When you are nearing the end of your pregnancy, it can feel like there are a lot of unknowns and things to know. This information will help you understand what an induction of labour (IOL) might mean for you and your baby. Remember, your treating team can also help to answer any questions you may have.
In most pregnancies, labour will start by itself between 37 and 42 weeks. Sometimes it may be recommended by your treating team to ‘induce’ or use different techniques to start your labour. In Australia, about one in three women choose, or are recommended, to start or induce labour for several reasons. There are different ways an induction can be done depending on your situation, and it may differ from one pregnancy to another.
IOL is a clinical process that may include vaginal examinations; medications or balloons inserted into your vagina to assist in the labour process; insertion of an intravenous (IV) line or 'drip' to allow medications and fluids to be given; monitoring ('observations') of your wellbeing; and continuous monitoring of your baby's wellbeing using heart rate sensors.
There are different ways of inducing labour, and your treating team will talk to you about the best options for your circumstances.
Choosing to have an IOL
Induction of labour is recommended by your treating team when giving birth to your baby is considered safer than staying pregnant. Some common reasons for induction of labour are:
- Your pregnancy has gone longer than 41 weeks (a week or more over your ‘due date’). When your pregnancy has gone beyond your 40-week estimated due date (EDD) by 10 days, this is called “post-dates”.
- You may see or hear this referred to as 40+10 (40 weeks and 10 days) or 41+3 (41 weeks and 3 days). Your baby is not growing as expected (your baby could be bigger or smaller) or is not well.
- You have a health condition (for example high blood pressure).
Benefits of IOL
IOL for health reasons
An induction of labour might be recommended for clinical or health reasons to reduce the risk of harm to you or your baby. Your treating team will talk with you about your circumstances and induction of labour options.
IOL for post-dates
The risk of stillbirth at the end of pregnancy (term) is very low but increases the longer your pregnancy goes past term, so an IOL is recommended because compared to waiting for labour to start on its own, you are:
- less likely to have a stillborn baby
- less likely to need a caesarean birth
- less likely to have a baby that needs care in a neonatal unit.
Risks of IOL
The risks depend on why you are being induced, the method of induction, and your circumstances. These will be discussed with you by your treating team. Some risks include:
Contractions too frequent or too long
Medications can help resolve this if it happens. Sometimes it might mean you or your baby will require to undergo an emergency caesarean section or an instrumental delivery (forceps or vacuum).
Cord prolapse
This is when your baby’s umbilical cord comes out before your baby is born. Although a rare complication, this will require an emergency caesarean.
Labour doesn’t start despite medication
Options for this depend on your individual circumstances. Your treating team will talk with you about your options, including the possibility of waiting and trying the induction again, or planning a caesarean section.
Declining recommended maternity care (including IOL)
- You are central to discussions about your care; ask questions to fully understand risks and benefits.
- You have the right to refuse care and the responsibility to ask questions to understand your options.
- Healthcare providers must ensure you understand the risks and benefits of both accepting and declining care and will ask you to sign some paperwork to show this.
- You should ensure you have looked at the information around declining recommended maternity care.
If you are considering declining your recommended IOL, your treating team will discuss conservative management (watch and wait) with you:
- No medical or physical treatment is given.
- Enables discussion of further recommendations based on ongoing assessments.
- Increased monitoring and checks to ensure the health of you and baby.
- Allows more time for labour to begin naturally.
- Helps assess if continuing this approach is safe.
- Can give a more accurate picture of the health of you and baby during active monitoring and cannot predict ongoing safety.
Resources
Your treating team can answer your questions and give your more information. You can also find links to more information below, to help you understand the risks and benefits of IOL.
- Induction of Labour Decision aid – Guide [PDF 496.91 KB]
- Induction of Labour Decision aid – Tool [PDF 197.98 KB]