Optimising the outcomes of induction of labour through robust evidence. 3.What is actually happening on the ground? Induction of labour timing, methods, and policies worldwide, comparing high-income countries versus low-income/low-middle-income countries

Induction of labour is carried out when the risks of advancing gestation outweigh maternal and foetal benefits. It is one of the most frequent obstetric interventions, accounting for nearly one-fourth of all births in high-income countries and generally lower rates in low- and middle-income countries. Recent rates of labour induction have been reported to be as high as 34% in the UK, 23% in the USA, and 25-35% in Australia. This rate will likely rise further due to evidence from the recent ARRIVE trial. The body of evidence is still growing. The goal is to find a method that can mimic the natural, spontaneous onset of labour with equal or higher maternal satisfaction and prioritise the seemingly less-medicated methods, putting safety first. There should be more room for client satisfaction, specifically evaluated in qualitative studies. Attention should also be given to the practical, cost-effective methods in low- and middle-income countries as they bear a significant portion of the global maternal and perinatal morbidity and mortality. Low-resource settings struggle with higher maternal and perinatal adverse outcome rates. All the large randomised controlled trials have been conducted in high-income settings, and major clinical guidelines are designed for the practice in the same settings. However, the epidemiology of labour induction varies in diverse resource settings worldwide. It is important to ensure the clinicians practise the evidence we are generating and look for potential barriers where it does not happen. This study will assess the induction of labour timing, methods, and policies in all countries, comparing high-income countries versus low-income/low-middle-income countries: a large online mixed-methods study. Targeted participants are members of FIGO representative country organisations in each country (for example RANZCOG in Australia).