Induction is an opportunity for natural vaginal birth

Labour induction, or “inducing labour,” is the process of artificially initiating the birth of your baby.

Your cervix should become relaxed, open, and soft, followed by the stimulation of uterine contractions to achieve a vaginal delivery of your baby.

Your pregnancy has now progressed to a stage where your physician or midwife feels that the risks of leaving the baby inside your uterus outweigh the risks of delivering your baby. The most common reason for labour induction is a pregnancy that has extended beyond the due date.

Oxytocin is the drug that promotes your contractions. Your physician is likely not to start you on an oxytocin drip until your cervix is favourable. DILAPAN-S helps prepare your cervix for successful induction, which means increasing its dilation and softness. This procedure is called “cervical ripening.”

The cervix, deep inside your vagina and the opening to your womb (uterus), should be firm, long, and closed tightly until you are near the end of your pregnancy. As you approach your due date, your cervix may begin to soften, shorten, and could even start to open slightly. Sometimes, clinicians may use other terms such as dilation or effacement. These terms refer to the shortening, softening, and opening of your cervix as it prepares for your baby’s delivery. It’s important to remember that this process does not happen naturally for all women before labour, so sometimes help with “cervical ripening,” as part of labour induction, is needed.

DILAPAN-S is a small dilator, made from patented hygroscopic gel, which is carefully inserted through your vagina and into your cervix. The dilator does not contain any drugs. Usually, multiple dilators are inserted together to gently ripen your cervix. Once the dilators are in place, the moisture from your cervix causes them to slowly expand, softening, dilating, and relaxing the cervix. The dilators are typically in place for 12–15 hours (no longer than 24 hours). Based on mothers’ experiences, you will almost not feel the dilators and nothing will protrude from your vagina. You will be able to rest, sleep, stand up, walk, take a shower, and perform your normal daily activities.

DILAPAN-S is a synthetic osmotic dilator made of patented Aquacryl hydrogel, guaranteeing predictable action.

The insertion can be slightly uncomfortable and perhaps even a bit painful for some. However, most mothers say it is similar to a usual vaginal examination. The diameter of each dilator is small, and generally, the insertion is well tolerated. The insertion itself usually takes only a few minutes, and after that, women benefit from DILAPAN-S’s gentle mode of action.

Progression towards labour is accompanied by uterine contractions. But the timing of these is important. Frequent uterine contractions during cervical ripening, when the cervix is not ready, are considered unnecessary and unwanted. Excessive contractions can be painful and might cause changes to the baby’s heart rate or cause womb hyperactivity. DILAPAN-S is designed to minimise these risks compared to pharmacological methods, contributing to high maternal satisfaction.

With the dilators inserted, you can continue your regular activities, including going to the bathroom, showering, and performing daily tasks. However, you should avoid vaginal douching, sitting in a bathtub, and sexual intercourse while the dilators are in place. Most women can relax or sleep during cervical ripening as there is a low rate of disturbing uterine contractions. If there is any excessive bleeding, pain, or other concerns during the ripening process, please report that to your clinician immediately. Under no circumstances should you try to remove the dilators yourself.

The dilators will be removed by your clinician, usually within 12-15 hours (no longer than 24 hours). If they fall out spontaneously, it may signal the onset of labour. In that case please contact your clinician immediately.

No. DILAPAN-S does not contain any hormonal substances, therefore CTG monitoring is typically not required. It means you can go and stay at home with dilators in. You can relax, sleep, and enjoy your time with your family before seeing your clinical team, usually the next day. If you go home, you need to follow the instructions given by your midwife or doctor.

Once DILAPAN-S has been removed, your clinician will examine whether your cervix is ready. The next step depends on the clinical protocol of the hospital. The goal is to stimulate your uterine contractions. You may be encouraged to mobilise, which can help. Alternatively, your waters might be broken, or your clinician may decide to promote contractions with an oxytocin (also called Syntocinon) drip immediately. Please ask your clinician about the next step.

Clinical studies have shown that cervical ripening with DILAPAN-S is successful in over 80% of women. It can be used in almost all induced women, including those with high blood pressure (pre-eclampsia), gestational diabetes, systemic disease, or those who have had a previous Caesarean section. The only contraindication for the use of DILAPAN-S is a clinically apparent genital tract infection. Your doctor and midwife will discuss with you the safest options for you and your baby.

Yes, DILAPAN-S, having no pharmacological content, has minimal limitations related to medical conditions. It can be used in pre-term, term, and post-term pregnancies, as well as in mothers with systemic diseases such as hypertension or diabetes. It is also suitable for mothers with a previous Caesarean section. Cervical ripening is usually gentle and gradual and will not cause your womb to over-contract or cause your baby to become distressed. DILAPAN-S should not be used only if you currently have any clinically apparent genital tract infection.