and strong.
Misoprostol
A pill that you take orally (in your mouth) every 4 hours.
You will need to stay at the hospital if we choose this method. We may give you this medication up to 4 times.
Breaking your water
If your cervix is already dilated more than 2 centimetres, your care provider may discuss breaking your water as a way to start or increase contractions. You will feel a warm gush of fluid as the water comes out. This process can be a bit uncomfortable but is usually not painful.
