Induction of labour means encouraging your labour to begin when it hasn't started naturally. In the UK, about 33 in 100 women have an induction of labour. You might be offered induction if: • You're overdue (past 41 weeks). • Your water breaks before labour. • You have certain health conditions. • Concerns about your baby's health. • You are expecting more than one baby. • You're 40 or older. • You request induction. Each pregnancy is different, you can discuss what's best for you based on your health and the baby's wellbeing with your midwife/doctor.

A stretch and sweep (membrane sweep) can be offered which involves using a finger to separate the membranes around the baby from the neck of the womb (cervix). A sweep is usually offered after 39 weeks of pregnancy, but can be offered earlier. There are different ways of starting labour depending on the readiness of the neck of your womb (cervix), your pregnancy history and what is available at your hospital. If your cervix is not yet open enough for your waters to be broken there are two ways to encourage it to open: Medication can be placed inside your vagina to ripen the neck of your womb, or a device (either a balloon or dilators) can be placed inside the neck of your womb (cervix). These methods can take up to 24 hours. If they do not work the first time, you may need to try the same or another method. Talk to your midwife or doctor about the best option for you. Once the neck of your womb (cervix) is open enough, your midwife/doctor will offer to break your waters (amniotomy/artificial rupture of membranes). Which may start contractions. If they do not start, we will recommend the hormone drip commences soon afterwards to speed up labour and reduce the risk of infection to baby. The hormone drip is oxytocin and mimics the natural oxytocin in your body – it is highly effective at starting contractions. If labour does not commence despite being induced, a doctor will discuss with you what your options are going forward. Depending on your specific case they may offer you: • Further attempt at inducing labour using a different method. • A period of rest after which we will re-examine the neck of your womb (cervix) to see if there has been any change. • Seeing if you go into active labour on your own. • A Caesarean birth.

You may want to try alternative methods for inducing labour. There is no clear evidence that they work. Some of the commonly mentioned methods are listed below: • Herbal Supplements • Acupuncture/Acupressure • Homeopathy • Castor Oil, Hot Baths, and Enemas • Sexual Intercourse • Breast/Nipple Stimulation • Hypnosis • Raspberry Leaf Tea • Curry (Spicy Foods) • Aromatherapy • Walking • Vaginal Douching • Reflexology • Evening Primrose Oil • Eating Dates • Fresh Pineapple There is no clear evidence that these methods work.