Talking to your midwife or doctor about induction

Norgine Pharmaceuticals provided a Grant to support the development of this material. Norgine had no editorial control or scientific input into this material.

On this page:

Thinking about induction 

Your right to choose

Asking questions about induction

Talking to your midwife or doctor about induction 

My doctor/midwife isn’t listening to me 

How do I make a complaint? 

Thinking about induction

There is a lot to think about when deciding whether to have your labour induced. Your midwife or doctor should help you understand more about your own situation and what is right for you and your baby.

You may find it harder to take in new information and think clearly if you feel under pressure. This will be easier if you have already thought about how you want to give birth and what you might choose in different situations.

I think it was very rushed and I ended up making decisions because I was tired and in pain. Next time I would want more information beforehand.

Tara

 

Your right to choose

You may want an induction and feel confident that it is best for you and your baby. You may feel strongly that you don’t want one.  Or you may want to give it a bit more time before deciding.

It’s important to fully understand what has been offered and why. Unless it is an emergency, it’s fine to take information away so you can think about it and talk to other people.  

You and your midwife or doctor should talk together and make a decision that feels right for you. They should explain your options for giving birth and answer any questions you have. They should make sure you understand the possible risks and benefits of each choice and how they will check on your baby's health if you decide not to have an induction.  

If you decide you don’t want an induction right now, or at all, don’t be afraid to say this. You may want to write down your decision and ask your midwife or doctor to add them to your medical records.  

On the other hand, if you want an induction but haven’t been offered one, it’s ok to talk to your doctor or midwife about this too.

I declined two offers of induction once I reached my due date. The first time I politely declined as I was only 3 days overdue and felt that there was no rush to get her out. The second time I had a long conversation with my midwife. I wanted to give myself a few more days than my hospital trust’s policy of 41+ 5. My labour didn’t begin spontaneously so I agreed to have the pessary and was admitted to hospital.

Nicole

Asking questions about induction

Midwives, nurses and doctors have a duty to make sure you understand your options. They should explain everything clearly and give you a chance to ask questions and share your opinions.  

Ask as many questions as you need.  Don’t worry that you are taking up too much time.

You should also be given written information to take away.

My midwife’s thorough explanation and support helped alleviate any fears I had for me and my baby. Although I didn’t get induced as I was already dilated, the midwife's response to this time was quite positive.

Shruti

Example questions about induction

Your doctor or midwife should be happy to answer these questions for you. Some of them might be ones you can research yourself as well, if you want to.

• Why are you offering me an induction? Is it because there is something wrong now, or because something might go wrong in the future?
• If there’s nothing wrong now, is there a reason why you think something might go wrong for me and my baby?  
• How likely is it to happen? Is there anything else we could do to help prevent this?
• Is it an emergency? If so, would a c-section be better?
• Why do you think induction/a c-section is not the right option for me?
• Can you tell me more about the benefits of going through a natural (spontaneous) labour and birth as well as the risks?  
• Can you tell me the actual risk of that happening, not just the risk of it happening compared to something else?
• What exactly will happen and when, and where will I be?
• How long is it likely to take?
• Can my partner or birth partner stay with me?
• What checks will you do on me and my baby during the induction?
• How likely is it that the induction does not work? What would happen then?
• What will happen if my baby needs extra care when they are born? Where will this happen?
• What will happen if I do not have an induction right now?

Looking back, I would have asked more about the cons to an induction and what an induction would feel like for me There is a lot of focus on the induction which is usually for the sake of the baby understandably, but no one really tells you what that process is like for yourself.

Kylie

 

Talking to your midwife or doctor about induction

Prepare for the conversation

Think about what you want to say first. You could write down some notes and any questions you want to ask.  

You’ll probably find that once you start talking, the conversation will get easier. People often say that asking questions and getting the information they need helps them to feel more in control.

You could also ask to record the conversation on your phone, so that you can listen to it again later or share with a partner if they can't make it. You have the right to record your appointment, because you are talking about your own case. But you should let your midwife or doctor know.

Below are some example questions and statements to help you think about what you want to say or ask. You will probably have your own ideas too - and want to say things in a way that feels right for you.

Tell them what you want to talk about

• I’ve been told to have an induction, but I need more information about it before giving my consent. Could you explain why you think it’s the right thing to do in my situation, including the pros and cons?
• I would like to talk about my other options for giving birth.
• I want to have my labour induced because...
• I want to talk about what will happen on the day – please can you explain the process, step by step?
• I’m feeling a bit overwhelmed, can we talk about how I’m feeling?

I felt completely involved in the decision to have a planned induction at 37 weeks, but what I hadn’t appreciated was that the speed and intensity of my contractions after induction was not an indicator of how fast my labour would be. 

Anita

Let them know if you’re worried about something

• I’ve heard stories about … happening and it’s worried me. How likely is it, and what do we do if it happens?
• I find intimate examinations upsetting. Could you tell me what happens and what we do if I decide not to have them?
• I’m scared about being in too much pain, what types of pain relief can I have?

Be honest if you feel confused

• I’m confused by all the different options and need someone to go through them with me.
• I know you’ve already explained this, but could go over it one more time?
• I don’t think I understand enough to give my consent right now, please can you explain it in a different way?
• It’s a big decision and I’m not sure. Could you show me what the guidance says, and explain the medical evidence behind it?

Say if you need more time to think

• I will give you my answer next time/ tomorrow. I need some time to think things through.
• It’s a lot to take in, I need to go through it in my own time when I’m feeling calmer.
• I don’t know what I want to do and I won’t remember everything you’ve said. Can you give me any written information, or tell me where to find some?

Tell them if you don’t agree

You may not agree with their recommendation. It’s okay to disagree, and it’s possible to say this politely but firmly.

• I have read about this, and I’m not sure the evidence for this is very strong. Can you explain more about why you think it is the right thing to do.
• I understand you think I should do this, but I have the right to choose for myself and my baby. With respect, I do not want this option right now (or at all).
• I feel really strongly that an induction/an elective c-section is right for me and my baby. Can we talk about it again.
• This doesn’t feel like the best thing for me and my baby. I know your thoughts on my situation, but this is what I want to do... and this is why.....
• I may feel differently in a day or two, and I’ll call you if I do. But for now, I’ve decided to do this.
• I want to wait a bit longer before deciding, can we see how things are going in a week?

Say if you need more help and support

If you’re finding things difficult to understand, you may need some extra support.

• It’s hard to take it all in, can I bring someone with me next time?
• English isn’t my first language, is there an interpreter available or information in my first language?
• Who can I contact in-between appointments to ask any more questions?

My doctor/midwife isn’t listening to me

If you feel your midwife or doctor has not listened to you, the first thing to do is to try talking to them again. For example, you could say:  

‘I feel as if you are putting pressure on me. I don’t think that is fair and I would like some more time/to talk to someone else/get a second opinion.’

It’s important to tell them if you are unhappy, even if you find this difficult. You can choose how and where you want to give birth. Healthcare professionals should respect your decision, even if they do not agree with it. They should not let their own views affect the care they give or put pressure on you to decide something different.

You can also ask for a second opinion from a different midwife or doctor. You may be able to call your maternity unit or hospital day unit and speak to someone directly, but you might need to make another appointment for a second opinion.

You could also contact your hospital’s Patient Advice and Liaison Service (PALS) They will try to help you resolve the issue. The service is free and confidential.

You can speak to our midwives if you have any questions or want to talk through your options. Call 0800 014 7800 (Monday to Friday, 9am to 5pm), or email us at [email protected].

How do I make a complaint?

You can usually sort things out by talking to your midwife or doctor or getting a second opinion. But if you still are not happy with your care, you have the right to make a complaint. PALS can help with this.  Birthrights also has lots of information about how to make a complaint.