Being overdue can be worrying. You may expect labour to start any minute and get very stressed when it doesn’t. Keep busy – don’t wait at home where you may be bored and worry even more.
Induction
Once you are past your due date, you may be given a date for induction of labour – where labour is started artificially. Induction will usually be offered 7-14 days past your due date. Undergoing induction at this time has been shown to reduce the risks to the baby. If you prefer to wait a little longer, you should be offered an extra scan and regular monitoring of your baby.
There are several ways to induce labour:
Membrane sweeping
At 41 weeks, you should be offered a ‘membrane sweep’. This releases prostaglandins, which start labour off. About half the women who have this done will go into labour within 48 hours. Your midwife or doctor will do an internal exam and try to sweep their finger around inside the cervix and loosen the membranes. It will not increase the risks of infection but it may feel uncomfortable and you may notice some slight bleeding afterwards. It can be done in hospital or at your antenatal clinic appointment, and you can go home afterwards to wait for labour to begin.
Prostaglandins
These hormones help to start labour by encouraging the cervix to soften and shorten, allowing it to open and contractions to begin. Prostaglandins are given as a tablet or gel inserted into your vagina. This is done in hospital. Most women soon go into labour, although more than one dose may be needed. When contractions start, your baby is monitored using an electronic fetal monitor. If the baby is fine, the monitor can be removed.
Oxytocin
This is a synthetic form of the hormone your body produces naturally to start labour off. Oxytocin is given through a drip, which is attached to a needle that is inserted in your arm. It may be used if prostaglandins don’t work. Once a drip is set up, your baby will be monitored continuously with an electronic fetal monitor. If the waters haven’t broken already, your midwife will suggest breaking them artificially. This is not usually painful but some women find it a bit uncomfortable. Many women find labour induced with a drip more painful than normal labour, and more women choose to have an epidural for pain relief.
Are there any alternatives?
Some women like to try DIY forms of induction or complementary therapies to try to start labour off. There has been little scientific evaluation for the following methods but they may be worth trying.
- Massage can relax you, which may help labour begin.
- Sex can help start labour sometimes. If you are overdue, it may well be worth a go. If labour doesn’t begin, at least it was fun trying!
- Nipple stimulation is also supposed to help labour begin... but it does have to be done for several hours!
- Acupuncture, homeopathy, reflexology and aromatherapy all have treatments that may help labour begin. Make sure you discuss this with your midwife, and use a qualified practitioner if you choose a complementary therapy.
How to cope with an induction
First - make sure that you understand why you are being offered an induction. How will it be carried out, and what will the likely course of your labour be? Ask whether you may need other interventions during labour.
Remember that you need not give up on all the self-help techniques you have learned just because you are having an induction. Talk with your midwife about how you can move around, change position and use your breathing and relaxation to help you cope with the pain, even if you have a drip up.
Keep an open mind about pain relief and choose what is best for you when, and if, you decide you need something to help.
