Once DILAPAN-S has been administered, it usually stays in your cervix for 12-15 hours. During this time you will be able to perform your normal daily activities. Have a rest before the labour. Only taking a bath or having sexual intercourse have to be avoided.
What is induction of labour?
Labour induction” or “inducing labour” — is the procedure to complete your pregnancy by natural birth. Your cervix should be relaxed, open and soft, followed by stimulation of the uterine contractions to achieve a vaginal delivery of your baby.
Why am I being induced?
Your pregnancy has now progressed to the stage where your physician or midwife feels that the risks of leaving the baby inside your uterus outweighs the risk of delivering your baby. The most common reason for labour induction is post due date pregnancy.
Why can’t I just be started on an oxytocin drip to get my contractions going?
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 and your waters have broken.
Hopefully, following the insertion of DILAPAN-S your waters will break either on their own or your physician or midwife will break it. The membranes are difficult to break artificially until your cervix is 2–3 cm dilated.
DILAPAN-S is used to prepare your cervix for successful induction which means increasing its dilation and softness. Such procedure is called “cervical ripening”.
What is cervical ripening?
The cervix is deep inside your vagina and is opening to your womb (uterus). The cervix should be firm, long and closed tightly until you are near the end of your pregnancy or going into labour. As you come near to your due date, your cervix may begin to soften, shorten and could even begin to open slightly. Sometimes your clinician may use other words – such as dilation or effacement, these simply mean shortening and opening of your cervix, as it is getting ready for your baby to be delivered. It is important to remember that this process does not happen to all women before labour naturally, therefore sometimes help called “cervical ripening” which is part of labour, is needed.
How does DILAPAN-S work?
DILAPAN – S is a small osmotic dilator, made from patented hygroscopic gel, which is inserted carefully through your vagina and inside your cervix. The dilators do not contain any pharmacological substances, usually up to 5 dilators are inserted to soften, open and ripen your cervix gently. Once the dilators are in place, the moisture from your cervix will cause the dilators to expand, causing the cervix to soften and dilate. The optimum time for dilators to be in place is 12 – 15 hours. Based on the experience of mothers, you will almost not feel the dilators in place 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.
What is it made of and how does it expand?
DILAPAN-S is a synthetic osmotic dilator made of Aquacryl hydrogel for guaranteed and predictable action. It expands by osmosis, absorbing fluid from the cervical tissue, resulting in a soft, open and relaxed cervix.
Is the insertion of DILAPAN-S painful?
Honestly, you can feel insertion little uncomfortable and perhaps even a bit painful. However most of induced mums say it is similar to usual vaginal examination. As the diameter of each dilator is small, and the cervix slowly stretches with each dilator placed, generally the insertion is well tolerated. Insertion itself usually takes a few minutes and after that women benefit from DILAPAN-S gentle cervical ripening.
Will I have painful contractions during the ripening?
There is no doubt that you are progressing with your labour which needs to be accompanied by uterine contractions. The question is when these should occur. We believe that too frequent uterine contractions during cervical ripening are useless and unwanted. In that stage when your cervix is not ready your baby can´t go through the birth canal. If there are too many contractions, or they are not under the control, besides that it is painful for you this can cause changes to the baby´s heart rate or cause your womb hyperactivity. DILAPAN-S was designed to minimise these risks over pharmacological methods and that is the reason why we refer to high maternal satisfaction.
Which regular activities can or cannot be done with DILAPAN-S inserted?
Inserted dilators do not limit your regular activities. You can go to the bathroom, shower normally and perform your normal daily activities. You will need to avoid vaginal douching, sitting in a bathtub and having 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 which occur during your ripening process, please report that to your clinician immediately. Under no circumstances should you try to remove the dilators yourself.
Will the dilators fall out on their own? If not, how are they removed?
Dilators will be removed by your clinician (obstetrician or midwife) usually within 12-15 hours. If they fall out spontaneously, it may signal the onset of labour. Please contact your clinician immediately. If possible, collect all available dilators and present them to your clinician.
Do I need to stay at the hospital for cervical ripening period?
No. DILAPAN-S does not contain any hormonal substances, which promotes its safety profile. Additional CTG monitoring is not required. That’s why you can go and stay home with dilators in. You can relax, sleep, enjoy your time and see your clinical team the other day morning. Usually, mums can leave the hospital for 12-15 hours allowing you e.g. to stay at home overnight.
In case you will go home, you need to follow instructions given by your midwife or doctor.
After the cervix has been ripened by DILAPAN-S what is the next step?
Once DILAPAN-S has been removed, your clinician will examine whether your cervix is ready. Women are then encouraged to relax and mobilise until the clinicians are able to break their waters. After that women may spend some time to see if their contractions start on their own. If this does not happen, an oxytocin (also called Syntocinon) drip will be commenced to promote uterine contractions and augment labour.
Is it for me?
Clinical studies have shown that cervical ripening with DILAPAN-S is successful in over 80% of women. Women likely have a normal vaginal delivery after their induction of labour with DILAPAN-S. Seven out of ten women have vaginal births after induction with DILAPAN-S. We know some of you might need extra care during your pregnancy. DILAPAN-S can be used in almost all induced women, incl. those with high blood pressure (pre-eclampsia), gestational diabetes, systemic disease, or women that have had a previous cesarean section. The only contraindication for the usage of DILAPAN-S is apparent genital tract infection. Your doctor and midwife will discuss with you the safest options for you and your baby.
DILAPAN-S is recommended by many national clinical guidelines, incl. NICE IOL Guideline [NG207]: Inducing labour.
Download a patient information leaflet here to discuss with your clinician.
“It’s basically like a tampon that expands inside your cervix to dilate it.”
“They sent my ass home with these things in me lol.”
“Very long boring day though so take entertainment!”
“No pharmacological active substances.”
“A majority of patients can perform daily routine, relax and sleep.”
“It increases options to use for patients seeking a natural alternative.”
“No hospital setting. Possibility to treat mothers as outpatients.”
“Breaking habitual choice!”
“It solves the issue of uterine tachysystole.”
“I had no side effects.”