There are a variety of reasons why induction of labour may be needed. The most common is that you may still be pregnant two weeks after your due date. If there is a different reason, your midwife or doctor will explain.

We will contact you the evening before your planned induction date, the senior midwife will give you a time for your admission. This will prevent an unnecessary wait for you and your partner if the unit is busy.

Delivery Suite is located on the fourth floor of the Leazes Wing at the RVI. You will need to arrange your own transport. There are some car parking spaces available for the day of labour. Please ask at the main reception desk in the Leazes Wing.

On Arrival

• Please report to Maternity Reception
• You will be shown to the Induction Suite by your allocated midwife
• She will explain about the induction procedure
• She will take your blood pressure, pulse and temperature
• The midwife will feel your abdomen to see how your baby is lying
• A tracing of the baby’s heart will be performed using a continuous electronic fetal monitor on your abdomen. This is called a C.T.G. (Cardiotocograph)

What to bring with you

• White hand held notes
• Personal hygiene products including maternity pads
• Baby clothes including disposable nappies if you plan to use these, and cotton wool
• Night wear and a change of clothes
• Magazines or books - induction of labour can take a long time so bring things that may help time pass for you 
• Please remember to leave valuables at home as we cannot ensure their safety

Your birthing partner can stay with you, although if you are not in labour by the evening your birthing partner will be asked to return home so that you can both get some rest. If labour starts overnight they will be contacted. Visitors are not allowed on Delivery Suite.

There are two methods of induction of labour. Your midwife or doctor will explain which method is suitable for you.

• Prostin pessary in the vagina
• Artificial Rupture of Membranes (ARM or breaking the waters)

Vaginal pessaries contain an artificial hormone to help soften your cervix (neck of womb) and hopefully start labour. The baby’s heartbeat will be monitored with the external fetal monitor. The midwife will do a vaginal examination and the prostin pessary is then inserted into your vagina by the midwife, with your permission.

This may need to be repeated six hours later and occasionally again six hours after that. The majority of women will need to have their waters broken (ARM).

The process of induction can take some time as each individual responds differently to the action of prostin.

On some occasions prostin may fail to induce labour If this occurs then your options will be discussed. There is an increased risk of having a caesarean section if induction is not straightforward.

Some women do not need prostin if the cervix has started to dilate (open). Your midwife will be able to break your waters if your cervix has thinned and opened out enough. This is performed with an amnihook - it looks a bit like a crochet hook. This procedure does not hurt but may be uncomfortable.

Once the waters are broken, and if the contractions are slow to establish or are not strong enough, a drip will be given through a small plastic tube in the back of your hand. This is attached to a syringe pump with an artificial hormone to help your womb contract. The drug used is called oxytocin. (brand name – Syntocinon).

The drip will usually remain in place until the birth of your baby. During this time you and your baby will be continually monitored.

Prostin may cause cramp like pains, backache and mild tightenings. Simple analgesia and warm baths are sometimes effective at this stage. 

As labour unfolds, you may want to reassess your need for pain relief. Your midwife will help you decide.

We will monitor your baby’s heartbeat for about an hour after insertion of the pessary. After this, we would encourage you to walk about. If you have a drip to increase the strength of contractions, we will monitor the baby’s heartbeat continuously. Your movements will be restricted if you choose to have an epidural for pain relief in labour.

• A light diet and plenty of fluids are encouraged in the early stages of induction. Your body requires a lot of energy for labour.
• Fluids, especially water, are also important for your body to perform properly. Drink bottled water if you prefer. We would advise you avoid carbonated drinks such as cola. 
• Your midwife will advise you about eating and drinking as labour progresses.

The time induction takes can vary and is dependent upon the method of induction used. Your baby will usually be born within two days of your admission. 

We appreciate this is an exciting time for everyone at home. Please let them know how long induction may take and ask them not to contact Delivery Suite. Because of confidentiality, no information will be given over the telephone. Please ask your relations and friends to wait until you contact them with news.

Pay phones are available throughout the maternity unit for your use.

After your baby is born, you will be transferred to the postnatal ward.The visiting times on the postnatal ward are as follows:

• Partners and siblings 8 AM to 12.00 noon and 2 PM to 8.30 PM
• There will be a rest period between 12.00 noon and 2.00 PM
• Others visitors 2 PM to 3.30 PM and 6 PM to 7.30 PM

We do hope that this information has been useful. Should you have any further questions your midwife will be pleased to discuss them with you. We wish you well with your labour and birth of your baby, and look forward to seeing you on the arranged induction.

If you have any questions please contact your community midwife, or speak to staff in the Antenatal Clinic or Maternity Assessment Unit.

Antenatal Clinic Mon - Fri 8.30am to 4.30 pm 0191 2825843

Maternity Assessment Unit 24 hours, 0191 2825748

An opportunity to meet with a midwife and talk about any concerns you may have following the birth of your baby.

Phone 0191 2820212 and leave a message on the answer phone. A midwife from the RVI will return your call.