Context

Guidance

Induced labour may be recommended in circumstances when it appears that the benefits outweigh the risks for the mother and baby of continuing with the pregnancy, but with the aim of still enabling a vaginal birth. However, induction has an impact on the birth experience of women as it:

removes the satisfaction of achieving the more natural birth that many woman hope for
is generally more painful than spontaneous labour
is more likely to lead to additional interventions such as assisted or operative birth, including caesarean birth, and
is more likely to need epidural analgesia.

Induction of labour is a common procedure, with approximately a third of all women in the UK undergoing induction, and there are a variety of methods available using both pharmacological treatments and mechanical methods. The choice of method depends on the readiness of the woman's cervix (assessed using a vaginal examination, and categorised using the Bishop score), whether the membranes have ruptured, and the woman's preferences. The options available should be discussed and this discussion should include:

an awareness of the efficacy and possible adverse effects for the woman and her baby associated with each method, and
the likelihood that additional interventions (such as emergency caesarean birth) might be needed if the induction is not successful.

Women can choose not to have induction of labour, and appropriate care should then be offered to optimise the outcome of the pregnancy while respecting the woman's wishes.

The aim of this guideline is to give advice to healthcare professionals providing obstetric services, and to pregnant women, on the information and support women and their families and birth partners should be offered when making decisions about induction of labour. It also aims to define the circumstances when induction of labour may be appropriate, and identify the most effective way to induce labour, including choice of method, setting, timing, monitoring and pain relief.