Sample Informed Consent For Labor Induction
This is a sample and should be modified as needed
Creating a Culture of Safety on Labor & Delivery
A true culture of safety on Labor & Delivery requires more than protocols and checklists—it demands an environment where transparent communication, standardized practices, and psychological safety converge to protect both patients and providers.
This means fostering open dialogue about complications without blame, implementing evidence-based bundles for hemorrhage and hypertension, ensuring all team members feel empowered to speak up about safety concerns regardless of hierarchy, and maintaining rigorous documentation that captures not just what was done but why clinical decisions were made. Central to this culture is the practice of comprehensive informed consent that respects patient autonomy while acknowledging the inherent uncertainties in obstetrics. When we normalize detailed consent discussions about any interventions such as specific induction agents, off-label medication use, and method-specific outcomes, we move beyond defensive medicine toward truly patient-centered care that builds trust even when outcomes are imperfect.
A Sample Framework for Truly Informed Consent in Labor Induction
This sample consent form represents a framework for what comprehensive informed consent for labor induction should entail, particularly in our current era of increasing elective inductions at 39 weeks. Too often, consent for induction is obtained with vague discussions about “starting labor” without explicit documentation of which pharmacologic agents will be used, their specific dosing protocols, or—critically—their FDA approval status.
The reality that misoprostol remains off-label for labor induction despite decades of obstetric use deserves transparent disclosure, as does the method-specific risk profile that can vary significantly between oxytocin, misoprostol, dinoprostone, and mechanical methods.
Patients have the right to understand not just that their labor will be induced, but exactly how it will be accomplished and what the evidence shows about their specific induction plan.
It’s important to note that informed consent does not legally require a written form—verbal consent is equally valid when properly obtained and documented in the medical record.
Many institutions rely solely on documenting verbal consent discussions in progress notes, including the indications discussed, methods explained, risks and benefits reviewed, alternatives offered, and the patient’s questions and agreement. However, this template provides a structured approach that can be used either as a written consent form or as a checklist to ensure comprehensive verbal consent discussions.
Whether using written or verbal consent, the critical element is thorough documentation that captures the specifics of what was discussed, particularly regarding off-label medication use and method-specific risks.
In an era of informed decision-making and increasing medical litigation, particularly around induction-related complications, documenting these detailed conversations—whether through a signed form or comprehensive progress notes—is not just good medicine but essential risk management.
Consider this a starting point for your institution’s consent process, recognizing that true informed consent is achieved not through a form alone, but through meaningful dialogue that ensures patients understand both what we’re recommending and why their specific clinical situation warrants that particular approach.
Template: Informed Consent for Labor Induction
Patient Name: ____________ Date: _____________ MRN: _________________
What is labor induction?
Labor induction means using medications or other methods to start labor before it begins naturally on its own. About 1 in 4 women in the United States have their labor induced.
Why is labor induction being recommended for me?
Your doctor is recommending labor induction for the following reason(s):
You are at 39 weeks or beyond in your pregnancy
Your water broke but labor has not started on its own
You have high blood pressure or preeclampsia
You have diabetes
There are concerns about your baby’s growth or well-being
You have low amniotic fluid
Other: _______________________
What are my options?
Proceed with induction using the methods described below
Wait for labor to start naturally (if medically appropriate for your situation)
Cesarean delivery (in certain situations)
Your doctor has discussed which options are safe for you based on your specific situation.
What medications or methods will be used?
Your induction will involve one or more of the following:
[ ] Misoprostol (Cytotec)
Given as a small tablet placed in your vagina or taken by mouth
Important Notice: Misoprostol is FDA-approved for preventing stomach ulcers, NOT for labor induction. However, it has been used for many years to induce labor and is supported by medical organizations like ACOG (American College of Obstetricians and Gynecologists)
Dose planned: _____ micrograms every _____ hours
[ ] Oxytocin (Pitocin)
Given through an IV to cause contractions
The dose is adjusted based on your contraction pattern
[ ] Dinoprostone (Cervidil/Prepidil)
A medication placed in or near your cervix to help it soften and open
FDA-approved for cervical ripening
[ ] Balloon catheter
A small balloon placed in your cervix and inflated with water to help it open
No medications involved with this method
[ ] Breaking your water (amniotomy)
Your doctor uses a small tool to break the bag of water around your baby
[ ] Other: _________________
What are the risks of induction?
All methods of induction carry some risks, including but not limited to:
Failed induction (labor doesn’t progress, may need cesarean delivery) - happens in about 20-30% of first-time mothers
Contractions that are too strong or too close together (more common with misoprostol)
Changes in baby’s heart rate requiring close monitoring or emergency delivery
Bleeding after delivery
Infection
Very rare but serious: Uterine rupture (tear in the uterus) - risk is higher if you’ve had previous uterine surgery
What are the benefits of induction?
May reduce your risk of cesarean delivery (especially if done at 39 weeks in first pregnancies)
Prevents complications from continuing pregnancy when medically indicated
Allows for planned, monitored delivery
How long will induction take?
Induction can take anywhere from a few hours to 2-3 days. First-time mothers usually take longer. Your cervix needs to be ready (soft, thin, and starting to open) for induction to work well.
What happens if induction doesn’t work?
If your cervix doesn’t change or labor doesn’t progress after attempting induction, your doctor will discuss options including:
Trying a different induction method
Resting and trying again later
Proceeding with cesarean delivery
Monitoring during induction
You and your baby will be monitored closely throughout the induction process, including:
Continuous fetal heart rate monitoring
Regular checks of your contractions
Periodic cervical exams to check progress
Your consent
I understand:
Why induction is being recommended for me
The methods and medications that will be used, including that misoprostol is being used off-label
The potential risks and benefits
My alternatives
That I can ask questions at any time
That I can withdraw consent if medically safe to do so
I have had the opportunity to ask questions, and they have been answered to my satisfaction.
[ ] I CONSENT to labor induction using the methods indicated above [ ] I DECLINE labor induction at this time and understand the risks of this decision
Patient Signature: _________________________________ Date/Time: _________________
Provider Signature: ________________________________ Date/Time: _________________
Interpreter (if used): _______________________________ ID#: _____________________
Retry