Propess
Information for women being induced with Propess
Maternity
This document can be provided in different languages and formats.
For more information please contact:
Induction Suite, QMC Tel: 0115 924 9924 ext 64499
Induction Suite, City campus Tel: 07805732169
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Introduction
This leaflet aims to give women information about Propess, and what to expect when being induced with
Propess. Prostaglandin induces labour by encouraging the cervix to soften and shorten (known as
‘ripening’). It can be given through a slow-release pessary called ‘Propess’, which is like a tiny tampon.
If you are given Propess
Your baby’s heart beat will be monitored using the Cardiotocograph (CTG) machine for 20 minutes
before the Propess is inserted by the midwife, and then for about half an hour afterwards. Once the
Propess is inserted it will swell up, which keeps it in place. You can walk around, shower, eat and drink
normally. Your midwife will continue to check on both you and your baby over the next few hours. If you
are suitable for outpatient induction the midwife will perform a check on you and your baby one hour after
discontinuing the CTG. If this is normal then you will be allowed home. If the string from the Propess
moves to the outside of your vagina you must be careful not to pull or drag on it, as this may cause it to
come out.
Please take special care when:
 Wiping yourself after going to the toilet
 Washing yourself
 Getting on and off the bed.
In the unlikely event that the Propess comes out, please tell the midwife straight away – they can then
make sure it is safely repositioned. If you are at home you will have been advised which telephone
number to ring if this should happen.
We encourage you to walk around as much as possible to help the labour process; however, if you are
remaining in hospital for your induction we ask that you do not go too far from the Maternity unit and
always stay in the hospital grounds in case you suddenly need medical attention. If you have any
concerns please return to the Induction Lounge or your midwife straight away. If you have been allowed
home during your induction, then if you have any concerns you must ring the number you were given
when you left the hospital.
If you experience any of the following please return to the Induction Lounge or your midwife straight away
(or ring if you have been allowed home):
 If you have any vaginal bleeding
 If you think your waters may have broken
 If you are having contractions
 If you are not feeling your baby move normally for you
 If you need some pain relief.
Your midwife will let you know when they would like to see you to monitor you and your baby, this will be
done every few hours if you have remained in hospital for your induction. If you have been allowed home
you will have been told when you will next be contacted or seen for assessment. When contractions
begin your baby’s heart rate will be monitored regularly.
The Propess will continue its slow release for 24 hours, although it may not be in place for that long.
Eventually, as your cervix ripens and opens, the Propess will be dislodged, and as your labour becomes
established it will be removed.
You do not need to have another internal examination unless the Propess needs to be removed – either
because you are advancing in labour, or for one of the following reasons:
 Your waters break
 You have some vaginal bleeding
 You have diarrhoea, vomiting or nausea (being or feeling sick)
 The midwife or doctor is concerned about your baby’s heart rate
 Your contractions come very close together
 You have had the Propess in for 24 hours, even if labour has not started.
However if after 6 hours you are not experiencing any period pains/contractions your midwife may offer to
examine you again to check the propess is still in the correct position. This is important because it will
increase the chance of it working.
The use of Propess will cause the womb to contract, and you may experience some period type pains
initially, which may slow down and disappear, but usually they build up to stronger contractions.
Sometimes this is enough to start off your labour, and you carry on by yourself.
What happens next?
There is a chance, that after 24 hours of Propess, it may not be possible to break the waters and the
midwife and doctor will discuss the options with you. These may include a prostaglandin tablet, a period
of waiting, an intravenous Syntocinon drip or delivery by Caesarean section.
The midwife will arrange for you to be transferred to Labour ward when you go into labour, if there are
any concerns about you or your baby, if your waters break and you are not in labour or you have had 24
hours of Propess. If you have had 24 hours of Propess we will endeavour to transfer you to labour ward
for continuation of your induction of labour as soon as possible. However at times there may be a delay
as the midwives and Doctors may have to prioritise other mothers and babies that may have a greater
need than you at that time or if the workload on labour ward means it would be unsafe to continue your
induction at that time. If you have been allowed home you will have been given a time to return to the
hospital around 24 hours after the propess was inserted.
Feedback
We appreciate and encourage feedback. If you need advice or are concerned about any aspect of care
or treatment please speak to a member of staff or contact the Patient Advice and Liaison Service
(PALS):
Freephone: 0800 183 0204
From a mobile or abroad: 0115 924 9924 ext 65412 or 62301
E-mail: [email protected]
Letter: NUH NHS Trust, c/o PALS, Freepost NEA 14614, Nottingham NG7 1BR
www.nuh.nhs.uk
The Trust endeavours to ensure that the information given here is accurate and impartial. If you require
a full list of references for this leaflet please email [email protected] or phone
0115 924 9924 ext 67754.
Sam Thomas, Maternity Department © May 2015. All rights reserved. Nottingham University Hospitals NHS Trust.
Review May 2017. Ref: 1248/v2/0615/AS.