Background The proportion of women undergoing induction of labour (IOL) has risen in recent decades, with significant variation within countries and between hospitals. The aim of this study was to review research supporting indications for IOL and determine which indications are supported by evidence and where knowledge gaps exist. Methods A systematic scoping review of quantitative studies of common indications for IOL. For each indication, we included systematic reviews/meta-analyses, randomised controlled trials (RCTs), cohort studies and case control studies that compared maternal and neonatal outcomes for different modes or timing of birth. Studies were identified via the databases PubMed, Maternity and Infant Care, CINAHL, EMBASE, and ClinicalTrials.gov from between April 2008 and November 2019, and also from reference lists of included studies. We identified 2554 abstracts and reviewed 300 full text articles. The quality of included studies was assessed using the RoB 2.0, the ROBINS-I and the ROBIN tool. Results 68 studies were included which related to post-term pregnancy (15), hypertension/preeclampsia (15), diabetes (9), prelabour rupture of membranes (5), twin pregnancy (5), suspected fetal compromise (4), maternal elevated body mass index (BMI) (4), intrahepatic cholestasis of pregnancy (3), suspected macrosomia (3), fetal gastroschisis (2), maternal age (2), and maternal cardiac disease (1). Available evidence supports IOL for women with post-term pregnancy, although the evidence is weak regarding the timing (41 versus 42

BackgroundIn many countries, planned vaginal breech birth (VBB) is a rare event. After the Term Breech Trial in 2000, VBB reduced and caesarean section for breech presentation increased. Despite this, women still request VBB. The objective of this study was to explore the experiences and decision-making processes of women who had sought a VBB.MethodsA qualitative study using descriptive exploratory design was undertaken. Twenty-two (n = 22) women who planned a VBB, regardless of eventual mode of birth were recruited. The women had given birth at one of two maternity hospitals in Australia that supported VBB. In-depth, semi-structured interviews using an interview guide were conducted. Interviews were analysed thematically.ResultsTwenty two women were interviewed; three quarters were primiparous (n = 16; 73%). Nine (41%) were already attending a hospital that supported VBB with the remaining women moving hospitals. All women actively sought a vaginal breech birth because the baby remained breech after an external cephalic version – 12 had a vaginal birth (55%) and 10 (45%) a caesarean section after labour commenced. There were four main themes: Reacting to a loss of choice and control, Wanting information that was trustworthy, Fighting the system and seeking support for VBB and The importance of ‘having a go’ at VBB.ConclusionsWomen seeking a VBB value clear, consistent and relevant information in deciding about mode of birth. Women desire autonomy to choose vaginal breech birth and to be supported in their choice with high quality care.

for women seeking vaginal breech birth, limited system and clinical support can impede access to balanced information and options for care. Recognition of existing evidence on the safety of vaginal breech birth, as well as the presence of clinical guidelines that support it, may assist in promoting vaginal breech birth as a legitimate option that should be available to women.

The women who responded to this international survey sought the option of a vaginal breech birth, were subsequently happy with this decision, and would attempt a vaginal breech birth in their next pregnancy. Access to vaginal breech birth is important for some women; however, this choice may be challenging to achieve. Consistent information and support from clinicians is important to assist decision-making.

In this article, we aim to explore the impact of social discourses of risk around childbirth on the decisions made for birth by women who planned to have a breech baby late in pregnancy. This article uses data from a qualitative descriptive study in New South Wales, Australia in 2013. In the study we talked to 22 women about their decision making process for planned a vaginal breech birth and the impact of social discourses of risk on this decision. Twelve of these women had a vaginal birth and the other 10 had a caesarean section. In this article we note that the mothers' talked about their option in a social setting in which the dominant discourse focussed on the riskiness of breech birth and the vulnerability of female bodies that required medical surveillance, supervision and intervention to ensure a safe delivery. Thus for these mothers their pregnancy was seen through the societal lens of risk and medicalisation with surgical intervention through a caesarean section, the optimum outcome. Women could resist this dominant discourse but such resistance required both justification and action, for example the women who wanted a vaginal birth often had to resist the pressure for their families to have a Caesarean section. We identified four related strands in women's talk about resisting the dominate discourse: acknowledgment that they would be considered irrational for wanting a vagina birth; having confidence in and believing that their body could give birth vaginally, 4 convincing significant others that a vaginal birth was possible and desirable and looking for sources of support, for example form new on-line social networks