Risks and benefits of induction of labour

Overview

Induction of labour is when your healthcare provider starts your labour artificially using medication or other methods. It is done when it is safer for you or your baby to be born than to remain in the womb.

Yes, induction of labour is a common procedure. For example, in the UK, about 1 in every 5 births is induced.

Induction of labour can affect any pregnant woman, but it is more common in women with certain health conditions, women over age 35, women expecting twins, or women with risk factors such as gestational diabetes or high blood pressure.

Symptoms

Common symptoms

• You are more than 41 weeks pregnant and labour has not started naturally.
• Your waters have broken but contractions have not started within 24 hours.
• You have a condition such as high blood pressure, pre-eclampsia, or diabetes that makes it safer to deliver early.
• The baby is not growing as expected inside the womb.
• There are concerns about the baby's health, such as reduced movement.

Causes

Main causes

• Prolonged pregnancy (more than 41 or 42 weeks).
• Rupture of membranes (waters breaking) without spontaneous labour.
• Maternal health conditions such as high blood pressure, diabetes, or pre-eclampsia.
• Concerns about the baby's growth or well-being (e.g., reduced amniotic fluid, poor growth).
• Medical problems in the mother like kidney disease or cholestasis of pregnancy.

Risk factors

• Older maternal age (over 35).
• Obesity (body mass index over 30).
• Smoking during pregnancy.
• Previous pregnancy with complications.
• Pregnancy with twins or multiples.

When to see a doctor

See a doctor urgently if:

• If you have heavy vaginal bleeding or a gush of fluid that feels like a leak.
• If you have severe pain or sudden swelling in your hands or face.

Book a routine appointment if:

• When you are around 40 weeks pregnant, talk to your midwife or doctor about your options.
• If you have a medical condition that might make induction safer for you or your baby, discuss it early in the third trimester.

Diagnosis

Induction is a decision, not a diagnosis. Your healthcare provider will assess your health and your baby's health through exams and tests to decide if induction is needed.

Tests that may be done

• Ultrasound to check baby's size, position, and fluid levels.
• Fetal heart rate monitoring (cardiotocography, or CTG).
• Blood pressure checks and urine tests to screen for pre-eclampsia.
• Blood tests to check for infection or other health issues.
• Cervical assessment (Bishop score) to see how ready your cervix is for labour.

What to expect at your appointment

Your doctor will explain why induction is being considered, the risks and benefits, and the process. You will usually be admitted to hospital for the procedure. It can take from a few hours to a couple of days. You will be monitored throughout.

Treatment

Induction of labour uses various methods to start contractions. The choice depends on your situation, how ready your cervix is, and your preferences. Your care team will explain each step.

Self-care at home

• During induction, you can try comfort measures like moving around, breathing exercises, or using a birthing ball.
• Stay hydrated and eat light if allowed.
• Ask your partner or support person for encouragement and help with relaxation.

Medical treatments

Common methods include: applying a hormone gel or tablet to the cervix to soften it (prostaglandins); giving a hormone drip through a vein in the arm (oxytocin); or breaking the water bag (amniotomy). Pain relief options such as gas and air or an epidural are available. Your care team will explain each option and help you choose based on your needs.

Living with this condition

Induction usually takes place in hospital. You will need to stay until after you give birth. If you have a partner or support person, they can usually stay with you.

Lifestyle tips

• Rest as much as you can before the induction starts.
• Bring items from home that make you comfortable: music, a pillow, snacks.
• Plan for your recovery after birth — ask about support for breastfeeding and postnatal care.

Diet and exercise

You may be allowed light food and clear fluids early in induction, but once active labour starts, you will likely be limited to sips of water. After birth, eat a balanced diet and gradually return to gentle activity as advised.

Mental health and emotional wellbeing

Induction can feel stressful or cause anxiety, especially if it was unexpected. It is normal to feel a loss of control. Talk to your midwife, partner, or a counsellor about your feelings. Many women feel relieved once their baby is born safely.

Prevention

You cannot always prevent the need for induction, but having a healthy pregnancy — eating well, staying active, and attending all prenatal check-ups — may lower your risk of conditions that lead to induction.

Vaccines

Getting recommended vaccines like the flu shot and whooping cough vaccine during pregnancy helps protect your health and may reduce complication risks.

Screening programmes

Routine prenatal screening for blood pressure, diabetes, and baby’s growth can help catch problems early and reduce the need for emergency induction.

Complications

If left untreated

• If induction is needed but not done, there is a small risk of stillbirth or serious harm to the baby, especially after 42 weeks.
• The baby could grow too large, making a vaginal birth difficult.
• If your waters have broken and labour does not start, you are at risk of infection for you and your baby.

Long-term outlook

For most women, induction is safe and leads to a healthy vaginal birth. There is a slightly higher chance of a caesarean birth compared to spontaneous labour, but the overall outlook is very good. Your healthcare team will choose the safest approach for you and your baby.

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