In most pregnancies, labour starts naturally between 37 and 42 weeks. But about half of women go past their due date. If your pregnancy goes for longer than 41½ to 42 weeks and your baby is overdue, your midwife or doctor might recommend induction of labour.
Your baby is overdue: what’s happening
If your baby is overdue, your baby is still very likely to be going well, even at 41-42 weeks of pregnancy. On the other hand, you might be tired, uncomfortable – and just ready to meet your baby.
Once your baby is overdue for sure, an ultrasound might sometimes show that your placenta isn’t supplying as much oxygen and as many nutrients to your baby as it was. There might also be other concerns about you or your baby.
In these cases, your doctor or midwife will probably suggest an induction of labour or a caesarean, depending on your situation. If tests show that your baby is fine and your health is good, you might choose to wait and see whether labour starts naturally.
Your doctor or midwife will probably recommend regular tests to check on your health and your baby’s health. These tests might include an ultrasound to check the amniotic fluid index and an ultrasound to check the biophysical profile.
These tests can help you and your doctor to decide whether it’s safe to keep waiting for labour to start or whether you might need to think about induction of labour. Your doctor or midwife might also ask you to let them know if you notice a change in your baby’s movements.
You might have heard about all sorts of things that can bring on labour, like hot curries, exercise or sex. But there’s no research to say these things actually work when your baby is overdue.
About induction of labour
Induction of labour – or ‘being induced’ – is when your doctor or midwife uses drugs or special tools and techniques to get your labour to start.
Induction of labour normally happens in a hospital, but it’s possible you could be induced in a birth centre too.
The chances are that you know someone who’s had an induction. In Australia, one in every four women is induced.
When you might need induction of labour
Your doctor or midwife might recommend induction of labour when:
- you’re 41 weeks pregnant or more
- you have health concerns, like high blood pressure or pre-eclampsia
- your baby is unwell or there are other concerning signs – for example, changes to your baby’s heart rate or your baby not growing well
- your waters have broken, but you haven’t started to have contractions.
Deciding about induction of labour
You’ll be able to make the best decisions when you have the right information about your health and your baby’s health.
If you feel you need to know more, don’t be afraid to ask a member of your health care team about:
- why the doctors and midwives think you need an induction of labour
- how an induction will affect you and your baby – that is, risks and benefits
- what could happen if your baby isn’t induced and you wait for labour to start by itself
- what steps doctors and midwives will take during induction, including how they’ll care for you and your baby.
Once you have all this information, you might still choose to ‘wait and see’ whether labour starts naturally.
If your labour has started but is progressing too slowly, your health professionals might give you drugs, or use special tools and techniques, to speed up labour. In this case, still ask your doctor or midwife about the risks, so that you can decide what’s best for you.
The risk of your baby dying unexpectedly increases after 42 weeks of pregnancy, but this is very rare.
If you decide that you don’t want to have an induction of labour, talk with your doctor or midwife so they can try to support your choices. They can also give you more information and help you to understand your situation.
What happens when you’re induced
If you choose to go ahead with an induction of labour, your doctor or midwife will do a vaginal examination to feel if your cervix is ready for labour.
Most women find this check a bit uncomfortable, but it should take only a few minutes.
If your cervix isn’t ready for labour, your doctor or midwife will recommend a method of induction that is like the natural hormones that bring on labour, or a procedure that will soften or open your cervix, or a combination of both.
These methods of induction include:
It’s important to ask your doctor about all your options and decide together on the best one for you.
Some women feel fine about being induced, whereas others feel disappointed or sad that labour didn’t start by itself. Whatever your feelings, it can be very helpful to talk them through with your partner, family, friends and health care professionals.
Possible problems with induction of labour
There are a few common risk factors with induced labour:
- Your chance of needing extra pain relief, like an epidural, is higher, because the contractions are often more painful. Having an epidural might also increase your risk of needing help to birth your baby with forceps or vacuum.
- Your risk of above-average blood loss after the birth is higher.
- Your chance of having a caesarean section is higher if your labour is induced for a reason other than pregnancy lasting longer than 41 weeks or it’s your first baby.
- Sometimes an induction doesn’t work in getting your body to go into labour.
Also, because your baby’s heartbeat will be monitored with special equipment during your labour, it can be harder for you to move around and use the bath or shower for pain relief.
It’s natural to be thinking about these risks and how you’ll cope during labour. Talk to a member of your health care team so that you feel comfortable you’re making the right decision for you and your baby.
Your birth setting
can make a difference to your experience of and feelings about birth. If you want to give birth in a particular place or in a particular way, it’s a good idea to plan ahead and talk with your doctor and midwives.