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Labour Induction and Augmentation

Dinoprostone vaginal insertion

A dinoprostone vaginal insert looks like a very small tampon with a long string. It has medicine on it to help start labour (induce labour). It is put in your vagina and gives off prostaglandin, which is the same hormone that your body makes to start labour. Dinoprostone relaxes and softens your cervix, getting it ready for labour and delivery.

Dinoprostone vaginal inserts are put in at the hospital. You can have a dinoprostone vaginal insert done as an inpatient, which means that you will be staying at the hospital, or as an outpatient, which means that 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.
  • Bring any prenatal papers you have (your doctor may have given you some) to the hospital.
  • Bring your packed bag or suitcase in case you need to stay at the hospital. If you have a car at the hospital, you can leave the bag there while getting the insert.
  • Bring your partner or someone else 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 and will ask if you have any concerns or questions. You will be asked questions about your pregnancy and your health. The doctor, nurse, or midwife will:

  • Check your blood pressure, pulse, and temperature.
  • Put a monitor on your belly 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 of your baby may be done.
  • Put the insert in 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.

When the insert is first put in, you may have some cramping, a backache, or a warm feeling in your vagina. It usually takes a few hours before you feel contractions. Nausea, vomiting, and diarrhea may happen, but this is not common.

Removing the insert

Your doctor, nurse, or midwife will remove the insert after 12 hours, or when it is no longer needed. They may leave it in for up to 24 hours.

If your labour starts, the insert may need to be removed once 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 have gone 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.

Things to watch for at home

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 bag of waters broke
  • think that your baby is moving less
Strong and long contractions can sometimes happen. If this happens to you, 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.

Current as of: June 5, 2023

Author: Maternal, Newborn, Child and Youth Strategic Clinical Network, Alberta Health Services