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It is widely believed that induction of labour increases the chance of caesarean delivery, posing unnecessary risks to mother and fetus.1 ,2 While many past observational studies have found higher risk of adverse outcomes with elective induction, these studies have all had a singular methodological flaw, in that they have been designed to compare induction of labour to spontaneous labour at the same gestational age—a comparison that is not clinically relevant and is potentially misleading. Immediate spontaneous labour is not the clinical alternative to induction of labour, allowing …
Competing interests None.
Provenance and peer review Commissioned; internally peer reviewed.