Induction of Labour: Types, Methods, and Questions Worth Asking

Induction of labour means starting labour artificially (using physical or medical methods) when it has not begun on its own. It is different from augmentation, which speeds up labour that is already underway. An induction begins the process from scratch.

It sounds straightforward, but the reality is that induction is rarely a single step. There are multiple methods, often used in sequence, and the whole process can unfold over hours or even days. Many women arrive at hospital knowing they are being induced and leave wishing someone had explained what that actually meant.

This article does exactly that. It covers what induction is, why it is recommended, what each method involves physically, a balanced look at the risks and benefits, and what questions are worth asking. Whether induction is being offered, recommended urgently, or something you are considering requesting, understanding the process is one of the most useful things you can do.

Why Are Induction Rates Rising in Australia?

Induction of labour is now a common part of the Australian birth landscape. According to the Australian Institute of Health and Welfare (AIHW), approximately one in three women giving birth in Australia had an induced labour in 2023. Rates sit around 33% across all births, rising to approximately 43% among first-time mothers (AIHW, 2023).

These numbers have climbed significantly over two decades. In 2004, induction was recorded in around 26% of first-time births. Rates peaked in 2020 and have eased slightly since, but remain substantially higher than a generation ago (AIHW, 2023).

Several factors are driving this trend:

  • Advanced maternal age. More women are having their first babies at 35 or older, a group for whom risk profiles shift with gestation.
  • Gestational diabetes (GDM). GDM is now one of the most common reasons for induction, cited in 15% of induced births in the 2023 AIHW data.
  • Pre-labour rupture of membranes (PROM). Waters breaking without labour following, the second most common reason cited, at 11%.
  • Prolonged pregnancy. Post-dates pregnancies (41+ weeks) accounted for 10% of inductions in the same data.
  • IVF pregnancies, obesity, preeclampsia, fetal growth restriction, and GBS-positive status are also contributing factors.
  • Evolving evidence on elective induction. A landmark 2018 US trial (discussed below) shifted how clinicians think about offering induction to low-risk women approaching 39 to 40 weeks.

Understanding why rates are rising helps contextualise why induction might be part of your birth. It is also why it is worth being informed about the process regardless of whether it is on your radar right now.

What did the ARRIVE trial find?

The ARRIVE trial (Grobman et al., 2018) was a large US randomised controlled trial published in the New England Journal of Medicine. It enrolled 6,106 low-risk nulliparous (first-time) women and compared elective induction at 39 weeks with expectant management (waiting for spontaneous labour, up to 41 weeks).

The finding that surprised many clinicians: elective induction at 39 weeks was not associated with a higher caesarean rate. Neonatal outcomes were similar between groups.

This does not mean elective induction is right for everyone. The trial was conducted in the US, in specific hospital systems, with specific populations. But it has meaningfully influenced how care providers discuss the option of induction with low-risk women at term. It is worth knowing about if this conversation comes up for you.

The picture is more nuanced than any single trial, however. While the ARRIVE findings are significant and have appropriately influenced clinical practice, they apply to a specific population, low-risk, nulliparous women enrolled in a controlled trial with standardised care. Other evidence suggests that outside this context, outcomes can look different.

Population-based observational research consistently shows that induction is associated with higher rates of caesarean delivery in certain groups. A particular risk factor is cervical readiness at the time of induction. A retrospective observational study found that women with an unfavourable cervix who required preinduction cervical ripening had more than four times the odds of caesarean delivery compared with those entering induction with a favourable cervix (OR 4.58; 95% CI 3.22–6.51) (Sieroszewski et al., 2020). Population-based cross-sectional data from over 40,000 uncomplicated first births similarly documented substantially higher caesarean rates among induced labours compared with spontaneous onset, particularly at lower gestational ages and in the presence of an unripe cervix (Nippita et al., 2015).

This is not a contradiction of ARRIVE, it is context. The outcomes of induction depend heavily on individual factors including cervical readiness, gestational age, the indication for induction, and the methods used. ARRIVE does not predict outcomes for every woman. It describes what happened in a specific, carefully controlled study of a specific group. This context is what makes the conversation with your care provider more precise, and more useful to you.

Key Takeaways

  • Approximately one in three women giving birth in Australia had an induced labour in 2023, rising to around 43% of first-time mothers.
  • The most common clinical reasons for induction include gestational diabetes, pre-labour rupture of membranes, post-dates pregnancy, and preeclampsia.
  • The ARRIVE trial found elective induction at 39 weeks did not increase caesarean rates in a controlled US trial of low-risk first-time mothers, but this finding is context-specific, not universal.
  • Cervical readiness (Bishop score) at the time of induction is a significant factor in how induction unfolds and what the likelihood of caesarean delivery is.
  • The evidence on induction outcomes is mixed and context-dependent. Your individual situation, gestation, indication, cervical readiness, and method, matters more than any headline statistic.

Why Might Induction Be Recommended for You?

Induction is recommended when the risk of continuing the pregnancy outweighs the risks associated with initiating labour. The reasons span a wide spectrum, from urgent medical indications to elective choices at term.

Common reasons your care provider might recommend induction include:

  • Post-dates pregnancy. RANZCOG guidelines support offering induction to women at 41 to 42 weeks, as the risk of stillbirth and other complications increases beyond this point (RANZCOG, 2023).
  • Preeclampsia or hypertension. One of the most urgent indications. Delivery is often the only resolution. Timing depends on severity and gestation.
  • Gestational diabetes (GDM). Particularly if the baby is measuring large or blood glucose is poorly controlled, induction may be recommended before 40 weeks.
  • Fetal growth restriction (IUGR). If the baby is not growing adequately, delivery may be safer than continuing the pregnancy, depending on gestation and monitoring findings.
  • Pre-labour rupture of membranes (PROM). Once the waters break, the risk of infection increases over time. If labour does not begin within a defined window, induction is usually recommended.
  • Obstetric cholestasis or other maternal conditions that carry fetal risk with prolonged gestation.
  • Maternal request at term. Some women request induction at 39 to 40 weeks for personal, logistical, or psychological reasons. This is a valid option to discuss with your care provider in light of your individual circumstances and local protocols.

Whatever the reason, you have the right to understand the clinical rationale, ask about the evidence, and ask what waiting would mean for your specific situation. Induction is a recommendation, not a requirement, and informed consent is a core part of the process.

Key Takeaways

  • Induction is recommended when continuing the pregnancy is considered to carry more risk than initiating labour, the reasons range from urgent (preeclampsia) to elective (low-risk term pregnancy).
  • The most common clinical indications are post-dates pregnancy (41–42 weeks), gestational diabetes, ruptured membranes without labour, preeclampsia, and fetal growth restriction.
  • If induction is recommended, you are entitled to ask: what is the specific clinical reason, what does the evidence say for my situation, and what are the risks of waiting versus proceeding?
  • Induction is a recommendation, not a directive. Informed consent requires understanding both sides before agreeing.

The Methods: What Actually Happens During an Induction

This is the section most women wish they had read beforehand. Induction is not a single event. It is usually a sequence of steps, each designed to prepare the cervix and then stimulate contractions. Not everyone needs every step. Some women move quickly from the first method to active labour; others require several methods over a longer period.

Here is what each method involves.

1. Membrane Sweep (Stretch and Sweep)

A membrane sweep is not technically an induction. It is a method to encourage labour to start on its own and reduce the need for formal induction. Your midwife or obstetrician inserts one or two fingers through the cervix and makes a circular sweeping motion to separate the amniotic sac from the uterine wall.

This releases local prostaglandins, hormones that can soften the cervix and trigger the onset of labour within 24 to 48 hours if the cervix is ready (Finucane et al., 2020).

A 2020 Cochrane systematic review found that membrane sweeping may increase the likelihood of spontaneous labour onset and reduce the need for formal induction, though the certainty of the evidence is rated as low (Finucane et al., 2020). It is unlikely to cause harm but is often uncomfortable, particularly if the cervix is not yet effaced or dilated.

Sweeps are typically offered from around 39 to 41 weeks. Some care providers offer them routinely at 40 weeks for first-time mothers. Whether you agree to one is entirely your choice.

2. Cervical Ripening Balloon (Foley Catheter / Cook Balloon)

If your cervix is not yet ready for labour (too long, firm, or closed), a mechanical balloon catheter may be used to ripen it. A thin catheter is inserted through the cervix and a small balloon at the tip is inflated with saline. The physical pressure gradually dilates and softens the cervix.

The balloon typically stays in place for 12 to 24 hours, often overnight in hospital. It may fall out on its own once the cervix has dilated to around 3 cm. It does not directly cause contractions. Its job is to prepare the cervix for the methods that follow.

Evidence suggests the Foley balloon is comparably safe and effective to prostaglandins for cervical ripening (Jozwiak et al., 2012). One advantage is a lower risk of uterine hyperstimulation compared with prostaglandins. Some hospitals use balloon catheters alone; others combine them with prostaglandins for a dual approach, depending on your clinical picture.

3. Prostaglandins (Cervidil / Dinoprostone / Misoprostol)

Prostaglandins are hormones that soften and ripen the cervix. In higher doses, they can also stimulate contractions directly. In an induction, they are administered vaginally as a gel, a controlled-release pessary (Cervidil, which contains dinoprostone), or a tablet (misoprostol, also known as Cytotec).

You will need to be in hospital for this step, usually for 6 to 24 hours or longer depending on your response. Some women go into labour from prostaglandins alone. Others need the cervix to ripen before moving to the next step.

The main risk to monitor for is uterine hyperstimulation, where contractions become too frequent or too long and can affect the baby's oxygen supply. This is why continuous CTG (cardiotocography, which monitors the baby's heart rate) is used during and after prostaglandin administration (RANZCOG, 2023).

Different hospitals use different prostaglandin agents and protocols, so ask your care team what they typically use and why.

4. Artificial Rupture of Membranes (ARM / Amniotomy)

Artificial rupture of membranes (ARM), sometimes called amniotomy or "breaking the waters," involves your care provider inserting a thin hook (an amniohook) through the cervix to rupture the amniotic sac. It can usually only be done once the cervix is dilated to around 3 cm or more.

Breaking the waters releases prostaglandins and allows the baby's head to press more directly on the cervix, which can stimulate contractions. It is commonly used in combination with a Syntocinon drip.

One important thing to understand: once your membranes are ruptured, the clock starts. The open pathway increases the risk of infection over time, which is why labour is monitored closely and the decision to proceed to further intervention is made with that timeline in mind.

5. Syntocinon (Oxytocin IV Drip)

Syntocinon is a synthetic form of oxytocin, the hormone your body produces naturally during labour, administered via an intravenous (IV) drip. It is usually the final step in an induction, or it may be used to augment labour that has stalled.

The drip is started at a low dose and increased incrementally until contractions are occurring regularly, typically three in every ten minutes. Because Syntocinon is delivered continuously via IV rather than in the natural pulses your body would produce, contractions can feel more intense and less graduated than in spontaneous labour (Buckley, 2015). There is not the same long, gradual build that often characterises the early hours of natural labour.

Continuous CTG monitoring is required throughout Syntocinon use, so you will be connected to a monitor for the duration. This affects mobility, though many hospitals have wireless or waterproof monitors that allow more movement than older equipment. It is worth asking about this before you start.

Some women respond to the Syntocinon drip very quickly, moving into active labour and delivering within a few hours. Others have a longer journey. Both are normal. The range of responses is wide, and your care team will adjust the drip rate based on how your body is responding and how the baby is tolerating the contractions.

Given the intensity of Syntocinon contractions, it is worth discussing pain relief options before you start. Epidural anaesthesia is available and widely used with Syntocinon inductions. This is not a decision to leave until you are in established labour. Ask about it at the start.

It is worth knowing that not every induction follows this full sequence. Your care provider will tailor the approach to your individual circumstances. Someone being induced for a medical reason that is progressing quickly, like worsening preeclampsia, may bypass cervical ripening methods and go directly to an amniotomy and Syntocinon drip, because the priority is delivery rather than a gradual process. Someone being induced electively at 39 weeks with a favourable cervix may need only minimal intervention. Ask your provider which methods are planned and why, so you understand what your individual induction is likely to look like.

Key Takeaways

  • Induction typically follows a sequence: cervical ripening (balloon catheter and/or prostaglandins), then amniotomy, then Syntocinon, but not every woman needs every step.
  • The process can take anywhere from several hours to two or more days, depending largely on cervical readiness at the start.
  • Syntocinon contractions can feel more intense than spontaneous labour contractions because the drug is delivered as a continuous drip rather than in natural pulses; discuss pain relief options, including epidural timing, before you begin.
  • Ask your care provider which specific methods are planned for your induction and why, the answer will depend on your Bishop score (a measure of cervical readiness) and clinical picture.

Understanding the Risks and Benefits: What You Need to Know for Informed Consent

Informed consent to induction, or to declining it, is only meaningful if it is genuinely informed. That means understanding not just why induction is being recommended, but what the research shows about both the potential benefits and the potential risks. This section aims to give you that fuller picture.

This is not a section designed to steer you in either direction. The evidence is sometimes mixed and always context-dependent. What it should do is help you have a more specific, more confident conversation with your care provider.

Benefits of induction when medically indicated

When induction is recommended for a genuine clinical reason, the case for acting is often clear.

  • Preventing post-dates complications. Beyond 41 to 42 weeks, placental efficiency typically begins to decline. Amniotic fluid volume often reduces. Research shows that the risk of stillbirth, fetal distress during labour, and meconium aspiration increases with advancing gestation (RANZCOG, 2023). Induction at an appropriate gestation may help prevent these outcomes.
  • Managing serious maternal conditions. Preeclampsia, eclampsia, obstetric cholestasis, poorly controlled gestational diabetes, and significant fetal growth restriction are conditions where the risk of continuing the pregnancy may be substantial. For these indications, timely induction or planned caesarean is often the medically appropriate course.
  • Planning and support structures. For some women, the ability to plan the timing of birth provides important practical and psychological support, including partner availability, childcare for existing children, geographic proximity to hospital, or access to family support that would not otherwise be available.

Potential risks and considerations

The following risks are documented in the research literature. They are not certainties, induction does not automatically lead to any of them, but they are part of an honest informed consent conversation.

  • Uterine hyperstimulation. Prostaglandins and Syntocinon can, in some cases, cause contractions that are too frequent or too prolonged (sometimes called tachysystole). This reduces the oxygen supply to the baby between contractions. It is a known and monitored risk, and your care team will watch for it continuously during induction using CTG monitoring (RANZCOG, 2023). If hyperstimulation occurs, the prostaglandin pessary may be removed or the Syntocinon drip rate reduced or ceased.
  • Higher intervention rates in some populations. In real-world settings, particularly for women with an unfavourable cervix at the time of induction, research shows higher rates of caesarean delivery than the ARRIVE trial would suggest. A retrospective observational study found more than four times the odds of caesarean delivery in women requiring preinduction cervical ripening compared with those who entered induction with a favourable cervix (OR 4.58; 95% CI 3.22–6.51) (Sieroszewski et al., 2020). Other research suggests induced labour is associated with higher rates of epidural use and, in some contexts, instrumental delivery (forceps or vacuum) compared with spontaneous labour onset. These outcomes are not inevitable, but they are part of the realistic picture for some women.
  • Syntocinon and breastfeeding. There is emerging, and still contested, evidence that synthetic oxytocin administered during labour may affect the body's own oxytocin system in the hours and days following birth. Oxytocin plays a central role in milk letdown and in the early bonding and feeding process. Some research suggests that prolonged exposure to synthetic oxytocin may desensitise oxytocin receptors, potentially affecting the natural oxytocin release in the postpartum period (Buckley, 2015; Uvnäs-Moberg et al., 2022). Studies have found associations between intrapartum synthetic oxytocin and reduced breastfeeding initiation in the early hours postpartum, though the relationship is not fully established and results across studies are mixed. This is not a reason to avoid Syntocinon when it is clinically indicated, but it is a reason to ensure good breastfeeding support is in place from the outset, regardless of how your labour began.
  • Prolonged oxytocin augmentation and postpartum haemorrhage. Some research has identified an association between prolonged use of oxytocin during labour and an increased risk of postpartum haemorrhage (PPH). One proposed mechanism is oxytocin receptor desensitisation, after extended exposure to synthetic oxytocin, the uterus may respond less effectively to oxytocin-dependent signals in the third stage of labour, which can affect uterine tone and increase bleeding risk (Buckley, 2015). A cohort study of nulliparous women found that oxytocin augmentation lasting four and a half hours or more was associated with higher rates of PPH compared with shorter durations or no augmentation. This association is not universal across all studies, and maternity units are well prepared to manage third-stage complications. It is a reason, however, to ensure your care team is actively monitoring and managing your third stage, particularly after a long Syntocinon induction.
  • The question of "normal range but toward one end." Some women are recommended induction because a clinical finding, a fetal size estimate, an amniotic fluid index measurement, a Doppler result, sits within the normal range but toward one end of it. It is important to understand that values within the normal range are not, by definition, abnormal. If induction is recommended on the basis of a borderline finding, it is reasonable to ask: where exactly does this measurement sit within the normal range, has it been confirmed, is it trending in a particular direction, and what would careful monitoring rather than immediate induction look like? Asking this is not a challenge to your care provider. It is engaged, informed consent.
  • Emotional experience. For some women, not going into labour spontaneously carries real emotional weight, particularly if induction was not their preference or happened in circumstances that felt sudden or unclear. This is a valid and documented experience. Feeling informed, heard, and actively involved in decision-making, whatever the birth, is consistently associated with more positive birth experiences. The quality of communication around induction matters.

Key Takeaways

  • Induction carries clear benefits when medically indicated, it helps manage serious post-dates and maternal complications that carry real risk if pregnancy continues.
  • Documented risks include uterine hyperstimulation, higher intervention rates in women with an unfavourable cervix, emerging evidence around Syntocinon and breastfeeding initiation, and a possible association between prolonged oxytocin use and postpartum haemorrhage.
  • If induction is recommended on the basis of a borderline finding, asking where your result sits within the normal range and what monitoring would look like is an entirely appropriate question.
  • Good breastfeeding support from the outset is particularly worth organising if you are expecting a Syntocinon induction.

Questions Worth Asking Before Your Induction

Knowledge is what makes the difference between an induction you move through with some sense of agency and one that feels like it is happening to you. These are the questions most worth asking at your pre-induction appointment or on the day.

  1. Why is induction being recommended at my specific gestation? Ask your care provider to explain the clinical reason and what the evidence says for your situation, not just "standard protocol."
  2. What are the risks of waiting? Ask what would happen if you chose expectant management instead, and over what timeframe those risks apply.
  3. What is my Bishop score, and what does it mean for my induction? Your Bishop score is a measure of cervical readiness. Knowing it helps you understand what your induction is likely to look like and how long it may take.
  4. What methods will be used and in what order? Ask for the planned sequence (balloon, prostaglandins, ARM, Syntocinon) and roughly how long each step takes.
  5. What happens if the first method doesn't work? Understanding the plan B (and plan C) helps you feel less at the mercy of uncertainty.
  6. Will I need to stay in hospital for the whole process? Some hospitals allow women to go home after a balloon is inserted; others require continuous admission. Ask what your facility's protocol is.
  7. What monitoring will I have? Ask whether you will be on continuous CTG, when, and whether wireless monitoring is available so you can move.
  8. What pain relief options are available? Specifically ask about epidural timing given that Syntocinon contractions can start intensely and escalate quickly.
  9. What are the options if induction is not progressing? Understanding when and why a caesarean might be recommended helps you stay informed rather than blindsided.

You can ask these questions at any point: at an antenatal appointment when induction is first mentioned, on the phone with your midwife, or at the hospital before you start. No question about your own birth is a small one.

Key Takeaways

  • Asking questions before your induction is how informed consent works, it is not disruptive or difficult, it is your right.
  • Key questions to ask: why is induction recommended at this specific gestation, what are the risks of waiting, what is the planned method sequence, and what happens if things don't progress?
  • Discuss pain relief, including epidural availability and timing, before contractions are established, not after.

The Emotional Side of Induction

For many women, induction feels disempowering. Not because it is inherently so, but because it often unfolds in a way that was not clearly explained. You expected to go into labour at home and instead you are in a hospital bed at 40 weeks, attached to a monitor, waiting to see if a gel is going to do something.

That is a real experience, and it is worth naming it.

Induction can also stretch over a long time. Not every induction is rapid. Some women spend two or more days moving through cervical ripening before labour becomes established. That is physically and emotionally exhausting, and it is useful to know that going in.

What is within your control is being informed. Knowing what each step is and why it is being used. Asking questions. Having a support person who understands the process alongside you. Writing down your preferences for pain relief, for who cuts the cord, for what you want if things change. Not because birth goes to plan, but because the act of articulating what matters to you keeps you an active participant rather than a passive one.

Induction does not make birth less yours. It just means it started a little differently.

This article is intended for general educational purposes only and does not constitute medical advice. Every pregnancy is individual. Always discuss your specific circumstances, clinical history, and birth preferences with your obstetrician, midwife, or care provider before making decisions about your care.

Frequently Asked Questions

What is the difference between induction and augmentation? Induction starts labour artificially when it has not begun on its own. Augmentation speeds up or strengthens labour that is already in progress, for example if contractions have slowed or stalled. Both may use Syntocinon, but they are distinct clinical situations.

At what point in pregnancy is induction typically offered in Australia? RANZCOG guidelines support offering induction to women at 41 to 42 weeks of gestation as a standard recommendation for prolonged pregnancy. For other medical indications such as preeclampsia, gestational diabetes, or fetal growth restriction, timing depends on the condition and its severity. Elective induction at 39 weeks may be discussed in some low-risk situations based on current evidence.

Does induction make a caesarean more likely? Not necessarily, and not automatically. The ARRIVE trial (Grobman et al., 2018) found that elective induction at 39 weeks in low-risk first-time mothers was associated with a lower caesarean rate compared with expectant management in that controlled study. However, real-world observational evidence shows a more complex picture, particularly for women with an unfavourable cervix at the time of induction, where caesarean rates are substantially higher. Outcomes depend on gestation, the indication for induction, cervical readiness, and individual response. This is worth discussing openly with your care provider for your specific situation.

Is a membrane sweep the same as an induction? No. A membrane sweep is a simple in-clinic procedure used to encourage spontaneous labour. It is not a formal induction. If it works, labour begins on its own. If it does not, or if labour does not begin within a certain timeframe, formal induction methods may be recommended. You can decline a sweep without it affecting your eligibility for formal induction later.

Why do contractions feel more intense with Syntocinon? Natural labour involves a gradual build of oxytocin and prostaglandins over hours. Syntocinon is delivered as a continuous IV infusion, which means contractions can start at a higher intensity and increase quickly without the same gradual warm-up period. This is well-documented (Buckley, 2015) and is one reason epidural rates tend to be higher in induced labours. Pain relief planning is an important part of induction preparation.

Can I decline induction? Yes. Induction is a recommendation, not a requirement, and informed consent is required. If induction is offered, you are entitled to understand the risks and benefits of proceeding versus waiting, ask questions, and make a decision that aligns with your values and circumstances. If you decline or want more time to consider, your care provider should support you with clear information and monitoring. This is a conversation, not a directive.

How long does an induction take? The range is genuinely wide. Some women go from first prostaglandin dose to delivery in under twelve hours. Others take two days moving through cervical ripening before active labour becomes established. Cervical readiness at the start, the method used, and individual response all affect the timeline. Ask your care team for a realistic expectation based on your Bishop score (a measure of cervical readiness) at the outset.

Will I be able to move around during my induction? It depends on the stage and your hospital's equipment. During prostaglandin administration, light movement is usually possible. Once on Syntocinon, continuous CTG monitoring is required, though many hospitals have wireless or waterproof monitors that allow more movement than stationary machines. Ask your hospital specifically, and whether you can use a birth pool or shower during parts of the process.

Why would someone choose an elective induction? Not all inductions are medically driven. Some women request an elective induction at 39 to 40 weeks for entirely personal, logistical, or psychological reasons, and this is a recognised and valid option to discuss with your care provider.

Common reasons include:

  • Anxiety about post-dates risk. Some women prefer the certainty of acting at a known gestation rather than waiting, particularly if they have experienced pregnancy loss or high-risk monitoring during their pregnancy.
  • Partner or support person availability. If a partner has finite leave, if a key support person is only available for a particular window, or if you live at a significant distance from a hospital, the ability to plan delivery timing carries real practical weight.
  • Childcare for existing children. For women who already have children at home, the logistics of spontaneous labour, particularly overnight, can be genuinely complex to manage.
  • Preference for a planned, predictable experience. Some women find the open-ended uncertainty of waiting for spontaneous labour onset distressing, and prefer the ability to plan and prepare with a known timeline.

Elective induction is a valid choice when made with full information. The most important thing is that the decision is yours, informed, and not the result of pressure or incomplete information.

References

Australian Institute of Health and Welfare (AIHW) 2023, National Core Maternity Indicators: Induction of Labour, AIHW, Canberra. Available at: https://www.aihw.gov.au/reports/mothers-babies/national-core-maternity-indicators/contents/labour-and-birth-indicators/induction-of-labour

Australian Institute of Health and Welfare (AIHW) 2023, Australia's Mothers and Babies: Onset of Labour, AIHW, Canberra. Available at: https://www.aihw.gov.au/reports/mothers-babies/australias-mothers-babies/contents/labour-and-birth/onset-of-labour

Buckley, SJ 2015, 'Hormonal physiology of childbearing: Evidence and implications for women, babies, and maternity care', Childbirth Connection Programs, National Partnership for Women and Families, Washington, DC.

Finucane, EM, Murphy, DJ, Biesty, LM, Gyte, GML, Cotter, AM, Ryan, EM, Boulvain, M & Devane, D 2020, 'Membrane sweeping for induction of labour', Cochrane Database of Systematic Reviews, issue 2, art. no. CD000451. https://pubmed.ncbi.nlm.nih.gov/32103497/

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Mozurkewich, EL, Chilimigras, JL, Berman, DR, Perni, UC, Romero, VC, King, VJ & Keeton, KL 2011, 'Methods of induction of labour: a systematic review', BMC Pregnancy and Childbirth, vol. 11, no. 84. https://link.springer.com/article/10.1186/1471-2393-11-84

Nippita, TA, Trevena, JA, Patterson, JA, Ford, JB, Morris, JM & Roberts, CL 2015, 'Caesarean section following induction of labour in uncomplicated first births: a population-based cross-sectional analysis of 42,950 births', BMC Pregnancy and Childbirth, vol. 15, no. 169. https://pubmed.ncbi.nlm.nih.gov/27121614/

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Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) 2023, Use of Prostaglandins in Induction of Labour (C-Obs 22), RANZCOG, Melbourne. Available at: https://ranzcog.edu.au/wp-content/uploads/Prostaglandins-lnduction-of-Labour.pdf

Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) 2023, Care in Labour in the Absence of Pregnancy Complications (C-Obs 31), RANZCOG, Melbourne. Available at: https://ranzcog.edu.au/wp-content/uploads/Care-Labour-Absence-Pregnancy-Complications.pdf

Sieroszewski, P, Kłos, P, Borowski, D, Wilczyński, J, Zborowski, J & Wójtowicz, A 2020, 'Is unfavourable cervix prior to labor induction risk for adverse obstetrical outcome in time of universal ripening agents usage? Single center retrospective observational study', International Journal of Environmental Research and Public Health, vol. 17, no. 17. PMC7481947. https://pubmed.ncbi.nlm.nih.gov/32953176/

Trends in induction of labour and associated co-morbidities and demographics in Queensland, Australia from 2001 to 2020: a population-based study 2024, BMC Pregnancy and Childbirth. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938751/