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Induction of labor

Deborah A Wing, MD, MBA
Section Editor
Charles J Lockwood, MD, MHCM
Deputy Editor
Vanessa A Barss, MD, FACOG


Induction of labor refers to techniques for stimulating uterine contractions to accomplish delivery prior to the onset of spontaneous labor. It is one of the most commonly performed obstetrical procedures in the United States.

Principles of induction of labor in women with an unscarred uterus will be discussed here. Issues regarding induction of labor in women who have had a previous cesarean delivery and methods of cervical ripening are reviewed separately. (See "Cervical ripening and induction of labor in women with a prior cesarean delivery" and "Techniques for ripening the unfavorable cervix prior to induction".)


Between 1990 and 2012, the overall frequency of labor induction more than doubled in the United States, rising from 9.5 to 23.3 percent [1], and early term (in the 37th and 38th week of gestation) inductions quadrupled, rising from 2 to 8 percent over a similar period of time [2]. Although an increase in medically and obstetrically indicated inductions contributed to the rise, marginally indicated and elective inductions accounted for a greater proportion of the increase [3]. Reasons for the latter include more relaxed attitudes toward marginal indications for induction, patient and provider desire to arrange a convenient time of delivery, and the availability of better cervical ripening agents [4]. Patient and provider concerns about the risk of fetal demise with expectant management near term or postterm have also contributed to the increased rate of induction.


Major societies have published guidelines for labor induction, including:

American College of Obstetricians and Gynecologists (ACOG) [5,6]


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Literature review current through: Dec 2016. | This topic last updated: Mon Dec 19 00:00:00 GMT+00:00 2016.
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