Induction of labour

1. Big picture

Induction of labour (IOL) is the artificial initiation of labour before spontaneous labour begins, with the aim of achieving a safe vaginal birth when continuing pregnancy is judged to be riskier than delivery.

The examiner wants you to think in this order:

Is there an indication?
        ↓
Is vaginal birth safe?
        ↓
What is the gestational age and fetal condition?
        ↓
What is the Bishop score?
        ↓
Choose cervical ripening or direct amniotomy + oxytocin
        ↓
Monitor mother, fetus, contractions, and complications

The key clinical principle:

Induction is not just “give oxytocin.” The cervix must be assessed first.

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