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The Portland Hospital
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36/40 weeks

Concerns with going overdue

After 42 weeks of pregnancy, the placenta becomes less efficient and the risk of still birth increases.
In Short
Induction means artificially prompting labour and it will be offered to you if you reach between 41+3 days and 41+5 days weeks pregnant, because of the risks described above.

Your healthcare team will discuss the options available and the pros and cons of 'waiting it out'.

The first step would be a cervical sweep - and this is described below.

If you are confident that your baby’s due date is accurate and the length of the pregnancy matches your other pregnancies you can ask for more Doppler scans to assess the efficiency of the placenta.

Is there a natural way to stimulate labour if I am (a little) overdue?

There are some non-medical techniques that some people believe help to encourage natural labour. They include eating foods, such as pineapple or spicy foods. There’s very little evidence to suggest these will actually induce labour. Raspberry leaf tea has been documented to make the uterus contract more effectively, but it’s not proven to induce labour.

Making love with your partner or having them stimulate your clitoris or nipples may help as the prostaglandins in semen can help ripen your cervix and the stimulation will boost oxytocin levels which will help with contractions.

You may have heard that certain things can trigger labour, such hot baths, certain food or drinks, having sex or herbal supplements. But there’s no evidence that these work. Also there’s no information about the safety of herbal supplements and they could be harmful to you or your baby.

We would recommend you talk to your birth team if you are going overdue, and get their advice.

Cervical sweeps

If you decide you’re happy for intervention to get your labour started, your midwife will probably initially suggest a cervical “sweep”.

Further latest guidance is available please click here

What if the sweep doesn’t work?

If the sweep doesn’t work, medical induction will be suggested.

Alternatives include:

  • Prostaglandin
  • Membrane rupture
  • Oxytocin
Prostaglandin

This is a naturally occurring hormone which triggers the softening of the cervix. It is delivered in gel, pessary or tablet form, by a midwife in the hospital. You then need to go home (if you are low risk and there are no concerns regarding your or your baby after the prostaglandin is inserted) and wait. If after gel or tablet your labour hasn’t started within 6 hours, you’ll be asked to return for another dose. 3 doses is the most you can have. If you have the pessary, you’ll be asked to return after 24 hours. If your cervix was already starting to soften, a prostaglandin induction can start labour within 24 hours.

Ballon catheter or osmotic dilator

The balloon rubs against and stretches the cervix causing it to produce a hormone called prostaglandin. The prostaglandin causes the cervix to become shorter and soften (ripening). This prepares the cervix for labour and allows your midwife or doctor to break your waters.

This is a type of sponge that gradually absorbs moisture from surrounding tissues causing it to expand within the cervical canal, usually over 12 – 15 hours. The gentle pressure on your cervix also encourages your body to release natural hormones to further prepare you for labour. Usually a set of 4–5 dilators are used to ripen your cervix sufficiently and get you ready for your labour’.

Membrane rupture

If prostaglandin doesn’t work for you, you might then be offered membrane rupture.

This technique is also known as ARM or the artificial rupture of membranes, and amniotomy. The midwife breaks your waters to get labour started. This happens in the hospital since there is a risk of infection.

Women generally go into labour within 24 hours of membrane rupture.

Oxytocin

Your body produces oxytocin naturally when your baby’s head starts pressing down on your cervix – and this triggers labour.

This is another option if prostaglandin hasn’t worked and is the most common form of labour induction in the UK. It is usually given through an intravenous drip.

What if none of these work?

If none of these work, you will probably be offered a C-section, but you will be involved in any decision making.

For more information, please click HERE.

For a list of useful contact details for The Portland Hospital, please click HERE.

DISCLAIMER
This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Essential Parent has used all reasonable care in compiling the information from leading experts and institutions but makes no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details click here.