This study is a secondary analysis of the WHO Global Survey (WHOGS) and the WHO Multi-country Survey (WHOMCS) conducted in Africa, Asia, Latin America and the Middle East. There were 33,003 women with low risk singleton pregnancies at ≥41 completed weeks from 292 facilities in 21 countries. Compared to induction of labour (IOL), ECS significantly increased risk of NICU admission while EM was significantly associated with decreased risk of CS. ECS should not be recommended for women at 41 completed weeks of pregnancy. However, the choice between IOL and EM should be cautiously considered since the available evidences are still quite limited.


  1. WHO. World Health Organization recommendations for induction of Labour 2011.

  2. Martin JA, Hamilton BE, Ventura SJ. Et al.National Vital Statistics Reports. Report no. 1.Hyattsville, Maryland. United States of America: National Vital Statistics System; 2012

  3. The Health and Social Care Information Centre.NHS Maternity Statistics 2011-2012 Summary report. Geneva, Switzerland: National Health Service; 2012


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