Efficacy and Safety of Non-Pharmacological Methods of Induction of Labour Compared to Pharmacological Methods in Term Pregnant Women: Protocol for Systematic Review and Meta-Analysis

Introduction Induction of labor is a widely used obstetric procedure aimed at stimulating uterine contractions before spontaneous onset. While pharmacological methods such as oxytocin and prostaglandins are commonly used, non-pharmacological alternatives like membrane sweeping, nipple stimulation, and acupuncture are gaining attention due to their perceived safety and acceptability. Objective To compare the efficacy and safety of non-pharmacological versus pharmacological methods for induction of labor in term pregnant women. Methods This protocol follows the PRISMA-P guidelines and is registered in PROSPERO. We will include randomized controlled trials (RCTs) that compare pharmacological and non-pharmacological methods of labor induction among women at term (37–42 weeks of gestation). Databases including MEDLINE, Embase, Cochrane Library, CINAHL, Scopus, and others will be systematically searched. Primary outcomes include vaginal delivery rate and the incidence of non-reassuring fetal heart rate patterns. Secondary outcomes encompass time to onset of labor, cesarean section rate, maternal and neonatal complications, among others. Risk of bias will be assessed using the Cochrane RoB 2 tool, and evidence certainty will be graded using the GRADE approach. Data will be synthesized using RevMan 5.4 and, if feasible, meta-analyses will be conducted. Expected Results We anticipate identifying a range of studies that evaluate both intervention types, which will allow us to quantify differences in efficacy and safety. This evidence may highlight specific contexts or populations where one method is more favorable. Conclusion This systematic review aims to provide high-quality evidence on the comparative effectiveness and safety of pharmacological versus non-pharmacological labor induction methods, ultimately guiding clinical decision-making and informing patient care.