Options for induction of labour:
1 . If artificial rupture of membranes (ARM) is possible (cervix open, soft, membranes felt, head well applied to cervix) then do the ARM and consider starting oxytocin infusion.
2 . If ARM not possible (cervix long, closed, firm, posterior), then use a method of “cervical ripening” (medications or methods to soften, efface, dilate cervix; will increase the success of the induction). Once cervix ripened then do ARM and start oxytocin infusion (same protocol as augmentation of labour for dystocia).
3 . “Ripen Cervix” with
• Prostaglandins (Prostin, Cervidil)
• Foley catheter balloon in cervix
• Oxytocin infusion (not as successful)