Induction of labor is one of the most common procedures on L&D. This episode covers the indications (including the landmark ARRIVE trial for 39-week elective induction), the Bishop score for determining readiness, cervical ripening options, pitocin protocols, and the criteria for failed induction. Show Outline: Indications – Post-dates (42+wks), late term (41+wks), elective 39+wks, diabetes, hypertension, and many more per ACOG ARRIVE Trial – Multicenter RCT showing 39wk IOL in low-risk primips had a LOWER c-section rate vs. expectant management to ~41wks, with a trend toward fewer neonatal complications. Many pregnant people are now offered a 39wk IOL. Evaluate and Prep – Full H&P, ultrasound for vertex position, cervical exam (dilation/effacement/station/position/consistency), calculate Bishop score Options for IOL If Bishop <8 (primip) or <6 (multip) → ripen first! Mechanical cervical ripening (balloon) Chemical cervical ripening (misoprostol or cervidil) Best yet – both! ...