Induction is offered when continuing the pregnancy poses more risk than delivery. Common reasons include going past 41 to 42 weeks, pre-eclampsia, waters breaking without contractions starting, and gestational diabetes. Methods include membrane sweeps, prostaglandin pessaries or gel, balloon catheters, and oxytocin drips. Induction is always your choice — you have the right to decline and opt for monitoring instead.
Induction of labour is the process of artificially starting labour when it does not begin on its own. According to NHS Maternity Statistics, around 1 in 3 labours in England are induced, making it one of the most common obstetric interventions. NICE recommends offering induction from 41 weeks of pregnancy to reduce the risks associated with post-term pregnancy.
Going overdue. The most common reason. NICE recommends offering induction between 41 and 42 weeks because the risk of stillbirth increases slightly after this point. You will usually be offered a membrane sweep at 40 weeks (first pregnancy) or 41 weeks first.
Pre-eclampsia. If you develop pre-eclampsia, delivery may be needed to protect your health and your baby''s.
Prelabour rupture of membranes (PROM). If your waters break but contractions do not start within 24 hours, induction is usually offered due to the risk of infection.
Gestational diabetes. If blood sugar is not well controlled, induction may be recommended from 38 to 40 weeks.
Reduced fetal movements or growth concerns. If monitoring suggests the baby may be better delivered than remaining in the uterus.
Other medical reasons. Including obstetric cholestasis, maternal health conditions, or the baby being small for gestational age.
Membrane sweep. Usually offered before formal induction. Your midwife inserts a finger into the cervix and makes a circular sweeping motion to separate the membranes from the cervix. This releases prostaglandins that can trigger labour naturally. It can be uncomfortable but is quick (under a minute). Around 1 in 8 people go into labour within 48 hours of a sweep.
Prostaglandin pessary or gel. If a sweep does not work, a pessary (such as Propess) or gel containing prostaglandins is inserted into the vagina to soften and ripen the cervix. This is usually done in hospital. The pessary may stay in for up to 24 hours. You may need one or two doses. Some hospitals now offer outpatient induction where you go home with the pessary and return when contractions establish.
Balloon catheter. A small balloon is inserted through the cervix and inflated with saline. The pressure helps the cervix dilate mechanically. This method has fewer side effects than prostaglandins and is increasingly used in NHS hospitals.
Artificial rupture of membranes (ARM). Once the cervix has dilated enough (usually 2 to 3cm), a midwife or doctor can break your waters using a small hook-like instrument. This is also called amniotomy. It is usually painless, though you may feel a gush of warm fluid.
Oxytocin drip (Syntocinon). If contractions do not establish after the above methods, an oxytocin drip is given through a cannula in your hand or arm. The dose is gradually increased until contractions are regular and strong. With an oxytocin drip, continuous fetal monitoring is required.
Induction can be a longer process than spontaneous labour, particularly for first-time parents. From the first pessary to delivery can take 24 to 48 hours or more. This can be frustrating, but it is normal.
You will usually start on the antenatal ward, where other people may also be being induced. Once contractions are established and you are in active labour, you will move to the labour ward or birth centre (depending on your hospital). You can still use pain relief options including gas and air, a TENS machine, a birth pool (in some units), and an epidural.
Induced labour may be perceived as more intense than spontaneous labour because contractions can start more abruptly rather than building gradually. This is particularly true with an oxytocin drip. Many people who are induced choose an epidural for pain management.
Induction is always a recommendation, never an instruction. You have the right to decline induction and opt for increased monitoring instead. If you decline induction after 42 weeks, your maternity unit will typically offer daily or alternate-day monitoring including cardiotocography (CTG) and ultrasound assessment of amniotic fluid.
If you are unsure, ask your midwife or consultant to explain the specific risks and benefits in your individual situation. The NICE shared decision-making guidelines support this approach. Questions to ask include: Why is induction being recommended for me specifically? What are the risks of waiting? What monitoring would be available if I decline? What methods of induction would be used?
Induction is successful in starting labour in the majority of cases. However, the success rate depends on the state of the cervix at the start. A favourable cervix (already soft, short, and slightly dilated) responds better to induction. If the cervix is unfavourable, the process may take longer or require multiple methods.
In a small percentage of cases, induction does not lead to established labour and a caesarean section may be recommended. Your clinical team will discuss this possibility with you before induction begins.
From first pessary to delivery can take 24 to 48 hours or more, particularly for first-time parents. The process may be quicker if your cervix is already favourable.
Induced labour may feel more intense because contractions can start more abruptly. Many people choose an epidural during induction. You can still use all available pain relief options.
Yes. Induction is always a recommendation, not an instruction. You can decline and opt for increased monitoring. Your midwife will support your informed decision.
A membrane sweep involves your midwife inserting a finger into the cervix and making a circular sweeping motion to separate the membranes. It releases natural prostaglandins that can trigger labour.
If you are on an oxytocin drip, continuous electronic fetal monitoring (CTG) is required. With prostaglandin methods alone, intermittent monitoring may be possible.
Milestones, partner sharing, notes, photos, and a curated essentials guide. Free, no app to install.
Get Started Free© 2026 Nuhah. All rights reserved.