Inducing labour
NICE guideline
Published: 4 November 2021
www.nice.org.uk/guidance/ng207
© NICE 2023. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-
conditions#notice-of-rights).
,Inducing labour (NG207)
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful
consideration of the evidence available. When exercising their judgement, professionals
and practitioners are expected to take this guideline fully into account, alongside the
individual needs, preferences and values of their patients or the people using their service.
It is not mandatory to apply the recommendations, and the guideline does not override the
responsibility to make decisions appropriate to the circumstances of the individual, in
consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment
or in a procedure should be reported to the Medicines and Healthcare products Regulatory
Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the
guideline to be applied when individual professionals and people using services wish to
use it. They should do so in the context of local and national priorities for funding and
developing services, and in light of their duties to have due regard to the need to eliminate
unlawful discrimination, to advance equality of opportunity and to reduce health
inequalities. Nothing in this guideline should be interpreted in a way that would be
inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally
sustainable health and care system and should assess and reduce the environmental
impact of implementing NICE recommendations wherever possible.
© NICE 2023. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- Page 2 of
conditions#notice-of-rights). 41
,Inducing labour (NG207)
Contents
Overview ..................................................................................................................................... 4
Who is it for? ......................................................................................................................................... 4
Recommendations ...................................................................................................................... 5
1.1 Information and decision making ................................................................................................... 5
1.2 Induction of labour in specific circumstances ............................................................................. 7
1.3 Methods for induction of labour ................................................................................................... 16
1.4 Methods that are not recommended for induction of labour..................................................... 18
1.5 Assessment before induction, monitoring and pain relief .......................................................... 20
1.6 Outpatient induction....................................................................................................................... 22
1.7 Prevention and management of complications ........................................................................... 23
Terms used in this guideline................................................................................................................ 25
Recommendations for research ................................................................................................ 27
Key recommendations for research ................................................................................................... 27
Rationale and impact.................................................................................................................. 31
Induction of labour for pregnancy lasting longer than 41 weeks .................................................... 31
Induction of labour for prelabour rupture of the membranes .......................................................... 32
Induction of labour for suspected fetal macrosomia ........................................................................ 33
Induction of labour for intrauterine fetal death after previous caesarean birth ............................ 33
Methods for induction of labour ......................................................................................................... 35
Context ........................................................................................................................................ 37
Finding more information and committee details .................................................................... 39
Update information .................................................................................................................... 40
© NICE 2023. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- Page 3 of
conditions#notice-of-rights). 41
, Inducing labour (NG207)
This guideline replaces CG70 and ESUOM11.
This guideline is the basis of QS60.
Overview
This guideline covers the circumstances for inducing labour, methods of induction,
assessment, monitoring, pain relief and managing complications. It aims to improve advice
and care for pregnant women who are thinking about or having induction of labour.
In this guideline we use the terms 'woman' and 'women', based on the evidence used in its
development. The recommendations will also apply to people who do not identify as
women but are pregnant or have given birth.
Who is it for?
• Healthcare professionals
• Commissioners and providers
• Pregnant women, their families and carers
© NICE 2023. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- Page 4 of
conditions#notice-of-rights). 41
NICE guideline
Published: 4 November 2021
www.nice.org.uk/guidance/ng207
© NICE 2023. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and-
conditions#notice-of-rights).
,Inducing labour (NG207)
Your responsibility
The recommendations in this guideline represent the view of NICE, arrived at after careful
consideration of the evidence available. When exercising their judgement, professionals
and practitioners are expected to take this guideline fully into account, alongside the
individual needs, preferences and values of their patients or the people using their service.
It is not mandatory to apply the recommendations, and the guideline does not override the
responsibility to make decisions appropriate to the circumstances of the individual, in
consultation with them and their families and carers or guardian.
All problems (adverse events) related to a medicine or medical device used for treatment
or in a procedure should be reported to the Medicines and Healthcare products Regulatory
Agency using the Yellow Card Scheme.
Local commissioners and providers of healthcare have a responsibility to enable the
guideline to be applied when individual professionals and people using services wish to
use it. They should do so in the context of local and national priorities for funding and
developing services, and in light of their duties to have due regard to the need to eliminate
unlawful discrimination, to advance equality of opportunity and to reduce health
inequalities. Nothing in this guideline should be interpreted in a way that would be
inconsistent with complying with those duties.
Commissioners and providers have a responsibility to promote an environmentally
sustainable health and care system and should assess and reduce the environmental
impact of implementing NICE recommendations wherever possible.
© NICE 2023. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- Page 2 of
conditions#notice-of-rights). 41
,Inducing labour (NG207)
Contents
Overview ..................................................................................................................................... 4
Who is it for? ......................................................................................................................................... 4
Recommendations ...................................................................................................................... 5
1.1 Information and decision making ................................................................................................... 5
1.2 Induction of labour in specific circumstances ............................................................................. 7
1.3 Methods for induction of labour ................................................................................................... 16
1.4 Methods that are not recommended for induction of labour..................................................... 18
1.5 Assessment before induction, monitoring and pain relief .......................................................... 20
1.6 Outpatient induction....................................................................................................................... 22
1.7 Prevention and management of complications ........................................................................... 23
Terms used in this guideline................................................................................................................ 25
Recommendations for research ................................................................................................ 27
Key recommendations for research ................................................................................................... 27
Rationale and impact.................................................................................................................. 31
Induction of labour for pregnancy lasting longer than 41 weeks .................................................... 31
Induction of labour for prelabour rupture of the membranes .......................................................... 32
Induction of labour for suspected fetal macrosomia ........................................................................ 33
Induction of labour for intrauterine fetal death after previous caesarean birth ............................ 33
Methods for induction of labour ......................................................................................................... 35
Context ........................................................................................................................................ 37
Finding more information and committee details .................................................................... 39
Update information .................................................................................................................... 40
© NICE 2023. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- Page 3 of
conditions#notice-of-rights). 41
, Inducing labour (NG207)
This guideline replaces CG70 and ESUOM11.
This guideline is the basis of QS60.
Overview
This guideline covers the circumstances for inducing labour, methods of induction,
assessment, monitoring, pain relief and managing complications. It aims to improve advice
and care for pregnant women who are thinking about or having induction of labour.
In this guideline we use the terms 'woman' and 'women', based on the evidence used in its
development. The recommendations will also apply to people who do not identify as
women but are pregnant or have given birth.
Who is it for?
• Healthcare professionals
• Commissioners and providers
• Pregnant women, their families and carers
© NICE 2023. All rights reserved. Subject to Notice of rights (https://www.nice.org.uk/terms-and- Page 4 of
conditions#notice-of-rights). 41
