Labor induction is common and frequently recommended based on maternal or fetal indications. It may also be chosen by a patient with a term pregnancy after 39 weeks’ gestation. When compared with expectant management, labor induction at term is associated with a reduced risk of cesarean delivery (CD) and the associated maternal and neonatal morbidities in current and subsequent pregnancies. In patients with unfavorable cervices undergoing induction, cervical ripening should be performed prior to administration of oxytocin to reduce the risk of CD and decrease time to delivery. Expected durations of the latent phase of spontaneous labor cannot be applied to induced labor. There are not widely accepted criteria for the diagnosis of a prolonged latent phase of induced labor, or a “failed induction.” The metrics described to diagnose arrest of dilation in the active phase of labor should also not be applied to the latent phase. Cesarean delivery can be avoided by requiring membrane rupture and oxytocin administration for at least 12–18 hours prior to diagnosing a failed induction for nonprogression to the active phase. Consideration should be given to allowing 24 hours or more of induction to enter the active phase if maternal and fetal statuses permit.

You are covering the obstetric practice of a colleague who just left on a two-month leave. A 28-year-old primigravida with a spontaneous singleton at 35+1 weeks’ gestation presents for a routine prenatal visit. Pregnancy dating was confirmed by first-trimester sonography. Your trainee informs you the patient is normotensive, fundal height is appropriate for gestation, and she does not have clinical complaints. Fetal activity has been normal. The patient wishes to discuss labor management with you at this visit.