What's an induction and what do the guidelines say?

What is an induction?

An induced labour is one that's started artificially. It's fairly common. Every year, 1 in 5 labours are induced in the UK.

Sometimes labour can be induced if your baby is 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.

Induction will usually be planned in advance so you will have time to discuss the advantages and disadvantages with your doctor and midwife, and find out why they think your labour should be induced. Remember to stop and take all the time you need, use your BRAIN!

As the following - What are the Benefits and Risks? What are your Alternatives (usually to wait!)? What does your Instinct tell you? What happens if you do Nothing?

***It's your choice whether to have your labour induced or not***

Most women go into labour naturally (spontaneously) by the time they're 42 weeks pregnant.

If your pregnancy lasts longer than 42 weeks and you decide not to have your labour induced, you should be offered increased monitoring to check your baby's wellbeing. This can often mean a daily trip to see your midwife or trips to triage every other day.

What does an induction feel like?

Induced labour is usually more painful than labour that starts spontaneously, and women who are induced are more likely to ask for an epidural to cope with that pain. Induced labours are also often a lot longer than spontaneous labours, meaning you are more likely to be offered an epidural so you can ease the discomfort for a while, get some rest and try to recharge your batteries.

Your pain relief options aren't restricted by being induced and you should have access to all the pain relief options usually available in the maternity unit.

Women who are induced are also more likely to have an assisted delivery, where forceps or ventouse suction are used to help the baby out. This is either due to exhaustion from the mother, a baby in distress or the epidural effecting the downward sensations that aid baby down the birth canal.

What do the guidelines say?

The NICE (National Institute for Health and Clinical Excellence) guidelines should become your birth bible, it is a one stop shop for all regulations on patient care and has so many handy articles as well as the standard guidelines for all clinical procedures. It also has a handy little flow chart on inductions if you're keen to read more (here).

NICE aims to improve the advice and care provided to women considering, and undergoing, induction of labour in hospital-based maternity units, midwifery led units and at home. So, in short, they're on your side! The following is directly transcribed from the NICE website for your accurate reference: -

Staying informed -

1.) Women should be informed that most women will go into labour spontaneously by 42 weeks. At the 38 week antenatal visit, all women should be offered information about the risks associated with pregnancies that last longer than 42 weeks, and their options. The information should cover:

  • membrane sweeping:

  • that membrane sweeping makes spontaneous labour more likely, and so reduces the need for formal induction of labour to prevent prolonged pregnancy

  • what a membrane sweep is

  • that discomfort and vaginal bleeding are possible from the procedure

  • induction of labour between 41+0 and 42+0 weeks

  • expectant management.

2.) Healthcare professionals should explain the following points to women being offered induction of labour:

  • the reasons for induction being offered

  • when, where and how induction could be carried out

  • the arrangements for support and pain relief (recognising that women are likely to find induced labour more painful than spontaneous labour)

  • the alternative options if the woman chooses not to have induction of labour

  • the risks and benefits of induction of labour in specific circumstances and the proposed induction methods

  • that induction may not be successful and what the woman's options would be.

3.) Healthcare professionals offering induction of labour should:

  • allow the woman time to discuss the information with her partner before coming to a decision

  • encourage the woman to look at a variety of sources of information

  • invite the woman to ask questions, and encourage her to think about her options

  • support the woman in whatever decision she makes.

As you can see, the guidance from NICE is clear, it is your choice whether to accept an induction or not. You should be supported and kept informed throughout the entire process and you should be given the opportunity to discuss and question everything, at every step. If this is not the care you are getting, empower your birth partner to advocate and push your questions for you too.

Lou xx

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