Prostaglandins are synthetic hormones that are inserted into the woman's vagina with a syringe (or as a pessary), behind the cervix by the caregiver, during an internal examination. Prostaglandins are absorbed onto the cervix, with the expected outcome of ripening, or softening and opening, the cervix, and if the body is receptive, to start uterine contractions. Prostaglandins are usually recommended if the cervix is tightly closed and 'unripe'. This can be the case if this is your first baby, or you have not reached your due date yet. Many caregivers prefer prostaglandins because they are effective, and usually mean no other interventions, (such as an drip in the vein).
How is it done?
The prostaglandins are inserted by the caregiver on the antenatal ward, gynaecological ward, or in the delivery suite or birth centre. You would be requested to stay in bed for at least 40 minutes to an hour afterwards, to enable absorption of the medication. You would then wait another 5 hours or so for labour to start (or before taking the next step).
Sometimes a single dose of prostaglandins starts the labour, without any further intervention. This is especially so if you have had a baby before. Once you are having regular contractions, then no other methods of induction are needed. If you were originally booked into a birth centre (or you wish to continue your labour and birth at home), then make this known to the staff so that this can be arranged. Otherwise you may wish to go to the delivery suite (if you are not already there).
Sometimes this first dose stimulates early labour and dilates the cervix to around 3 to 4 cms. If this were the case, your caregiver would then probably break the waters, to stimulate the labour to progress further. Again, this may be all that is required for you to go on to give birth. Be aware that the waters will probably be
meconium stained. That is, they will be dark green or brown in colour, due to the baby opening their bowels.