When you imagine going into labour, you might picture your contractions starting naturally at home before making your way to hospital or your chosen birth setting.
In reality, labour doesn’t always begin on its own.
For many pregnancies, labour starts naturally between 37 and 42 weeks, with most babies arriving somewhere around their estimated due date (but not necessarily on it!). That’s why your midwives will advise you that your due date is more a “due window” rather than a fixed day.
Sometimes, however, it may be safer for you or your baby to recommend starting labour before it begins naturally. This is known as induction of labour.
Understanding why induction might be offered, what it involves and what your options are can help you make informed decisions that feel right for you.
So what is an Induction of Labour?
An induction of labour is when labour is started artificially using medicines or mechanical methods.
The aim is to help your cervix soften and open (known as cervical ripening) and encourage contractions so your baby can be born.
There are several different methods of induction, and not everyone will need the same approach.
Why Might I Be Offered Induction?
Your maternity team may recommend induction if they believe that continuing the pregnancy carries a greater risk than your baby being born.
Some of the reasons induction may be discussed include:
- pregnancy continuing beyond 41 weeks
- your waters breaking before labour starts (prelabour rupture of membranes)
- concerns about your baby’s growth
- reduced amniotic fluid
- diabetes (pre-existing or gestational)
- high blood pressure or pre-eclampsia
- obstetric cholestasis (ICP)
- certain medical conditions affecting you or your baby
- some twin pregnancies and other higher-risk pregnancies.
Every situation is different. The recommendation will depend on your individual pregnancy and medical history.
Remember, any offer of induction or any intervention should always be a two way conversation with your healthcare professional providing you with non-judgemental, unbiased advice based on evidence and your individual circumstance. You should never be told you are having an intervention or procedure – always a conversation to explore your options and choice.
Will I Be Offered a Membrane Sweep?
If your pregnancy is uncomplicated, your midwife may offer a membrane sweep from around 39 weeks onwards (depending on your individual circumstances and local policy).
During a membrane sweep you will have an internal examination, where a finger is gently inserted into your vagina and on reaching the cervix is used to sweep and stretch inside the cervix or around it. This is to encourage your body to release natural prostaglandins, which may help labour begin naturally.
Some people find membrane sweeps uncomfortable, while others tolerate them well.
Although they don’t work for everyone, they may reduce the need for a formal induction.
Having a membrane sweep is your choice.
Do I Have to Agree to an Induction?
No.
Like any medical procedure, induction of labour requires your informed consent.
Your midwife or obstetrician should explain:
- why induction is being recommended
- the benefits and possible risks
- what may happen if you choose to wait
- any alternative options available
- how your baby will be monitored
- what each stage of induction involves.
You should have the opportunity to ask questions, take time to consider your options where appropriate and make the decision that feels right for you.
If you decide not to have an induction, your maternity team will discuss how you and your baby can continue to be monitored and supported.
What Happens During an Induction?
The method used depends on how ready your cervix is, your medical history and why induction is being recommended.
You may need just one method, or a combination.
Cervical Ripening Medicines
Prostaglandins are medicines that help soften and prepare the cervix.
They may be given as:
- a pessary
- a gel
- a tablet placed in the vagina.
Some work over several hours, while others slowly release medication over 24 hours.
Your baby will usually be monitored before and after these medicines are given.
Mechanical Methods
Mechanical methods don’t use medication.
These include:
- a balloon catheter
- Dilapan-S® rods.
These gently encourage the cervix to open by applying pressure.
Depending on your pregnancy and local maternity unit policy, some people may be able to return home while waiting for labour to begin after a mechanical induction.
Breaking Your Waters (Artificial Rupture of Membranes)
If your cervix is already open enough, your midwife or obstetrician may recommend breaking your waters.
This is called an artificial rupture of membranes (ARM) or amniotomy.
For some people, this is enough to start labour.
Oxytocin Drip
If contractions haven’t started or need strengthening after your waters have been broken, you may be offered a drip containing oxytocin.
This medicine encourages regular contractions.
Because contractions can become stronger and closer together, your baby’s heartbeat will usually be monitored continuously while oxytocin is running.
Can I Go Home During an Induction?
Depending on:
- why you’re being induced
- the method being used
- your baby’s wellbeing
- your maternity unit’s policy
you may be offered outpatient cervical ripening, where you return home while waiting for labour to establish.
This isn’t suitable for everyone but research suggests many people appreciate being in familiar surroundings during the early stages.
Ask your maternity team whether this is an option for you.
Is Induction Painful?
The induction procedures themselves can cause some discomfort, particularly vaginal examinations or inserting medicines or balloons.
Once labour becomes established, contractions may feel similar to spontaneous labour, although some people describe induced contractions as becoming intense more quickly.
You should have access to the same pain relief options as anyone else in labour, including movement, water, TENS, gas and air, opioid medications and epidural if appropriate.
Are There Any Risks?
Like any intervention, induction has both benefits and risks.
For some pregnancies, inducing labour significantly reduces the chance of complications associated with continuing the pregnancy.
Induction can also increase the likelihood of additional interventions, such as continuous fetal monitoring or the use of an oxytocin drip.
Whether induction changes your chance of having an assisted birth or caesarean section depends on many factors, including:
- why induction is recommended
- how ready your cervix is
- how many weeks pregnant you are
- whether you’ve given birth before.
Your maternity team will explain how these factors relate to your individual pregnancy.
What If the Induction Doesn’t Work?
Sometimes labour doesn’t start after the first stage of induction.
If this happens, your maternity team will discuss your options with you.
These may include:
- waiting a little longer
- repeating part of the induction process
- trying another induction method
- planning a caesarean birth.
Together, you’ll make a plan based on how you and your baby are doing.
Preparing for an Induction
If you’re planning an induction, it can help to:
✔ Pack extra snacks and drinks.
✔ Bring long phone chargers, headphones and entertainment.
✔ Wear comfortable clothing.
✔ Be prepared that induction can sometimes take longer than expected.
✔ Ask your birth partner about hospital visiting arrangements in advance.
Want to Learn More?
Our Complete Antenatal Course includes a dedicated section on induction of labour, birth choices and what to expect if your pregnancy doesn’t follow your original birth plan.
The course is self-directed, allowing you to learn at your own pace, with ongoing support from experienced midwives by email whenever questions arise.
Our aim is to help you understand your options so you can make informed decisions that feel right for you.
References
- NICE Guideline NG207. Inducing Labour (updated 2025).
- NICE Guideline NG201. Antenatal Care.
- NHS England. Induction of Labour.
- Royal College of Obstetricians and Gynaecologists (RCOG). Induction of Labour Information.
- Royal College of Midwives (RCM). Supporting informed choice during induction of labour.
- World Health Organization (WHO). WHO recommendations: Induction of Labour at or Beyond Term.
- PIF TICK. Making health information trustworthy.