When induction of labour is indicated on medical grounds, it is undertaken when the risks of continuing the pregnancy are greater than the risks associated with being born (McDonnell 2011). For the woman to make a fully informed decision, clear information should be given regarding the risks of continuing the pregnancy and awaiting the spontaneous onset of labour versus the risks of the intervention of induction.
Maternal factors such as wellbeing, cervical assessment, parity and previous mode of delivery, and fetal factors such as gestational age, growth and wellbeing of the fetus need to be considered when deciding whether labour should be induced (McCarthy & Kenny 2013). These factors also assist in determining the method of induction, which can be surgical (including artificial rupture of membranes) and/or medical (including use of prostaglandins and/or oxytocin) (RANZCOG 2021; Queensland Health 2017).
There are numerous indications for induction of labour. Prolonged pregnancy is the most common indication, with births after 42 weeks associated with increased risk for the baby and perinatal death (Gulmezoglu et al. 2012). It is widely recommended that induction be offered to women at 41–42 weeks of gestation (Gulmezoglu et al. 2012; NICE 2008; Queensland Health 2017).