Maternity
Introduction
This leaflet explains what will happen if you choose to have your induction using Dilapan-S® as an outpatient. You can speak to a member of staff if you have any further questions after reading this.
Where will I be induced?
By choosing an induction using Dilapan-S®, you can spend the initial part of the induction process at home. This is a safe option, which many women prefer as it reduces the amount of time you spend within the hospital setting. It may also enable you to remain ‘low risk’ during your labour and give birth on the midwifery led unit.
How is labour induced?
Induction of labour is usually a 3-step process: –
There are two different methods which can be used in step one to open the cervix- hormonal methods and mechanical methods.
Hormonal induction usually involves the insertion of a medicine into the vagina (in the form of a pessary or gel) which slowly releases prostaglandins, causing the cervix to soften and open. As these products contain hormones there is the potential for unwanted side effects such as; hyperstimulation (when the uterus contracts too much), pain and vaginal dryness. If you choose this method, the induction will take place within the hospital setting so that we can monitor you and baby more regularly. This process usually takes 24-32 hours.
Dilapan-S® is a mechanical method of induction. It involves the use of slim rods made of a synthetic gel. These rods are gently inserted together into the opening of the cervix (4 or 5 rods are usually required) where they absorb the fluid from the surrounding tissue. Each rod slowly expands over 12 hours allowing the cervix to dilate and soften.
Cervical ripening with Dilapan-S® is very safe for you and your baby and this means you are able to go home during this stage of the induction process if you opt for this method.
What will happen on the day of my induction?
On the morning of your planned induction, you will go to Delivery Suite on the 2nd Floor at a pre-agreed time. On arrival and following discussion, the midwife will undertake a full examination. This will include: measuring your blood pressure and pulse rate to assess your general wellbeing, feeling your abdomen to assess baby’s positioning, and monitoring your baby’s heart rate using a continuous monitor this monitoring will continue whilst. they perform a vaginal examination using a speculum device and gently insert the rods into the opening of the cervix. The monitoring will continue for a further 30 minutes post application, as a minimum to confirm baby’s wellbeing. After this you will be able to go home.
If you have any questions, contact Pregnancy Day Assessment Unit on:- 01384 456111 Ext.
What should I expect when I am at home?
At home, you can continue with your usual daily activities and toilet use. We do not recommend having a bath, but a shower is fine. While the rods are in place it is not safe to use a vaginal douche or have penetrative sexual intercourse. Do NOT attempt to remove the rods yourself.
It’s also a good idea to try and get some rest in preparation for your labour to start.
When should I contact Labour Ward?
Returning to have the rods removed
The rods can be left in position for a maximum of 24 hours. You will be given a time to return once the rods are inserted- usually around 16 hours later. On your return to delivery suite, you will be admitted. Your midwife will check your vital signs, take a urine sample and monitor the baby’s heartbeat
again. You will then have an examination to gently remove the rods and assess your cervix to see how much it has opened. At this point, the midwife will attempt to break the waters, unless they have already broken naturally in the meantime. Very occasionally, the cervix is still too closed for us to break the waters, in which case the doctor may recommend inserting a new set of rods for another 24 hours or using a hormonal method instead.
Once the waters have been broken, this may cause a surge of natural hormones that can cause contractions to start. You may be encouraged to mobilise for 2-4 hours after this procedure to encourage your body to start to labour.
If labour or contractions do not commence through the breaking of your waters alone, then we will aim to start the hormone infusion (Syntocinon). This will build contractions over a number of hours. During this process you and your baby will be closely monitored until birth.
Can I find out more?
You can find out more from the following:
http://www.nice.org.uk/nicemedia/pdf/CG70publicinfo.pdf
http://www.patient.co.uk/doctor/Labour-Active-Management-and-Induction.htm
http://whqlibdoc.who.int/publications/2011/9789241501156_eng.pdf
If you have any questions, or if there is anything you do not understand, please contact the Russells Hall Hospital switchboard number on (01384) 456111 and ask for the relevant department who issued this leaflet.
This leaflet can be made available in large print, audio version and in other languages, please call 0800 073 0510.