When and why an induction of labour may be offered

Induction of labour means any intervention encouraging labour to begin when it hasn’t started naturally.

Around 30 in 100 women in the UK will have an induction of labour.

There are many reasons why you may be offered an induction of labour. Some of the reasons include:

1. If you are overdue

   This is when you have been pregnant for more than 41 weeks and have not gone into labour yet.
   
   You may be offered an induction because of the risks of being overdue. These include a higher chance of having a caesarean birth, your baby needing to go to the neonatal intensive care unit (NICU) and the very small but increased chance of stillbirth and neonatal death. 
   
   

   • The chance of having a caesarean birth is around 18 in 100 if you are induced at 39 weeks.
     If you are induced between 40 and 42 weeks this chance increases to around 22 in 100.  

   • The chance of your baby going to the NICU is around 12 in 100 if you are induced at 39 weeks and increases to 13 in 100 if you are induced between 40 and 42 weeks.

   • The chance of perinatal death (death of baby inside womb and up to first week of life) is 4 in 10,000 if you are induced at 41 weeks and this increases to 35 in 10,000 if you are induced at 42 weeks.

   • The chance of stillbirth (baby not being born alive) is around 6 in 10,000 at 39 weeks of pregnancy and this increases to around 23 in 10,000 births at 42 weeks.
     
     

   To find out more about pregnancy care after your due date click here

   
   

2. If your waters break before labour

   This is called pre-labour rupture of membranes.
   
   The risk of getting an infection increases when your waters are broken.

   • The risk of your baby getting an infection if your waters have not broken before labour is 0.5 in 100. If they have broken before labour, this risk increases to 1 in 100

   • If your waters break before labour and you are full term (37 weeks), you will be offered an induction straight away or you can wait until up to 24 hours after your waters have gone. 

   • If you are known to have “group b strep” you will usually be offered an induction if your waters break after 34 weeks.

   
   If you have special circumstances that would prompt your team to offer you an induction, they will discuss this with you.

   
   

3. If you have certain health conditions

   There are some specific conditions that mean it is safer to have your baby sooner:

   • High blood pressure in pregnancy
     This will depend on:

     • How many weeks pregnant you are.

     • Your blood pressure.

     • Your blood tests.

     • Whether you are diagnosed with ‘pre-eclampsia’.

     • How your baby is doing.

     • The reason for recommending birth for mother is to prevent seizures (eclampsia), stroke and damage to your kidneys and liver.

     • The reason for recommending birth for your baby is to prevent growth problems and stillbirth.

   • Diabetes (developed before or during pregnancy)
     This depends on:

     • How well your blood sugars are controlled 

     • The growth of your baby

     • The type of diabetes you have.

     • The usual reason to offer induction is to prevent stillbirth.

   • Obstetric cholestasis (intrahepatic cholestasis of pregnancy)
     This depends on:

     • The levels of bile acids in your blood. 

     • How your baby is doing.

     • The reason for recommending birth is that it is associated with an increased risk of stillbirth. 

   
   If you already have a medical condition let your midwife know at your booking appointment and they may organise for you to speak to a doctor about your birth plans, which may include recommending induction of labour.
   
   

4. If there are concerns about your baby’s health

   • Some babies are thought to be small on ultrasound scan.
     If this is the case, you may be offered an earlier birth. Depending on how your baby is growing and how the placenta is working your team will discuss the timing of birth with you. 

   • Your baby may have had multiple episodes of reduced movements.
     It can be very worrying when your baby’s movements are reduced. It is important to attend your local unit to be assessed. If it happens on multiple occasions, you may be offered an induction of labour from around 39 weeks – this decision will be made with an experienced obstetrician.

   
   

5. You are expecting more than one baby

   The timing of birth and whether induction is offered will depend on the type of twins you have, and how they are doing. Your team will work with you to plan your birth by 37 weeks, if there are no concerns beforehand.

   
   

6. If you are 40 years or older

   The risk of stillbirth increases if you are over 40 years old:

   

   For this reason, you will be offered the opportunity plan a birth around 39-40 weeks, which includes the option of induction.
   
   

7. You request an induction

   You can discuss the risks and benefits with your team and make an informed choice that’s best for you.