Guideline No. 432c: Induction of Labour

J Obstet Gynaecol Can. 2023 Jan;45(1):70-77.e3. doi: 10.1016/j.jogc.2022.11.009.


Objectives: This guideline presents evidence and recommendations for cervical ripening and induction of labour. It aims to provide information to birth attendants and pregnant individuals on optimal perinatal care while avoiding unnecessary obstetrical intervention.

Target population: All pregnant patients.

Benefits, risks, and costs: Consistent interprofessional use of the guideline, appropriate equipment, and trained professional staff enhance safe intrapartum care. Pregnant individuals and their support person(s) should be informed of the benefits and risks of induction of labour.

Evidence: Literature published to March 2022 was reviewed. PubMed, CINAHL, and the Cochrane Library were used to search for systematic reviews, randomized control trials, and observational studies on cervical ripening and induction labour. Grey (unpublished) literature was identified by searching the websites of health technology assessment and health technology related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.

Validation methods: The authors rated the quality of evidence and strength of recommendations using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. See online Appendix A (Tables A1 for definitions and A2 for interpretations of strong and conditional [weak] recommendations).

Intended audience: All providers of obstetrical care.

Summary statements: Misoprostol OXYTOCIN: RECOMMENDATIONS.

Keywords: cervical ripening; induction; labour.

Publication types

  • Practice Guideline

MeSH terms

  • Female
  • Humans
  • Labor, Induced
  • Labor, Obstetric*
  • Obstetrics*
  • Oxytocin
  • Pregnancy
  • Systematic Reviews as Topic


  • Oxytocin