Induction of labor in a contemporary obstetric cohort

Am J Obstet Gynecol. 2012 Jun;206(6):486.e1-9. doi: 10.1016/j.ajog.2012.03.014. Epub 2012 Mar 23.


Objective: We sought to describe details of labor induction, including precursors and methods, and associated vaginal delivery rates.

Study design: This was a retrospective cohort study of 208,695 electronic medical records from 19 hospitals across the United States, 2002 through 2008.

Results: Induction occurred in 42.9% of nulliparas and 31.8% of multiparas and elective or no recorded indication for induction at term occurred in 35.5% and 44.1%, respectively. Elective induction at term in multiparas was highly successful (vaginal delivery 97%) compared to nulliparas (76.2%). For all precursors, cesarean delivery was more common in nulliparas in the latent compared to active phase of labor. Regardless of method, vaginal delivery rates were higher with a ripe vs unripe cervix, particularly for multiparas (86.6-100%).

Conclusion: Induction of labor was a common obstetric intervention. Selecting appropriate candidates and waiting longer for labor to progress into the active phase would make an impact on decreasing the national cesarean delivery rate.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Adult
  • Cervical Ripening
  • Cesarean Section / statistics & numerical data*
  • Cohort Studies
  • Elective Surgical Procedures
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Labor Onset
  • Labor, Induced / methods
  • Labor, Induced / statistics & numerical data*
  • Parity
  • Pregnancy
  • Pregnancy Complications
  • Retrospective Studies
  • United States
  • Young Adult