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Induction of labour

Induction is always carried out following a thorough assessment and is only recommended when it is considered the best option for the mother and/or baby.

The aim of all maternity care is to achieve the best possible outcome for both mother and baby. Labour that starts spontaneously around the due date (between 37 and 42 weeks of pregnancy) usually results in the most straightforward course of labour.

In some cases, conditions may arise during pregnancy that make it necessary to induce labour before it begins naturally, in order to avoid potentially serious complications for the mother and/or baby.

The most common reasons for this include high blood pressure/pre-eclampsia, diabetes/gestational diabetes, and slow fetal growth (a small baby). Maternal age over 38 years (in some maternity units, over 39 years) may also be a contributing factor. In addition, induction is recommended for all women who have not given birth within 11 days after their ultrasound due date (42 weeks).

How long does it take?

It is difficult to predict how long an induction will take. If your labour is induced, you should be prepared for it to take some time before labour becomes established and you give birth. For some women, this may take several days, while for others it may progress more quickly. Factors that may influence this include how many weeks pregnant you are at the time of induction, whether you have given birth before, whether contractions have already started, and whether your water has broken.

Referral and assessment

You will need a referral from your GP or community midwife to be assessed at a maternity unit for induction of labour. In urgent situations, you may contact the maternity unit directly. If possible, always telephone the maternity unit before attending.

Before induction of labour

A pregnancy is defined as post-term from day 294 (completed 42 weeks), or 11 days beyond the due date as determined by ultrasound. The Norwegian Directorate of Health recommends a wellbeing check (post-dates assessment) with a specialist in obstetrics when the pregnancy has reached 41 weeks.

You will be offered a wellbeing check (post-dates assessment) at the antenatal clinic within the maternity unit when you are 4–7 days past your ultrasound due date. At this stage, the pregnancy is not yet considered post-term. You must contact the hospital yourself on the third day after your due date to arrange this appointment.

Women with known risk factors during pregnancy will be given an appointment for induction in consultation with a midwife or doctor, who will inform you whether you need to arrange the appointment yourself.

Booking a wellbeing check (post-dates assessment)

Post-dates assessments are carried out on weekdays. You should call to book an appointment when you are 40 + 6 (three days past your due date) on telephone 47 66 04 12 (between 10:00 and 14:00).

What happens during the post-dates assessment?

The post-dates assessment is an extended antenatal check. Please remember to bring your maternity record and any other documents you have received from your midwife or doctor. This is important to give us an overview of your pregnancy.

A routine antenatal examination is included. In addition, the following assessments are carried out:

  • CTG monitoring, where your baby’s heart rate and movements are recorded. This usually takes around 30 minutes.
  • Ultrasound scan to assess the amount of amniotic fluid, observe fetal movements, and estimate the baby’s size.
  • Vaginal examination may sometimes be performed if indicated.

In many cases, a follow-up appointment will be arranged for further assessment and, if necessary, induction of labour, if labour has not started spontaneously.

During the induction

Methods used to induce labour

Different methods may be used to induce labour. The choice of method is based on an individual assessment.

During pregnancy, the cervix is firm and several centimetres long. As you approach labour, the cervix becomes softer and shorter, and begins to open. To determine the most appropriate method of induction, a doctor or midwife will carry out a vaginal examination to assess whether this process has begun.

If the cervix is not yet favourable (unripe), the first step is usually to promote cervical ripening. If the cervix is favourable (ripe), methods to stimulate contractions will be used.

Before the treatment begins, a doctor or midwife will perform a vaginal examination to assess the cervix – its length, position, softness, whether it has started to open, and the baby’s position in the pelvis (this is called the Bishop score).

Artificial rupture of membranes (“breaking the water”)

When the cervix is ripe and ready to start opening, an amniotomy—“breaking the water”—may help stimulate contractions. This means that a midwife or doctor uses a small plastic hook to make a hole in the membranes so that the amniotic fluid can drain.

When the cervix is ripe and ready to open, an oxytocin drip is often chosen to induce labor.

The body is then given the hormone oxytocin. Oxytocin causes the uterus to contract and triggers labor contractions. These contractions help the cervix thin out and open, allowing the baby to pass through the birth canal.

Most women need to stay on the drip until the baby is born. However, in some cases, the drip can be reduced or stopped if the body takes over the production of oxytocin. At that point, the body’s own contractions have started and replace the drip.

When labor is induced with an oxytocin drip, the baby’s heart rate and your contractions are closely monitored. You will therefore be connected to a CTG machine, which records the baby’s heart rate, movements, and activity. CTG (cardiotocography) is an electronic monitoring method for tracking the baby’s heart rate and activity, as well as the mother’s uterine contractions.

In some cases, contractions do not start even with the drip. You may experience Braxton Hicks contractions or contractions that do not cause the cervix to open or do not move labor forward. In such situations, it may be necessary to pause or stop the treatment.

After the induction

It can take anywhere from a few hours to several days from the start of induction until labor begins and you give birth. It is not possible to predict how long it will take before the treatment has started and we can see how your body responds.

Once contractions have started and the labor process is underway, the birth will most often proceed without complications.

If labor does not start

If the treatment does not lead to the onset of labor, the doctor will work with you to make a plan for further follow-up and treatment. It may be appropriate to stop the treatment and take a break before restarting induction. Experience shows that such a break can be beneficial, and that labor may begin when treatment is resumed.

If induction does not result in a vaginal delivery, or if your condition and/or the baby’s condition requires a quicker delivery, a cesarean section will be considered.

Read about Caesarean section

Last updated 4/20/2026