If you’re overdue by a week or two and can't wait any longer, it’s likely you’ve considered an induction. But before you schedule your induction date, there are a few things you need to know.

The method used for induction will depend on four deciding factors; whether this is your first or subsequent pregnancy, whether you have the presence of a uterine scar from a previous birth, whether the membranes are still intact, and the state of your cervix.

It is unlikely that an induction will be agreed upon if the baby is not in a cephalic presentation (head pointing downwards ready for birth), and the head is not engaged.

But if you are ripe and ready for induction, here’s what to expect.

What happens during induction of labour?

Membrane sweep

Before setting a date for your induction, your midwife will offer to sweep your membranes to help bring on spontaneous labour. To carry out a membrane sweep, your doctor or midwife will sweep their finger around your cervix during an internal examination. Having a membrane sweep is usually only mildly uncomfortable followed by some slight bleeding, but it should not give you any pain. If spontaneous labour does not happen, you will be offered an induction.

Assessing the cervix

Before an induction, you will need to have an internal examination to assess the state of your cervix. If your cervix is short and soft, referred to as “favourable” or “ripe” (rather than long and firm) it will make induction a lot easier. The position of the head , dilatation of the cervix and softness all contribute to a score called the ‘Bishop's’ score which can assess the likelihood of successful induction.

Softening the cervix

If your cervix is not ripe, it can be softened using prostaglandins, which are naturally occurring chemicals that help stimulate contractions. Prostaglandins can be given in the form of a vaginal pessary, which is placed near the cervix at the top of the vagina. For some women, just one dose is enough to have dramatic effects. But for others, even after several doses, prostaglandins will not always work to soften the cervix, which means this will have to be tried again a few days later.

Breaking the waters

This is one of the most important parts of the induction process - the artificial rupture of the membranes or amniotomy - and happens when the cervix is soft and slightly dilated, and once the head has begun to enter the pelvis. A thin plastic probe is used to make a small tear in the amniotic membranes causing the amniotic fluid to leak out. This further softens the cervix and stimulates contractions. If contractions do not come, then you will require treatment with a drug called syntocinon.

Oxytocin and syntocinon

Oxytocin is a natural hormone that provokes contractions by stimulating the uterus. A synthetic version called syntocinon is used which has the same effect and is fed through a drip that’s connected to your arm. If used correctly, this method is safe and effective, but it must be used with care as excessive contractions can cut off the baby’s oxygen supply. This means your baby’s heartbeat will need to be carefully monitored throughout the process.

What do I need to know about induction?

From Unii’s Giving Birth Journey, we share what it’s like to be induced.