A normal vaginal delivery is natural, but isn’t always possible. Sometimes women need help to start labour and sometimes babies need help to be born once labour has begun. Whatever happens you won’t be alone. Your midwife will always be there to support you and help you make decisions.
About 6 in 10 women in Scotland have a natural birth that starts on its own, so many babies will need at least some help to be born.
Due date is only a guide
Most babies don’t appear on their due date – only 1 in 20 do – and there’s no way to tell whether they’ll arrive on time.
Most babies will either be born early or late.
Having your labour induced
Induction of labour is when labour is started by a health professional. You may be offered induction if:
- your baby's overdue
- there are medical reasons to protect your health or the health of your baby
If you’re induced, 3 in 10 are, it can take a while before you go into labour, so don’t worry if it takes 2 or 3 days.
Some women say an induced labour can also hurt more than a natural labour, so make sure you’re prepared and have thought about pain relief.
If you're overdue
If you’re overdue and have had a straightforward pregnancy, then you’ll be offered induction between 41 to 42 weeks because:
- the risk of stillbirth increases when pregnancy goes beyond 42 weeks
- at 37 weeks pregnant the chance of stillbirth is 1 in every 3,000 births
- after 43 weeks that goes up to 6 in every 3,000 births
If you want to carry on your pregnancy after 42 weeks, you can talk to your midwife or obstetrician.
You and your baby will be monitored closely until labour starts on its own or you decide to go ahead with induction.
How induction's done
Before you’re offered induction, you should be offered a membrane sweep at your 39 or 41 week appointment.
This is a vaginal examination where your midwife or doctor uses a finger to ‘sweep’ your cervix. This can be uncomfortable, and you might bleed a little, but it’s more likely you’ll go into labour naturally.
Having a membrane sweep usually means you’re less likely to need other methods of induction. It wouldn’t be done if:
- your baby isn’t in the right position
- you’ve had significant bleeding during pregnancy
- you had a very low lying placenta covering your cervix (placenta praevia)
Drugs to trigger labour
You can have drugs called prostaglandins to bring on labour.
These act like natural hormones and are put into your vagina either as a gel, tablet or pessary.
You’ll have a vaginal examination after 6 hours or, if you have had a pessary, after 24 hours.
Prostaglandins make your cervix soften and open enough to break your waters. Sometimes they can start labour.
Breaking your waters
Having your waters broken is another way to get labour started.
You’ll have a vaginal examination to see if your cervix has dilated enough to have your waters broken with a sterile plastic hook.
Hormone helps contractions
You may also need to have a drip put into your arm, so you can have the hormone oxytocin.
This hormone is started at a very slow rate and increased slowly until you are having regular contractions.
It will need to be continued throughout your labour to keep the contractions going. If the drip is stopped, the contractions usually slow down, or stop too.
You’ll only be offered this if your midwife or doctors believe it's safe for you and your baby.