{
  "release_id": "cb1244a2c7003676",
  "id": "maternal:guide-induction-questions",
  "owner": "maternal",
  "kind": "patient_guide",
  "slug": "induction-questions",
  "name": "Questions to ask about induction",
  "aliases": [],
  "atlases": [
    "maternal"
  ],
  "summary_plain": "What the sources say about why labour may be induced, how induction is done, and what the ARRIVE and SWEPIS trials studied, with questions to ask a clinician.",
  "summary_technical": "Static guide from a MedlinePlus page, an NICHD page, the ARRIVE registry record, claims on the two trials, a SWEPIS abstract and three US product records. It gives no advice and takes no input.",
  "editorial_state": "draft",
  "last_substantive_edit": "2026-10-15",
  "last_evidence_check": "2026-10-15",
  "next_review_due": "2027-04-15",
  "identifiers": [],
  "navigation": {
    "maternal": {
      "life-stage": [
        "pregnancy",
        "childbirth"
      ],
      "care-area": [
        "labour-and-birth"
      ]
    }
  },
  "payload": {
    "purpose": "preparing_for_care",
    "audience": "People who are pregnant and thinking about induction, and the people with them",
    "about": [
      "maternal:induction-of-labour",
      "maternal:arrive-trial",
      "maternal:swepis-trial",
      "maternal:cook-cervical-ripening-balloon",
      "maternal:dinoprostone",
      "maternal:labour-and-birth"
    ],
    "reading_grade_target": 9,
    "scope_note": "Written from two US government health pages, a trial registry record, summaries of two trials and three US product records. The NICHD page was last reviewed in 2017. It does not compare methods of induction.",
    "warning_blocks": [],
    "sections": [
      {
        "heading": "What induction is and why it may be done",
        "statements": [
          {
            "id": "what-1",
            "text": "MedlinePlus says induction uses medicines or other methods to start labour.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-childbirth-2026-10-15",
                "locator": "Summary, What are the stages of labor?, paragraph 4, sentences 1 and 2"
              }
            ]
          },
          {
            "id": "what-2",
            "text": "NICHD says induction is used to make contractions start so that delivery can occur.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Opening paragraph, sentence 2"
              }
            ]
          },
          {
            "id": "why-1",
            "text": "MedlinePlus says induction is usually done only for one of two reasons.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-childbirth-2026-10-15",
                "locator": "Summary, What are the stages of labor?, paragraph 4, sentence 3, part 1"
              },
              {
                "snapshot_id": "maternal:medlineplus-childbirth-2026-10-15",
                "locator": "Summary, What are the stages of labor?, paragraph 4, sentence 3, part 2"
              }
            ]
          },
          {
            "id": "why-2",
            "text": "One is that the due date has passed.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-childbirth-2026-10-15",
                "locator": "Summary, What are the stages of labor?, paragraph 4, sentence 3, part 1"
              }
            ]
          },
          {
            "id": "why-3",
            "text": "The other is a problem with the pregnancy that risks the health of the mother or the fetus.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-childbirth-2026-10-15",
                "locator": "Summary, What are the stages of labor?, paragraph 4, sentence 3, part 2"
              }
            ]
          },
          {
            "id": "why-4",
            "text": "NICHD also says induction is usually used only for those two reasons.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "When would a provider induce labor?"
              }
            ]
          },
          {
            "id": "why-5",
            "text": "The NICHD page on induction shows a last reviewed date of 9/1/2017.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Page footer, Last Reviewed Date"
              }
            ]
          },
          {
            "id": "why-5b",
            "text": "The ARRIVE results were published in 2018 and the SWEPIS results in 2019, after that review.",
            "cites": [
              {
                "snapshot_id": "maternal:pubmed-30089070-2026-10-14",
                "locator": "Journal issue, publication date"
              },
              {
                "snapshot_id": "maternal:pubmed-31748223-2026-10-14",
                "locator": "Journal issue, publication date"
              }
            ]
          },
          {
            "id": "why-6",
            "text": "NICHD says that in most cases induction is limited to a problem with the pregnancy or to a pregnancy that has gone past the infant's due date.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Can induction be requested?, sentence 1, part 1"
              },
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Can induction be requested?, sentence 1, part 2"
              }
            ]
          },
          {
            "id": "why-7",
            "text": "NICHD says that women who want induction for non-medical reasons can discuss it with their health care providers.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Can induction be requested?, sentence 3"
              }
            ]
          },
          {
            "id": "why-8",
            "text": "The US Pitocin label lists induction for a medical indication, with examples that include maternal diabetes and pre-eclampsia at or near term.",
            "cites": [
              {
                "claim": "maternal:claim-fda-nda018261-pitocin"
              }
            ]
          }
        ]
      },
      {
        "heading": "Getting the cervix ready",
        "statements": [
          {
            "id": "rip-1",
            "text": "NICHD says providers use a scoring system, called the Bishop score, to judge how ready the cervix is for labour.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Monitoring the Body's Preparation for Labor, paragraph 2, sentence 1"
              }
            ]
          },
          {
            "id": "rip-2",
            "text": "If the cervix is not ready, NICHD says a provider may suggest one of three steps to ripen it.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Preparing the Cervix for Labor, lead-in"
              }
            ]
          },
          {
            "id": "rip-3",
            "text": "The three steps are stripping the membranes, giving prostaglandins and inserting a catheter.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Preparing the Cervix for Labor, list item 1"
              },
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Preparing the Cervix for Labor, list item 2"
              },
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Preparing the Cervix for Labor, list item 3"
              }
            ]
          },
          {
            "id": "rip-4",
            "text": "NICHD describes stripping the membranes as separating the thin tissue of the amniotic sac from the wall of the uterus.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Preparing the Cervix for Labor, list item 1"
              }
            ]
          },
          {
            "id": "rip-5",
            "text": "NICHD says this makes the body release prostaglandins, which soften the cervix and cause contractions.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Preparing the Cervix for Labor, list item 1"
              }
            ]
          },
          {
            "id": "rip-6",
            "text": "NICHD says prostaglandins may be inserted into the vagina or given by mouth.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Preparing the Cervix for Labor, list item 2"
              }
            ]
          },
          {
            "id": "rip-7",
            "text": "NICHD adds that the body makes prostaglandins naturally to ripen the cervix, but that sometimes extra amounts are needed.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Preparing the Cervix for Labor, list item 2"
              }
            ]
          },
          {
            "id": "rip-8",
            "text": "NICHD describes the catheter as a small tube with an inflatable balloon on the end that can be placed in the cervix to widen it.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Preparing the Cervix for Labor, list item 3"
              }
            ]
          }
        ]
      },
      {
        "heading": "Starting contractions",
        "statements": [
          {
            "id": "start-1",
            "text": "NICHD says a provider may recommend amniotomy or oxytocin once the cervix is ripe.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "How is labor induced?, lead-in"
              },
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "How is labor induced?, list item 1"
              },
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "How is labor induced?, list item 2"
              }
            ]
          },
          {
            "id": "start-2",
            "text": "NICHD says these techniques start contractions or make them stronger.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "How is labor induced?, lead-in"
              }
            ]
          },
          {
            "id": "start-3",
            "text": "NICHD describes amniotomy as making a small hole in the amniotic sac, so that the water breaks and contractions start.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "How is labor induced?, list item 1"
              }
            ]
          },
          {
            "id": "start-4",
            "text": "NICHD says oxytocin, also called Pitocin, is a hormone the body makes that causes contractions.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "How is labor induced?, list item 2"
              }
            ]
          },
          {
            "id": "start-5",
            "text": "NICHD says oxytocin is given to start labour or to speed up labour that has already begun.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "How is labor induced?, list item 2"
              }
            ]
          }
        ]
      },
      {
        "heading": "What the US labels say about three products",
        "statements": [
          {
            "id": "lab-1",
            "text": "The US label for Cervidil, a vaginal insert, covers starting or continuing cervical ripening at or near term.",
            "cites": [
              {
                "claim": "maternal:claim-fda-nda020411-cervidil"
              }
            ]
          },
          {
            "id": "lab-2",
            "text": "It applies to pregnant women who have a medical or obstetrical (pregnancy-related) reason for induction.",
            "cites": [
              {
                "claim": "maternal:claim-fda-nda020411-cervidil"
              }
            ]
          },
          {
            "id": "lab-3",
            "text": "FDA cleared the Cook Cervical Ripening Balloon in 2013.",
            "cites": [
              {
                "claim": "maternal:claim-fda-k131206"
              }
            ]
          },
          {
            "id": "lab-4",
            "text": "The cleared use is mechanical dilation of the cervical canal before labour induction at term, when the cervix is unfavorable (not ready) for induction.",
            "cites": [
              {
                "claim": "maternal:claim-fda-k131206"
              }
            ]
          },
          {
            "id": "lab-5",
            "text": "The Pitocin label has a boxed notice about elective induction.",
            "cites": [
              {
                "claim": "maternal:claim-fda-nda018261-pitocin"
              }
            ]
          },
          {
            "id": "lab-6",
            "text": "The notice defines elective induction as starting labour in a pregnant individual who has no medical indication for induction.",
            "cites": [
              {
                "snapshot_id": "maternal:openfda-label-6e5a66fc-e507-497c-b5ce-44a8c95898ad-2026-10-14",
                "locator": "results[0].boxed_warning[0], sentence 1"
              }
            ]
          },
          {
            "id": "lab-7",
            "text": "The notice says \"the available data are inadequate to evaluate the benefits-to-risks considerations\", and that Pitocin is not indicated for elective induction.",
            "cites": [
              {
                "snapshot_id": "maternal:openfda-label-6e5a66fc-e507-497c-b5ce-44a8c95898ad-2026-10-14",
                "locator": "results[0].boxed_warning[0], sentence 2"
              },
              {
                "claim": "maternal:claim-fda-nda018261-pitocin"
              }
            ]
          },
          {
            "id": "lab-8",
            "text": "The atlas records for these products note that a label or clearance is not a recommendation to use a product for any woman.",
            "cites": [
              {
                "claim": "maternal:claim-fda-nda018261-pitocin"
              },
              {
                "claim": "maternal:claim-fda-nda020411-cervidil"
              },
              {
                "claim": "maternal:claim-fda-k131206"
              }
            ]
          },
          {
            "id": "lab-9",
            "text": "They add that labelled uses differ by country.",
            "cites": [
              {
                "claim": "maternal:claim-fda-nda018261-pitocin"
              },
              {
                "claim": "maternal:claim-fda-nda020411-cervidil"
              }
            ]
          }
        ]
      },
      {
        "heading": "What the ARRIVE trial studied",
        "statements": [
          {
            "id": "wk-1",
            "text": "MedlinePlus says labour usually begins between 37 and 42 weeks of pregnancy.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-childbirth-2026-10-15",
                "locator": "Summary, What is childbirth?, paragraph 2, sentence 2"
              }
            ]
          },
          {
            "id": "wk-2",
            "text": "In both trials, expectant management means waiting instead of inducing at the set week.",
            "cites": [
              {
                "snapshot_id": "maternal:ctgov-nct01990612-2026-10-14",
                "locator": "protocolSection.armsInterventionsModule.armGroups[0].description"
              },
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "arr-1",
            "text": "ARRIVE was a multicentre trial in the United States of low-risk first-time mothers.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-primary-composite"
              }
            ]
          },
          {
            "id": "arr-2",
            "text": "The women were randomly assigned at 38 weeks 0 days to 38 weeks 6 days.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-primary-composite"
              }
            ]
          },
          {
            "id": "arr-3",
            "text": "They were assigned either to induction between 39 weeks 0 days and 39 weeks 4 days, or to expectant management.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-primary-composite"
              }
            ]
          },
          {
            "id": "arr-4",
            "text": "The ARRIVE registry record labels the induction group \"Elective Induction of Labor\".",
            "cites": [
              {
                "snapshot_id": "maternal:ctgov-nct01990612-2026-10-14",
                "locator": "protocolSection.armsInterventionsModule.armGroups[1].label"
              }
            ]
          },
          {
            "id": "arr-5",
            "text": "The registry record says the induction group was to be induced with oxytocin.",
            "cites": [
              {
                "snapshot_id": "maternal:ctgov-nct01990612-2026-10-14",
                "locator": "protocolSection.armsInterventionsModule.interventions[0].description"
              }
            ]
          },
          {
            "id": "arr-6",
            "text": "The registry record says the other group was managed expectantly, unless a medical indication arose, until at least 40 weeks 5 days.",
            "cites": [
              {
                "snapshot_id": "maternal:ctgov-nct01990612-2026-10-14",
                "locator": "protocolSection.armsInterventionsModule.armGroups[0].description"
              }
            ]
          },
          {
            "id": "arr-mask",
            "text": "The ARRIVE registry lists no masking, so women and staff knew each group.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-primary-composite"
              }
            ]
          },
          {
            "id": "arr-7",
            "text": "The main outcome was a composite, a single count of several outcomes: death around birth or severe newborn complications.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-primary-composite"
              }
            ]
          },
          {
            "id": "arr-8",
            "text": "It occurred in 4.3% of babies in the group assigned to induction and 5.4% in the group assigned to expectant management.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-primary-composite"
              }
            ]
          },
          {
            "id": "arr-9",
            "text": "The authors report that induction did not result in a significantly lower frequency of that combined outcome, meaning a difference no larger than chance alone would explain.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-primary-composite"
              }
            ]
          },
          {
            "id": "arr-10",
            "text": "Caesarean delivery was the main secondary outcome.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-cesarean"
              }
            ]
          },
          {
            "id": "arr-11",
            "text": "It occurred in 18.6% of women in the group assigned to induction and 22.2% in the group assigned to expectant management, a significantly lower frequency with induction.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-cesarean"
              }
            ]
          },
          {
            "id": "arr-12",
            "text": "The ARRIVE results concern low-risk first-time mothers assigned to induction at 39 weeks.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-primary-composite"
              },
              {
                "claim": "maternal:claim-arrive-cesarean"
              }
            ]
          },
          {
            "id": "arr-13",
            "text": "They do not describe induction for a medical reason or at other times.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-primary-composite"
              },
              {
                "claim": "maternal:claim-arrive-cesarean"
              }
            ]
          }
        ]
      },
      {
        "heading": "What the SWEPIS trial studied",
        "statements": [
          {
            "id": "swe-1",
            "text": "SWEPIS was a Swedish trial in women with an uncomplicated, low-risk pregnancy of one baby.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-2",
            "text": "The women were randomly assigned either to be induced at 41 weeks or to wait, with induction planned at 42 weeks.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-3",
            "text": "The main outcome was a composite that included stillbirth, newborn death and a list of serious newborn problems.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-4",
            "text": "It occurred in 2.4% of pregnancies in the group assigned to induction, and in 2.2% of those assigned to expectant management.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-5",
            "text": "The difference was not significant.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-6",
            "text": "No deaths around birth occurred in the group assigned to induction.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-7",
            "text": "Six occurred in the group assigned to expectant management: five stillbirths and one death in the early newborn period.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-8",
            "text": "The trial was stopped early because deaths around birth were more frequent among the women managed expectantly.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-9",
            "text": "The authors call the lower mortality a secondary outcome and ask for cautious interpretation.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-11",
            "text": "The groups did not differ in caesarean births, in instrumental vaginal births, or in major maternal morbidity.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-maternal"
              }
            ]
          },
          {
            "id": "swe-12",
            "text": "The trial was open label, meaning women and staff knew each group, and it was stopped early.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-13",
            "text": "The expectant management group could still be induced at 42 weeks.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          },
          {
            "id": "swe-14",
            "text": "So SWEPIS compares two timings of induction, not induction against no induction.",
            "cites": [
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          }
        ]
      },
      {
        "heading": "Reading the two trials together",
        "statements": [
          {
            "id": "both-1",
            "text": "The two trials used different weeks, countries and groups of women, so each result describes its own group.",
            "cites": [
              {
                "claim": "maternal:claim-arrive-primary-composite"
              },
              {
                "claim": "maternal:claim-swepis-perinatal"
              }
            ]
          }
        ]
      }
    ],
    "checklists": [
      {
        "heading": "Topics the sources raise about induction",
        "items": [
          {
            "id": "ck-1",
            "text": "The reason for induction, which MedlinePlus and NICHD give as a problem with the pregnancy or a due date that has passed.",
            "cites": [
              {
                "snapshot_id": "maternal:medlineplus-childbirth-2026-10-15",
                "locator": "Summary, What are the stages of labor?, paragraph 4, sentence 3, part 1"
              },
              {
                "snapshot_id": "maternal:medlineplus-childbirth-2026-10-15",
                "locator": "Summary, What are the stages of labor?, paragraph 4, sentence 3, part 2"
              },
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "When would a provider induce labor?"
              }
            ]
          },
          {
            "id": "ck-2",
            "text": "How ready the cervix is, which NICHD says providers judge with the Bishop score.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Monitoring the Body's Preparation for Labor, paragraph 2, sentence 1"
              }
            ]
          },
          {
            "id": "ck-3",
            "text": "Which steps would be used to ripen the cervix or to start contractions, among those NICHD lists.",
            "cites": [
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "Preparing the Cervix for Labor, lead-in"
              },
              {
                "snapshot_id": "maternal:nichd-labor-induction-2026-10-15",
                "locator": "How is labor induced?, lead-in"
              }
            ]
          },
          {
            "id": "ck-4",
            "text": "The week of pregnancy, because ARRIVE and SWEPIS each tested induction at a set week.",
            "cites": [
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                "claim": "maternal:claim-arrive-primary-composite"
              },
              {
                "claim": "maternal:claim-swepis-perinatal"
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            ]
          },
          {
            "id": "ck-5",
            "text": "The kind of pregnancy, because both trials studied low-risk women.",
            "cites": [
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                "claim": "maternal:claim-arrive-primary-composite"
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              {
                "claim": "maternal:claim-swepis-perinatal"
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        ]
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    ],
    "questions": [
      {
        "text": "What is the reason induction is being suggested: a problem with the pregnancy, or a due date that has passed?",
        "grounded_in": [
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      },
      {
        "text": "Is there a medical reason for induction here, and what would waiting for labour to start on its own involve?",
        "grounded_in": [
          "why-6",
          "why-7",
          "arr-6",
          "swe-2"
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      },
      {
        "text": "How ready is the cervix, and would it need to be ripened before labour is induced?",
        "grounded_in": [
          "rip-1",
          "rip-2"
        ]
      },
      {
        "text": "Which methods would be used to ripen the cervix or start contractions, and what does each one involve?",
        "grounded_in": [
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          "rip-6",
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      {
        "text": "Which medicine or device might be used, and what is it labelled for?",
        "grounded_in": [
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          "lab-4",
          "lab-5",
          "lab-7"
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      },
      {
        "text": "Do the ARRIVE or SWEPIS results apply to this pregnancy, given who took part in each trial?",
        "grounded_in": [
          "arr-12",
          "arr-13",
          "swe-14",
          "both-1"
        ]
      },
      {
        "text": "What are the possible benefits and risks of induction at this point in pregnancy, compared with waiting?",
        "grounded_in": [
          "arr-8",
          "arr-11",
          "swe-4",
          "swe-7",
          "swe-11"
        ]
      },
      {
        "text": "If waiting is chosen, at what point would induction be offered?",
        "grounded_in": [
          "arr-6",
          "swe-2"
        ]
      }
    ]
  },
  "content_digest": "29442f10b4c5aa133d4611cf9bc61d9b3cc7ba49e1b730f6daf06fe54df6c2e8",
  "review": {
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  "page_path": "guides/induction-questions/",
  "context_path": "api/v1/context/maternal--guide-induction-questions.md"
}