Induction of labour
including outpatient induction of labour (IOL)
Obstetrics & Gynaecology
You have been offered an Induction of Labour, which means using either pharmacological methods (hormone based medication) mechanical methods (a balloon catheter or small hydrogel coated rods) or a combination of both with the aim to start your labour artificially. This leaflet aims to provide you with general information about the procedure. It is very important that you understand the care choices being offered to you by the doctors and midwives caring for you, so that you and your birthing companions can make fully informed decisions regarding the timing, place and method of induction.
Your doctor or midwife should explain to you the reasons why you are being offered an induction (artificial starting of labour). They should be able to talk with you about this and the alternatives should you feel that an induction is not the right choice for you, this could include waiting for natural labour to start or a caesarean birth. These options will be discussed in full during an appointment with your doctor or midwife and based on individual preferences and clinical circumstances. The risks associated with each method of induction will also be discussed with you, based on your individual circumstances, as part of this appointment.
You will be able to discuss where, when and how your labour will be induced and also what pain relief options are available or may be required at different stages of the induction. If the induction of labour does not work further discussions will take place between yourself and the doctors on what options are available including further attempts at induction after a rest period or caesarean birth. You will be able to speak about your medical situation and what you would prefer to happen.
From 39 weeks of pregnancy you will be offered a membrane sweep to help encourage your labour to start spontaneously, unless there is a reason not to do this, for example if your waters have broken before labour starts. If your pregnancy is classed as more high risk you may be offered more than one sweep, this will be discussed and agreed between yourself and your doctor.
A membrane sweep involves the doctor / midwife examining you internally by putting two fingers up through your vagina and up into your cervix and making a circular sweeping movement to separate the membranes around baby from the cervix. This is to stimulate the production of hormones called prostaglandins that encourage labour to start. There may be some discomfort and / or light bleeding during or immediately following the sweep but it will not cause harm to you or your baby.
How will I be induced?
When you and your baby have been checked over you will need to have an internal examination to assess your cervix (the neck of your womb) to see how ready you are to go into labour.
The examination will be done by either a doctor or a midwife, who will explain which method of induction will be most suitable for you.
If the cervix is ready and open it may be possible to break the waters. If your cervix is not ready then one/or all of the methods below will be used to get things ready.
There are four different ways induction of labour can be undertaken. These are:
- Balloon induction - can be done as an outpatient or in hospital if required
- Dilapan-S (small coated rods) - requires you to stay in hospital
- Hormone pessary / tablet - requires you to stay in hospital
- Breaking of the waters - once this is done you need to stay in hospital
- Breaking of the waters and use of a hormone drip
You may only need one or all of these methods.
Induced labours may be more painful than natural labour. You will be offered support and different pain relief options.
Produced by Teresa Walker, July 2011. Revised February 2012, June 2014, July 2015,
Revised by Susan Rutter and Kerry Green, January 2019, Revised by Elizabeth Halley and Olanike Bika, November 2020,
Revised by the Maternity Voices Partnership, Deputy Head of Midwifery, Maternity Matron, Governance Lead Midwife July 2022.
Revision due September 2024. Version: 7.0 ©The Rotherham NHS Foundation Trust 2022. All rights reserved.