NHS Suffolk and North East Essex - Labour and Birth Booklet

29 Assisted birth Step 1 Prostaglandin Many women find that their cervix is not quite ‘ready’ for labour yet, and in this case your midwife will insert a gel or pessary containing a hormone known as prostaglandin during vaginal examination. The gel works over six hours, and you will be asked to stay in the maternity unit for this time. The pessary is released slowly over twenty four hours, and if you and your baby are responding well you may be able to go home during this time. Some women find that the gel or pessary is enough to start contractions and labour. Other women may not experience any changes. After the medication has had time to work, a midwife will assess the cervix again and see if it is possible to break the waters. Some women may be offered further doses of prostaglandins. Balloon catheter If the prostaglandin pessary does not work or is not suitable for your circumstance, you may be offered a balloon catheter. This is a small balloon which is inserted in the cervix, putting pressure on it, causing your body to release its own natural labour hormones that may cause mild cramps and dilatation of the cervix. The balloon catheter works over 12-24 hours to stretch and soften the cervix in preparation for labour. Step 2 Amniotomy Some women (particularly those who have had a baby before) may be told that their cervix is thin and starting to open. In this case it will be recommended that your waters are broken artificially, this is called amniotomy. A midwife will insert a small sterile hook into the vagina to make a hole in the bag of waters that surrounds your baby. After the waters are broken, labour may start on its own. Amniotic fluid may continue to drain from the vagina for the duration of your labour.