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Your pregnancy: 40+ weeks

If you haven’t given birth by 40 weeks, your midwife will want to discuss options for induction with you, which is a way of starting labour artificially. See "Going past your due date" for more information. The reason for inducing labour is that the placenta has a “best before” date: it starts to do its job less well after a certain amount of time, potentially creating health problems for the baby. If your waters break but contractions do not start, doctors will usually advise induction to minimize the risk of your developing an infection. For more information, see "Induction and augmentation".

There may also be reasons to induce before 40 weeks if you have high blood pressure or the baby is failing to grow or develop normally.

Some hospitals have a policy of inducing at 41 weeks; some are happy to leave it a little longer. You do not have to agree to an induction, but can ask to be monitored every day to check that there aren’t any problems.

The induction will be planned in advance, so you can have everything prepared before you go into hospital. There are three ways labour can be induced: 

  • Through a prostaglandin pessary, which is inserted into the vagina. Prostaglandin is a hormone that softens the cervix and so helps labour to start. Sometimes, this doesn’t have the effect of starting labour, in which case another pessary is usually given a few hours later. 
  • By breaking your waters – also known as artificial rupture of the membranes. The midwife uses a long thin plastic instrument, a bit like a crochet hook, to break the amniotic sac. This usually succeeds in starting labour off, but contractions can be quite strong. 
  • Through a syntocinon drip. Syntocinon is an artificial version of the hormone oxytocin. You will receive it through a drip in your arm. Contractions can be very strong, and your baby’s heartbeat will need to be monitored.

Labours that are induced by syntocinon can be more painful than usual, and because the baby is being monitored, you will not be able to move around. A labour induced by prostaglandin is likely to proceed normally.

See “Guide to labour” and “Positions for labour and birth” for more information. See also “Straightforward birth” and "Induction and augmentation".