DILAPAN-S® Digital Insertion: Tips, Technique and Guidance for Midwives

Hannah Hunt
Mar 20
2 min read

As the use of DILAPAN-S® for cervical ripening continues to increase, more clinicians are adopting digital insertion of DILAPAN-S® as a practical and efficient alternative to speculum-guided insertion.

For midwives experienced in vaginal examination and artificial rupture of membranes (ARM), digital insertion is a natural extension of existing clinical skills- and with practice, can become a confident and effective technique in induction of labour (IOL).

What is digital insertion of DILAPAN-S®?

Digital insertion of DILAPAN-S® is a technique where the dilator is guided into the cervix using tactile feedback via a vaginal examination, rather than visualisation with a speculum.

This method is increasingly used in maternity settings to support cervical ripening during induction of labour, particularly where a speculum examination may be more challenging or less comfortable.

Why use digital insertion for cervical ripening?

Digital insertion offers several clinical and practical advantages:

Uses tactile feedback, familiar to midwives performing vaginal examinations
May be easier in cases of posterior cervix or challenging anatomy
Can improve maternal comfort and experience
Reduces reliance on speculum use in some clinical scenarios
Supports flexibility in induction of labour pathways, including outpatient care

DILAPAN-S® digital insertion technique: Top tips for midwives

Building confidence in digital insertion starts with applying existing clinical skills in a slightly different way.

1. Optimise positioning for cervical access

Encourage the woman to adopt a position that tilts the pelvis and improves access to the cervix. Good positioning is key to successful digital cervical access.

2. Use familiar ARM technique

Approach insertion as you would an artificial rupture of membranes (ARM). Hold the DILAPAN-S® dilator in sponge forceps and guide it along your examining finger.

3. Locate and access the cervix

Perform a vaginal examination to locate the cervix, then guide the dilator through the external os and internal os. A slight “pop” sensation may be felt as the dilator passes through the cervical canal.

4. Maintain control throughout insertion

Keeping your finger on the cervix helps maintain accuracy and improves patient comfort. When learning, consider asking a colleague to assist with loading additional dilators.

Ensuring correct DILAPAN-S® placement

Correct placement is essential for effective cervical ripening.

Each dilator must pass through both the external os and internal os. Failure to achieve this may result in ineffective dilation.

To confirm correct insertion:

Check that all plastic handles are aligned
Confirm placement either visually or by feel

This step is critical for both clinical effectiveness and patient safety.

Building confidence with DILAPAN-S® digital insertion

For many midwives, digital insertion becomes easier with repetition. It is not a completely new skill, but rather an adaptation of core competencies already used in daily practice.

With experience, digital insertion can become: