What should you know about sublingual misoprostol for induction of labour?

Induction is offered when continuing the pregnancy may carry concern for the pregnant person or baby, such as some situations involving [Pre-eclampsia](/conditions/pre-eclampsia/), or when labour has not started as expected. Misoprostol acts on the cervix and uterus. The tablet is used in a maternity setting according to a prescribed schedule, with assessment between doses.

The team may check contractions, fetal heart rate, cervical change, temperature, pulse, and blood pressure. Cramps, contractions, nausea, diarrhoea, chills, and vaginal bleeding can occur. The response varies; another method, including [Oxytocin](/materials/oxytocin/), may be considered when clinically appropriate.

Tell the midwife or obstetrician about previous caesarean or uterine surgery, allergies, bleeding, medicines, and any change in fetal movement. Follow the instructions about eating, drinking, movement, and monitoring. Do not take a dose yourself or repeat one because contractions have not started quickly.

Ask how cervical checks will be done and what happens if induction does not progress. Possible next steps may include a membrane sweep before formal induction, another method, or [Caesarean Section](/treatments/pregnancy-and-birth-care/caesarean-section/), depending on the clinical picture.

Report severe constant abdominal pain, contractions that are unusually close together or prolonged, heavy bleeding, reduced fetal movement, faintness, difficulty breathing, or a persistent high temperature. The monitoring team needs to know promptly about any sudden change in pain or how you feel.

Ask why misoprostol is recommended, how the baby and contractions will be monitored, how long the process may take, what alternatives exist, and what would lead to a change in the induction plan.