In most pregnancies, labour will begin naturally between 37 and 42 weeks. If your labour has not started by 41 weeks, or if there is any risk to you or your baby, your physician or midwife may discuss inducing your labour. This process encourages labour to start artificially.
What are the risks of inducing labour?
Inducing labour is safe when supervised by qualified physicians and members of your health care team. When induction is necessary, having your baby is safer than continuing with the pregnancy. The risks of inducing labour involve:
- changes in your baby's heart rate
- increased risk of infection to mother and baby
- problems with the umbilical cord
- overstimulation of the uterus
- uterine rupture
For this reason, we do not induce labour for reasons of convenience. Your physician or midwife will discuss all the possible risks with you.
When do I come to the hospital?
Your physician or midwife will book your induction through the labour and delivery (L&D) team. This may be an inpatient or outpatient procedure. The night before your induction date, a L&D nurse will call to tell you what time you should come to the hospital. Please:
- give yourself time for parking and registration at the L&D front desk
- have your partner or support person come with you
- bring all your medications
What will happen?
When you arrive at the hospital, a nurse will:
- record your heart rate (pulse), temperature and blood pressure
- review your pregnancy history with you
- assess your baby using an electronic fetal monitor to monitor your baby's heart rate. This may take 20 to 30 minutes
We use various methods to induce labour. Your physician or midwife will discuss with you the right methods for you.
Methods for inducing labour include:
- Artificial rupture of membranes: If your cervix is soft and slightly open, your physician may insert a small plastic hook to break the water surrounding your baby. This is called artificial rupture of membranes.
- Cervidil: Medication to soften the cervix is placed in the vagina and attached to a string, similar to a tampon. It remains there up to 12 hours or until labour starts. We will monitor your baby's heart rate for one to two hours. You may be required to stay in the hospital.
- Oxytocin: Also known as Pitocin, this medication is given intravenously to start or enhance labour. As this can be a strong medicine, its effects on you and your baby must be watched very carefully. You will be admitted to the Birthing Unit and we will monitor you and your baby throughout your labour. This medication is adjusted at regular intervals, so your contractions will occur regularly until your baby is born.
- Foley (balloon) induction: A doctor inserts a catheter (tube) during a vaginal exam and adds water to inflate balloons on either side of your cervix. The balloons place gentle pressure on your cervix, encouraging it to prepare for birth. The balloon catheter may fall out on its own as your cervix opens. If not, it will be removed by the physician before you water is broken. Once the balloon catheter is in place, you will be assessed by the nurse and may be asked to go home to return in the morning.
- Prostin or gel: A doctor inserts medication into your vagina to help prepare your cervix for labour. We will monitor your baby's heart rate for one to two hours. If labour does not begin, you may be discharged home and return to the hospital later for a second gel insertion.
It is normal to feel contraction-like pains after this procedure. However, if you have menstrual-like bleeding, need pain relief or have any other concerns, please let your nurse know right away.
If you go home, you should return to the hospital before your reassessment time if you have any of the following:
- painful and intolerable contractions
- four or more contractions in 10 minutes, lasting longer than 45 seconds each
- bright red bleeding that is period-like and more than mucous show
- vaginal or rectal pressure with an urge to push down
- your water breaks
- decreased fetal movement
Please be assured that we are here to support you as you prepare for the birth of your baby. If you need more information or have questions, please call the L&D triage nurse:
Brampton Civic: 905-494-2120 ext. 57975
Etobicoke General: 416-747-3561
