Should I Be Induced?
A helpful conversation if you’re 38+ weeks
My two pence worth — on patience, trusting your body and the quiet power of running your own race.
"Patience is essential at this stage. The more we can do nothing to interfere — the better. Really."
Here you are. Thirty-eight weeks pregnant, baby heavy and warm inside you, the world full of well-meaning people telling you to bounce on a ball, eat a curry, book the sweep. And then there's the medical system, doing what it does — offering protocols designed to manage populations, not to serve you as an individual.
I've been in this field for twenty years. I've heard hundreds of birth stories. And the thing I come back to again and again is this: you are not a protocol. You are not an average. You are the only you, and your baby is the only them. This post is an invitation to slow down, get informed, and decide what's right for YOUR race — because nobody else can run it for you.
First — Can We Talk About How Extraordinary Your Baby Is?
Before anything else, I want you to really sit with this. Because in the rush and the pressure and the discomfort of late pregnancy, we completely forget what is actually happening inside you.
The Miracle That's Already Happening
Right now, inside you, your baby's brain is producing around 250,000 new neurons every single minute during peak development. Every organ, every system, every fingerprint — orchestrated by an intelligence so precise it genuinely staggers me, even after all these years.
Your baby knows exactly where to place a kidney. Exactly when to start laying down fat on their cheeks. Exactly how to curl a finger. This is not random. This is biological intelligence at its most awe-inspiring. And that same intelligence — that same exquisite, ancient knowing — is what tells your baby when it's time to be born.
~250,000 new brain neurons formed per minute at peak fetal development
The fetal heart begins beating just 22 days after conception — often before a woman knows she's pregnant
By 38 weeks, your baby already recognises your voice — learned through the womb wall over months
In spontaneous labour, it is the baby who initiates it — their hormonal signal triggers your body to respond
That last point is the one I most want you to hold. In spontaneous labour, your baby starts it. When we induce before that signal arrives, we are stepping in ahead of that conversation. Sometimes that's the right call. But it's worth knowing that's what we're doing.
What Induction Actually Involves — All Four Stages
Induction sounds like one thing. A sweep sounds minor. A pessary sounds manageable. But induction is a cascade — each stage increasing intensity, each one potentially leading to the next. Let's lay it out clearly.
Sizing & Positioning Scan / Stretch & Sweep
This is where it often begins — a sizing and positioning scan (which usually leads on to) and/or a membrane sweep where a midwife inserts a finger through the cervix and makes a circular motion to separate the membranes. This releases local prostaglandins and may trigger labour if the body is already close. It can be uncomfortable or painful, may cause spotting and irregular cramping — but without guaranteeing established labour. It's still intervention, even if it feels minor.
Prostaglandin Pessary or Gel
Synthetic prostaglandins (often dinoprostone) placed near the cervix as a pessary, gel, or slow-release device (Propess, worn for 24 hours). This aims to ripen and soften the cervix. It can produce strong, irregular contractions and requires monitoring. If it doesn't work, or concerns arise, the next stage follows.
Breaking the Waters (ARM)
Once the cervix has dilated enough, a midwife uses a small instrument to make a hole in the amniotic sac. This releases the waters and increases pressure on the cervix, intensifying contractions sharply. Once waters are broken, a clock starts — typically 24 hours — after which infection risk rises and further intervention becomes more likely.
Syntocinon (Oxytocin) Drip
Synthetic oxytocin delivered via IV, dose gradually increased to produce regular, strong contractions. This is the most medically intensive stage — it requires continuous electronic fetal monitoring, limits mobility significantly, and produces contractions often stronger and closer together than spontaneous labour. Risk of further intervention (forceps, ventouse, caesarean) increases here. If the team is very concerned at any stage, a caesarean may be offered directly.
Each is a valid tool in the right circumstances. But knowing all four stages before agreeing to stage one is essential. The cascade is real and it happens more often than people expect.
You Are Not a Protocol. Run Your Own Race.
The medical system treats everyone the same. You don't have to.
Protocols are written for populations, not individuals. They're written for "women at 40 weeks" as a category — not for you, with your history, your instincts, your baby, your body. The system is not designed to be cruel; it is designed to be manageable. But manageable for a system is not always what's best for a person.
Being sovereign in your birth means understanding what's being offered, asking why, asking what happens if you wait, and making your own informed decision. It doesn't mean rejecting all care — it means being an active participant in your own story rather than a passenger in someone else's protocol.
You are allowed to think differently. You are allowed to take time. You are allowed to say "not yet." Informed consent isn't just a form you sign — it's an ongoing conversation you are entitled to have.
I have seen so many women swept along by a timetable that wasn't theirs. Who agreed to a sweep because the pressure was overwhelming and it felt rude to say no. Who found themselves on the drip two days later, exhausted and in pain they weren't prepared for, wondering how it escalated so quickly. And I've seen women who held their ground, waited, and had the most straightforward, empowering births imaginable.
Neither path is guaranteed. But going in with your eyes open and your own compass engaged makes all the difference.
What About "Natural" Induction? An Honest Word…
Raspberry leaf tea. Long walks. Pineapple. Spicy food. Clary sage. Acupuncture. Sex. Evening primrose oil. The list is long and the internet is enthusiastic. The intention is always lovely — a desire to feel proactive, to do something, to meet your baby.
Here's my honest view, after twenty years: if these things work, they are still induction. They are still asking your baby to come before they may have chosen to. And if your baby is truly ready — they are coming anyway. We can never really know whether the raspberry leaf tea tipped the balance, or whether labour would have started that evening regardless.
"I've seen this over and over — a long, exhausting latent phase, hours or days of irregular contractions that derail what could have been a far more straightforward birth. Because the body was nudged before it was quite ready."
The latent phase of labour (the early part, working towards 4cm) can go on for days when it's been encouraged too soon. It eats through reserves before active labour even begins. The smoothest births — the ones with fewest unwanted interventions — are statistically the ones we don't interrupt.
Easier said than done when the pressure to "get things going" is everywhere, I know. But sitting on your hands and doing absolutely nothing? If truth be told, it might be the most powerful thing you do.
The Uncomfortable Truth: Nearly Everyone Gets Offered One
Here's something I feel strongly about and don't think gets said enough: induction is now being offered to almost every pregnant woman, whether there is a genuine clinical reason or not. And I think that is wrong.
Around 1 in 3 women in the UK — over 33% — now has their labour induced. That figure has more than doubled since 2008. In some NHS trusts it's as high as 40–41%. Think about that for a moment. We haven't suddenly become a population of women with twice as many high-risk pregnancies. What's changed is the threshold for offering intervention — and the culture around it.
"When induction is offered routinely, the message it sends — even unintentionally — is that your body probably can't be trusted to do this on its own. That is a seed of doubt that is very hard to un-plant."
And here's the thing about our culture: we find it incredibly hard to say no. When a medical professional — someone we trust, someone in authority, someone who we believe has our baby's best interests at heart — tells us something is advisable, declining feels almost impossible. It can feel like you're being reckless. Like a bad mother before you've even started.
But there is a difference between a recommendation and a requirement. You are allowed to ask "why specifically for me?" You are allowed to say "I'd like some time to think about it." You are allowed to decline. The 2021 NICE guidelines themselves state that healthcare providers should "recognise that women can decide to proceed with, delay, decline or stop an induction." That's your right, written into the official guidance — yet how many women are ever told that?
Early discussions about induction — sometimes now happening from as early as 38 weeks — can quietly undermine a woman's confidence in her body at exactly the moment she needs that confidence most. As Dr Sara Wickham has written, this matters: planting doubt early shapes the whole experience that follows.
Let's Look at the Stats. Honestly.
Because if we're going to make an informed decision, we deserve real numbers — not just the benefits case, which is usually all that gets presented.
What the Latest UK Data Actually Shows (2023)
The National Maternity and Perinatal Audit (NMPA) published its most comprehensive induction snapshot in late 2025, based on over 170,000 induced labours across England, Scotland and Wales in 2023. Here is what it found:
1 in 3 women now has an induction of labour in the UK — up from 1 in 5 in 2008
1 in 3 women who are induced end up giving birth by caesarean section — roughly double the rate for spontaneous labour
Spontaneous vaginal births have fallen from 60% in 2018/19 to under 50% of all UK births in 2023 — the lowest on record
Induced women are more likely to need an epidural, episiotomy, forceps or ventouse than those who labour spontaneously
To put it plainly: when labour is induced, around 56% of first-time mothers achieve a straightforward vaginal birth. When labour starts spontaneously, that figure is around 72%. That's a meaningful difference — and one that most women are not given when induction is offered.
National Maternity Statistics for England confirm that caesarean births are roughly twice as common after an induction compared with a spontaneous labour. Induction is also associated with higher rates of epidural use, instrumental delivery (forceps or ventouse), episiotomy and postpartum haemorrhage in women with uncomplicated pregnancies.
But hasn't induction helped save lives?
This is the question that underlies so much of the pressure. And it deserves a careful, honest answer — not a dismissive one, because lives absolutely do matter.
The evidence here is genuinely complicated. While induction does prevent some stillbirths by definition (a baby that is born cannot die in utero), a major Australian study by Dahlen et al (2021) found something striking: although the induction rate tripled in some groups of women over 16 years, there was no reduction in stillbirth. The numbers of babies and mothers dying each year has not fallen in line with the dramatic rise in induction rates. It has not proven to be the magic bullet it was hoped to be.
What the same study did find was that induction for non-medical reasons was consistently associated with more interventions and more adverse outcomes for mothers, babies and children — across every gestational age studied. Meanwhile, areas with lower induction rates have been shown to have lower unplanned caesarean rates and no worse perinatal outcomes.
This is not an argument against induction when it is genuinely needed. It is an argument for making sure that when it is offered, there is a real, specific, evidence-based reason — for you.
Induction is not a safety net that catches everyone. For some women, in some situations, it is absolutely the right and necessary choice. But for the healthy woman at 40+, 41+ weeks with a thriving baby? It may be — as I have come to think of it — less of a safety net and more of a net that can tangle the very birth you were hoping for.
The Numbers That Really Matter
The Full Moon Factor
I've known this anecdotally for decades and it never stops delighting me — babies do seem to arrive in clusters around the full moon. Hospitals are genuinely busier on those nights.
Nature has her rhythms, and your baby appears to be tuned right into them. Check the lunar calendar — it might give you something to gently aim toward rather than a hospital appointment.
Birthing Beyond Protocol
Something that is becoming more visible is women choosing to birth when their baby comes — sometimes well beyond what guidelines suggest. I've witnessed this as late as 43 and 44 weeks. These women felt well, felt their babies were well, and made informed, sovereign choices to wait.
This is not right for everyone and needs honest, careful conversations with your care team. But the fact that it's happening — and that many of those births have been beautiful — is worth knowing. You have more choices than the protocol suggests.
Everything above applies to the healthy, uncomplicated pregnancy. If you or your baby are unwell — pre-eclampsia, signs of fetal compromise, serious gestational complications — this is a completely different conversation. In those situations, getting your baby out safely and promptly is the right priority, and your medical team will guide you. If the team is seriously concerned, a caesarean may be the straightest, safest path — and that is a perfectly valid, sometimes brilliant decision. Always follow clinical advice when genuine risk is involved.
When You Need to Decide: Use Your BRAIN
Whatever you're being offered — a sweep, a scan, an induction date — there's a simple tool to help you think clearly in the moment, even when you feel pressure or you're tired or just want someone to tell you what to do. It's called BRAIN.
The BRAIN Decision-Making Tool
Ask these five questions about any recommendation before you say yes — and don't move forward until you have honest answers to all of them.
BRAIN is widely used in the birth world. Dr Sara Wickham discusses it as BRAN / BRAINS — read her full explanation here.
Write it on a card. Put it in your birth bag. Give it to your birth partner. Because in the moment — in a hospital room at 41 weeks, tired and emotional — having a simple framework stops you from agreeing to something because it felt like the only option when it wasn't.
Get Yourself a Doula. Seriously.
If there is one single thing I would tell every pregnant woman — regardless of birth plan, risk level, or setting — it's this: get a doula.
A doula is a trained, experienced birth companion. Not a midwife, not a medical professional — a human being whose entire focus for your birth is YOU. They know the system. They know your rights. They hold the space when things get emotional. They translate the jargon. They advocate. They remind you of your BRAIN when you've forgotten how to think straight at 3am.
What the Evidence Says
This isn't just anecdotal. The research on doula-supported births is genuinely remarkable and consistent across decades of study.
Women with doulas are also less likely to need pain relief, less likely to have forceps or ventouse, less likely to feel negatively about their birth, and more likely to breastfeed. The research reports no known downsides to doula support. None.
→ Find a doula at Doula UK (doula.org.uk)If cost is a barrier — Doula UK has a matching service for those who need financial support. Doulas are not just for the wealthy. Everyone deserves that layer of continuous, unwavering human support.
People Whose Work I Love & Wholeheartedly Recommend
You shouldn't have to piece this together alone. Here are the voices I'd send every pregnant woman to — doing extraordinary work to make sure you have what you need to make genuinely informed choices.
Dr Sara Wickham
The world's leading researcher on induction of labour. Her books Inducing Labour: Making Informed Decisions and In Your Own Time are essential reading. Evidence-based, accessible, genuinely life-changing.
Education & ClassesErin Fung — Better Birth UK
Birth educator, activist and hypnobirthing instructor. One of the most informed and passionate voices in the UK birth space. Her classes, Instagram and podcast are brilliant.
Birthkeeper & ActivistKemi Johnson
Former NHS and independent midwife, now birthkeeper and birth activist. Kemi wants you to expect more, ask questions and say no. Her work is powerful, honest and essential.
Find SupportDoula UK
The UK's professional doula organisation. Find a doula near you, learn what doula support looks like, and apply for matched support if cost is a concern.
🎙 Recommended Listening
Erin shares her own induction story, breaks down the risks and benefits of every stage, and gives her top tips for a positive birth if you choose to be induced. Essential.
Kemi talks about questioning your care, what you're entitled to expect, and why she's so passionate about families making truly free, informed choices. Powerful and direct.
Dr Wickham on the rising rates of induction, the evidence landscape, and practical guidance for navigating induction decisions. World-class and grounded.
Erin and Kemi on what physiological birth really is, why it's becoming rarer, and why informed empowerment is the greatest gift you can give yourself.
"The smoothest path is often the one we don't pave ourselves. Trust the process, rest deeply, get the right people around you — and let your extraordinary body do what it already knows how to do."
With love, encouragement, and twenty years of believing in you xxHi, I'm Clare — and I've been passionate about yoga, pregnancy, birth and motherhood for as long as I can remember. I founded LushTums back in 2007, when my son was just six months old, after experiencing first-hand how profoundly yoga, breathwork and mindfulness can transform the journey into motherhood. I wanted every woman to have access to those same tools.
Today I'm a Senior Yoga Teacher (SYT) with over 10,000 hours of teaching experience, a trained Doula, Antenatal Educator and mother of two. I've worked with tens of thousands of women and families over 25+ years, spoken at midwifery conferences, and trained over 150 LushTums teachers now teaching across the UK and around the world.
LushTums offers pregnancy yoga, postnatal yoga, antenatal education and birth trauma support — in-person across the UK and online wherever you are. It takes a village, and we built one. 💚