Nurse-Midwifery M.S.

Year Approved


First Advisor

Missal, Bernita


Background/Purpose: The purpose of this paper is to critically review current literature regarding current methods for labor induction and their impact on the duration of labor and rate of cesarean section. Theoretical Framework: Imogene King’s Theory of Goal Attainment is the framework used for this literature appraisal. King’s theory focuses on the dynamic interacting systems for goal attainment (Gonzalo, 2011). Methods: Twenty-one original research articles involving labor induction methods were critically reviewed. Additionally, six systematic reviews involving labor induction methods were also included. Results/Findings: Labor induction is associated with an overall increased risk of cesarean section. Intravenous oxytocin use alone was associated with the highest risk of cesarean section when used in nulliparous women. The risk of cesarean section was not as high when a combination of labor induction methods was utilized. The use of mechanical cervical ripening agents, such as Foley-bulb or Cook catheters were associated with a lower rate of cesarean section when compared with pharmacological cervical ripening agents. Mechanical cervical ripening is also associated with a shorter duration of labor when used simultaneously with intravenous oxytocin. Implications for Research and Practice: Nurse-midwives need to be knowledgeable about the various methods for labor induction. It is crucial that they discuss the risks and benefits of labor induction with their patients and that labor inductions are not performed without medical indication. When a labor induction is performed nurse-midwives should utilize a combination of methods to shorten the duration of labor and minimize the risk of cesarean section. Conclusion: The findings of this critical review of the literature support the use of a combination of labor induction methods and avoiding non-medically indicated inductions due to the increased rate of cesarean section associated with labor induction.

Degree Name

M.S. Nurse-Midwifery

Document Type

Masterʼs thesis