A dinoprostone vaginal insert looks like a very small tampon with a long string. It is put in your vagina and gives off prostaglandin, the same hormone your body makes to start labour. Dinoprostone is used to relax and soften your cervix, getting it ready for labour and delivery. Dinoprostone may start labour for some people.
Your dinoprostone vaginal insert is put in at the hospital. You may have it done as an inpatient, which means you will stay at the hospital, or as an outpatient, which means you will go home after the insert has been put in.
Before coming to the hospital for the vaginal insert
- It's OK to shower and eat a light meal.
- Don't smoke or vape for at least 2 hours before coming to the hospital. Nicotine can have harmful effects during the induction.
What to bring
- Bring any prenatal papers you have (your doctor may have given you some) to the hospital.
- Bring your packed bag in case you need to stay at the hospital. If you have a vehicle at the hospital, you can leave the bag in your vehicle while getting the insert.
- Bring your partner or someone to support you, if you wish.
At the hospital
The doctor, nurse, or midwife will talk to you about the reasons for getting the dinoprostone vaginal insert. They will ask you about your pregnancy and your health and if you have any concerns or questions.
The doctor, nurse, or midwife will:
- Check your blood pressure, pulse, and temperature.
- Put a monitor on your belly to monitor your baby's heart for at least 20 minutes to make sure all is well with your baby.
- Do a vaginal exam to check your cervix and the baby’s position. An ultrasound may be done.
- Put the insert into the back of your vagina and tuck the strings just inside your vagina.
After the insert has been put in, your doctor, nurse, or midwife will monitor you for at least 1 hour. After that, you may be able to go home or you may be asked to stay longer. If you are able to go home, you will be told when you need to come back.
Side effects
It usually takes a few hours before you can feel contractions.
When the insert is first put in, you may have some cramping, a backache, or a warm feeling in your vagina.
Nausea, vomiting, and diarrhea may happen, but this is not common.
Removing the insert
Your doctor, nurse, or midwife will check you again after you've had the insert for 12 hours. They may leave it in for up to 24 hours.
If your labour starts, your doctor, nurse, or midwife may need to remove the insert when your labour progresses.
If your labour doesn't start and you're asked to take the insert out yourself, you will be told how to remove it. If you were not told to remove the insert, it will be taken out at the hospital.
If your labour has not started, your doctor or midwife will reassess you and talk with you about what to do next.
If you went home after getting the insert
You can do your normal activities, like eating, showering, or walking. If you have a midwife, call them when you get home from the hospital.
Follow the directions you get from your doctor or hospital about when to call or when to come back to the hospital. You may be told to call or come back after a certain number of hours.
When to get help
Pull out the insert and come to the hospital or call your midwife right away if you have:
- more than 5 contractions every 10 minutes
- contractions lasting longer than 2 minutes
- more vaginal bleeding than your normal period
- fever, chest pains, wheezing or problems breathing
Come to the hospital or call your midwife right away if you:
- have contractions every 5 minutes for 30 minutes
- have vaginal bleeding like a period
- think your water broke
- think that your baby is moving less
Strong, long contractions can happen. If they do, call your midwife or come back to the hospital. You might need medicine to relax your uterus.
If you have concerns, call your hospital or midwife or go back to the hospital.
