Private Antenatal and Delivery Care

Induction of Labour What is a sweep? An internal is done and a finger is inserted into the neck of the womb and massages the area between the membranes and the womb. This produces a rise in your natural hormones called prostaglandins, which start off the birth.

The sweep can be uncomfortable, but this will definitely improve the chances of you starting your labour naturally. After a sweep it is common to have contractions and a pink/red discharge. If you have any worries, just phone Mike or Chris or the office during business hours. A sweep is performed at MUMS.

The sweep can be uncomfortable, but this will definitely improve the chances of you starting your labour naturally. After a sweep it is common to have contractions and a pink/red discharge. If you have any worries, just phone Mike or Chris or the office during business hours. A sweep is performed at MUMS.

The remainder of this page describes methods that are only performed in the hospital.

Before you come into delivery suite please phone Mike or Chris to check that the hospital is not too busy to be able to start your labour and avoid a wasted journey. We normally like to start the process of induction before 8 am. What happens to me when I come into hospital? You will come to the delivery suite to be admitted. A midwife or Mike or Chris will check your general condition. Your baby’s heart rate will be checked using a trace machine. Sometimes due to the workload on delivery suite it may be necessary to delay starting your birth off as planned. Should this happen please remember that this is only done in the interests of you and your baby. We will keep you informed of any changes. If your cervix is not favourable to have your waters broken then we will be using the Prostin method first. What is the Prostin method? Prostin is given as a vaginal tablet containing a natural hormone called prostaglandin. This hormone works by stretching and softening the cervix. Prostin may also cause the womb to contract. It is put into the vagina by doing an internal examination. How many doses of Prostin will be given? If this is your first baby you may need two doses six hours apart. If you have had a baby before you may only need one dose. The average time from the first dose to delivery in first time mothers is 22 hours. For women who already have had a baby the average time is 16 hours. What happens if the Prostin does not work? You can choose either to restart the Prostin again the next day or try the catheter method (described below). Very occasionally you may be asked if you wish to stop the birthing process and to be allowed home to be checked up by your midwife and a new plan of care arranged. Will Prostin be painful? No, some women don’t report any discomfort or pain. Most women will however feel period type pains and in a small number of women stronger contractions may be felt. You will always be able to have pain relief should you need it. Will starting the birth harm my baby? Your baby’s heart rate will be checked regularly during the induction process. In 1% of women, the Prostin can cause strong, frequent contractions, which may affect the baby If this occurs you will be given a medicine to reduce the contraction strength and frequency. This will then stop the the baby from being affected by the abnormally strong contractions.

If Prostin fails we can use another method where we insert a urinary catheter into the neck of the womb – Foley or catheter method. What is a Foleys? Again, during an internal a thin soft rubber tube called a Foleys catheter is put through the neck of the womb. The tip of the catheter lies between the neck of the womb and membranes around the baby’s head.

We then put some sterile water through the catheter to blow up a small balloon at the tip. The bottom end of the tube is attached to your thigh and you are free to walk around as normal. Having the tube inserted is like having a smear test, we look inside the vagina to see the neck of the womb. Does it hurt? Like the Prostin gel it does not hurt, but the internal can be uncomfortable. How long does the tube stay in for? The catheter normally falls out after 6 to 12 hours, but sometimes stays in up to 18 hours. When the catheter falls out we then know that the neck of the womb has been opened.

We can then either break your waters and/or start the drip to make your womb contract. What happens if the catheter method doesn’t work? We can offer you the Prostin method or again discuss whether we wait longer and go home. However, it is your choice as to what happens and some women decide to have a caesarean section. The chance of the Prostin or catheter method not working happens in about three out of every one hundred women after 37 weeks of pregnancy. Which should I choose – Prostin or Foleys? There is no best method. Both of these methods are the same when used to open the cervix. However, the catheter method does not cause your womb to contract so strongly before the neck of the womb opens, but some women find the idea of the catheter method too complicated. The use of either method depends upon how you feel, it is up to you. Having your waters broken
(Artificial Rupture of Membranes or ARM) How is it done? During this examination a thin plastic crochet hook is passed through the neck of the womb until it reaches the bag of in front of the baby’s head. The bag is then broken with the hook If your cervix is very favourable and allows us to break your waters then the average time to delivery is 12 and 8 hours respectively for first time and previous mothers respectively. Will it hurt? Most women find it uncomfortable, but not painful. The only discomfort is from the internal Will I need a drip? You will be given a couple of hours to walk about. If labour does not start, we will offer you the drip. In special cases we sometimes start the drip before we break your waters. What is in the drip? This is a mild salt fluid with a drug in it. The drug is called syntocinon. Your body normally produces a natural form of this drug during your birth process to bring about contractions. Will the drip cause my baby any harm? The drip is increased very slowly. Very occasionally, the drip causes the contractions to be too strong and may need to be slowed down or stopped. This is why it is important to keep a constant check on the baby’s heart with the trace machine. This can be taken off now and again so you can walk around or go to the toilet. Can I eat and drink? You can eat and drink until your contractions start. After this time the midwife caring for you will advise.