J Clin Gynecol Obstet

Journal of Clinical Gynecology and Obstetrics, ISSN 1927-1271 print, 1927-128X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Gynecol Obstet and Elmer Press Inc

Journal website https://jcgo.elmerpub.com

Original Article

Volume 15, Number 3, September 2026, pages 97-113

Exploring Traditional Labor Practices: The Efficacy and Safety of Wives’ Tales Methods for Labor Induction and Augmentation

↓ **Table 1.** Inclusion and Exclusion Criteria
Study characteristics	Inclusion criteria	Exclusion criteria
Population	Pregnant patients with delivery during third trimester Intervention initiated prior to labor and occurred in the third trimester	Intervention occurred before third trimester Intervention initiated during labor Non-human subjects
Context	Discusses “wives’ tales” methods to augment labor in the setting of pregnancy	Does not discuss “wives’ tales” methods to augment labor in the setting of pregnancy Only discusses pain management in labor
Publication year	On or after 2005	Before 2005
Study design	Randomized controlled trials, cohort, case control, cross sectional, retrospective chart reviews, case series > 5 participants	Literature reviews, scoping reviews, meta-analyses, editorials, case reports, case series < 5 participants
Language	English	Non-English

↓ Table 1. Inclusion and Exclusion Criteria

Study characteristics

Inclusion criteria

Exclusion criteria

Population

Pregnant patients with delivery during third trimester
Intervention initiated prior to labor and occurred in the third trimester

Intervention occurred before third trimester
Intervention initiated during labor
Non-human subjects

Context

Discusses “wives’ tales” methods to augment labor in the setting of pregnancy

Does not discuss “wives’ tales” methods to augment labor in the setting of pregnancy
Only discusses pain management in labor

Publication year

On or after 2005

Before 2005

Study design

Randomized controlled trials, cohort, case control, cross sectional, retrospective chart reviews, case series > 5 participants

Literature reviews, scoping reviews, meta-analyses, editorials, case reports, case series < 5 participants

Language

English

Non-English

↓ **Table 2.** Acupuncture & Acupressure for Induction of Labor
Study	Groups	Labor Initiation	Timing	Secondary findings
Labor initiation: rate of spontaneous labor or rate of requiring induction; Timing: duration of intervention to labor onset or intervention to delivery of newborn; IG: intervention group; CG: control group.
Ajori et al (2013) [5]	IG: Acupressure CG: Sham acupressure	Spontaneous labor: IG: 94.7% CG: 89.2% P = 0.430	Intervention to delivery: IG: 7.76 ± 6.84 days CG: 9.46 ± 5.97 days P = 0.066	Delivery method: Rate of vaginal delivery: P = 0.191
Alsharnoubi et al (2015) [6]	IG: Laser acupuncture CG: Sham laser	Spontaneous labor: IG: 66.7% CG: 26.7% P = 0.002	-	Delivery method: Higher rate of vaginal delivery in IG: P = 0.002
Asher et al (2009) [7]	IG: TCM acupuncture CG: Sham acupuncture	Spontaneous labor: IG: 67% CG: 69% P = 0.66	Intervention to delivery: IG: 9.3 ± 2.2 days CG: 11.9 ± 2.2 days P = 0.066	Delivery method: Rate of cesarean section: P = 0.37
Cole (2017) [8]	IG: Electroacupuncture CG: None	Required induction: IG: 0%	Intervention to delivery: Less than 26 h after first treatment IG: 37.5%	-
Gaudet et al (2008) [9]	IG: Acupressure CG: Sham acupressure	Required induction: IG: 66% CG: 71% P = 0.42	Intervention to delivery: IG: 146 h CG: 208 h P = 0.070	Labor duration: P = 0.14
Gregson et al (2015) [10]	IG: Acupressure CG: Sham treatment	Required induction: IG: 41% CG: 24% P = 0.04	Intervention to labor: IG: 103 h CG: 72 h P = 0.19	Delivery method: Rate of vaginal delivery: P = 0.90
Gribel et al (2011) [11]	IG: Electroacupuncture CG: Misoprostol	Spontaneous labor: IG: 42.9% CG: 40.6% P = 0.28	-	Delivery method: Higher rate of vaginal delivery in IG: P = 0.01 Labor duration: Longer in IG: P = 0.03
Harper et al (2006) [12]	IG: Acupuncture CG: Standard care	Spontaneous labor IG: 70% CG: 50% P = 0.12	Intervention to delivery: IG: 124 ± 86.7 h CG: 145 ± 82.7 h P = 0.36	Delivery method: Rate of cesarean section: P = 0.07
Koh et al (2019) [13]	IG: CAM (acupressure/reflexology) CG: Standard care	Required induction: Nulliparous patients IG: 44% CG: 42% P = 0.52	Intervention to labor: IG: 17.2 h CG: 14.6 h P = 0.009 Intervention to delivery: IG: 23.8 CG: 21.2 P = 0.0001	Labor duration: 3.2 h longer in IG: P = 0.0001
Lokugamage et al (2020) [14]	IG: Acupuncture CG: Standard care	Required induction: P = 0.29	-	-
McCullough et al (2017) [15]	IG: Reflexology CG: Standard care	Required induction: IG: 41.7% CG: 36% P = 0.986	-	Delivery method: Rate of vaginal delivery: P = 0.716 Second stage duration: Significantly reduced in IG: P < 0.05
Modlock et al (2010) [16]	IG: Acupuncture CG: Sham acupuncture	Spontaneous labor: IG: 11.7% CG: 13.8% P = 0.79	-	Cervical dilation: P = 0.90 Labor duration: P = 0.38 First stage duration: P = 0.51 Second stage duration: P = 0.52
Mollart et al (2016) [17]	IG: Acupressure CG: Standard care	Spontaneous labor: IG: 50% CG: 40.9% P = 0.37	-	Delivery method: Rate of vaginal delivery: P = 0.48
Neri et al (2014) [18]	IG: Acupuncture CG: Standard care	Required induction: IG: 20% CG: 17% P > 0.05	-	-
Neri et al (2018) [19]	IG: Acupuncture CG: Standard care	Spontaneous labor: IG: 75% CG: 52.8% P < 0.01	-	Delivery method: Rate of cesarean section: P > 0.05
Smith et al (2008) [20]	IG: Acupuncture CG: Sham acupuncture	Spontaneous labor: IG: 28.2% CG: 57% P = 0.83	-	Bishop score: P = 0.34
Teimoori et al (2014) [21]	IG: Shiatsu CG: Standard care	Spontaneous labor: IG: 56.9% CG: 8.3% P < 0.001	Intervention to labor: IG: 25.5 h CG: 9.9 h P > 0.05	Delivery method: Rate of vaginal delivery: P = 0.207 Labor duration: P > 0.05 First stage duration: P > 0.05 Second stage duration: P > 0.05
Torkzahrani et al (2015) [22]	IG: Acupressure CG: Standard care	-	-	Bishop score: Greater improvement within 48 h in IG: P = 0.012 Delivery method: Rate of vaginal delivery: P = 0.726
Torkzahrani et al (2017) [23]	IG: Acupressure CG: Sham acupressure	Spontaneous labor: < 48 h IG: 30% CG: 20% P = 0.464	Intervention to delivery: IG: 124.88 ± 75.93 h CG: 135.39 ± 70.09 h P = 0.565	-

↓ Table 2. Acupuncture & Acupressure for Induction of Labor

Study

Groups

Labor Initiation

Timing

Secondary findings

Labor initiation: rate of spontaneous labor or rate of requiring induction; Timing: duration of intervention to labor onset or intervention to delivery of newborn; IG: intervention group; CG: control group.

Ajori et al (2013) [5]

IG: Acupressure
CG: Sham acupressure

Spontaneous labor:
IG: 94.7%
CG: 89.2%
P = 0.430

Intervention to delivery:
IG: 7.76 ± 6.84 days
CG: 9.46 ± 5.97 days
P = 0.066

Delivery method:
Rate of vaginal delivery: P = 0.191

Alsharnoubi et al (2015) [6]

IG: Laser acupuncture
CG: Sham laser

Spontaneous labor:
IG: 66.7%
CG: 26.7%
P = 0.002

Delivery method:
Higher rate of vaginal delivery in IG: P = 0.002

Asher et al (2009) [7]

IG: TCM acupuncture
CG: Sham acupuncture

Spontaneous labor:
IG: 67%
CG: 69%
P = 0.66

Intervention to delivery:
IG: 9.3 ± 2.2 days
CG: 11.9 ± 2.2 days
P = 0.066

Delivery method:
Rate of cesarean section: P = 0.37

Cole (2017) [8]

IG: Electroacupuncture
CG: None

Required induction:
IG: 0%

Intervention to delivery:
Less than 26 h after first treatment
IG: 37.5%

Gaudet et al (2008) [9]

IG: Acupressure
CG: Sham acupressure

Required induction:
IG: 66%
CG: 71%
P = 0.42

Intervention to delivery:
IG: 146 h
CG: 208 h
P = 0.070

Labor duration: P = 0.14

Gregson et al (2015) [10]

IG: Acupressure
CG: Sham treatment

Required induction:
IG: 41%
CG: 24%
P = 0.04

Intervention to labor:
IG: 103 h
CG: 72 h
P = 0.19

Delivery method:
Rate of vaginal delivery: P = 0.90

Gribel et al (2011) [11]

IG: Electroacupuncture
CG: Misoprostol

Spontaneous labor:
IG: 42.9%
CG: 40.6%
P = 0.28

Delivery method:
Higher rate of vaginal delivery in IG: P = 0.01
Labor duration:
Longer in IG: P = 0.03

Harper et al (2006) [12]

IG: Acupuncture
CG: Standard care

Spontaneous labor
IG: 70%
CG: 50%
P = 0.12

Intervention to delivery:
IG: 124 ± 86.7 h
CG: 145 ± 82.7 h
P = 0.36

Delivery method:
Rate of cesarean section: P = 0.07

Koh et al (2019) [13]

IG: CAM (acupressure/reflexology)
CG: Standard care

Required induction:
Nulliparous patients
IG: 44%
CG: 42%
P = 0.52

Intervention to labor:
IG: 17.2 h
CG: 14.6 h
P = 0.009
Intervention to delivery:
IG: 23.8
CG: 21.2
P = 0.0001

Labor duration:
3.2 h longer in IG: P = 0.0001

Lokugamage et al (2020) [14]

IG: Acupuncture
CG: Standard care

Required induction:
P = 0.29

McCullough et al (2017) [15]

IG: Reflexology
CG: Standard care

Required induction:
IG: 41.7%
CG: 36%
P = 0.986

Delivery method:
Rate of vaginal delivery: P = 0.716
Second stage duration:
Significantly reduced in IG: P < 0.05

Modlock et al (2010) [16]

IG: Acupuncture
CG: Sham acupuncture

Spontaneous labor:
IG: 11.7%
CG: 13.8%
P = 0.79

Cervical dilation: P = 0.90
Labor duration: P = 0.38
First stage duration: P = 0.51
Second stage duration: P = 0.52

Mollart et al (2016) [17]

IG: Acupressure
CG: Standard care

Spontaneous labor:
IG: 50%
CG: 40.9%
P = 0.37

Delivery method:
Rate of vaginal delivery: P = 0.48

Neri et al (2014) [18]

IG: Acupuncture
CG: Standard care

Required induction:
IG: 20%
CG: 17%
P > 0.05

Neri et al (2018) [19]

IG: Acupuncture
CG: Standard care

Spontaneous labor:
IG: 75%
CG: 52.8%
P < 0.01

Delivery method:
Rate of cesarean section: P > 0.05

Smith et al (2008) [20]

IG: Acupuncture
CG: Sham acupuncture

Spontaneous labor:
IG: 28.2%
CG: 57%
P = 0.83

Bishop score: P = 0.34

Teimoori et al (2014) [21]

IG: Shiatsu
CG: Standard care

Spontaneous labor:
IG: 56.9%
CG: 8.3%
P < 0.001

Intervention to labor:
IG: 25.5 h
CG: 9.9 h
P > 0.05

Delivery method:
Rate of vaginal delivery: P = 0.207
Labor duration: P > 0.05
First stage duration: P > 0.05
Second stage duration: P > 0.05

Torkzahrani et al (2015) [22]

IG: Acupressure
CG: Standard care

Bishop score:
Greater improvement within 48 h in IG: P = 0.012
Delivery method:
Rate of vaginal delivery: P = 0.726

Torkzahrani et al (2017) [23]

IG: Acupressure
CG: Sham acupressure

Spontaneous labor:
< 48 h
IG: 30%
CG: 20%
P = 0.464

Intervention to delivery:
IG: 124.88 ± 75.93 h
CG: 135.39 ± 70.09 h
P = 0.565

↓ **Table 3.** Castor Oil for Induction of Labor
Study	Labor initiation	Timing	Delivery method	Gestational age	Labor duration
Labor initiation: rate of spontaneous labor or rate of requiring induction; Timing: percent of patients with labor onset within 24 h of intervention; Gestational age: gestational age of baby at time of delivery; Labor duration: in hours; IG: intervention group; CG: control group; NSVD: normal spontaneous vaginal delivery; VBAC: vaginal birth after cesarean section; C-sec: cesarean section; RLTCS: repeat low-transverse cesarean section.
Azhari et al (2006) [25]	Spontaneous labor: IG: 54.2% CG 4.3% P < 0.001	-	IG - NSVD: 79.2% CG - NSVD: 52.2% P > 0.05	-	-
Bayoumi et al (2022) [26]	Required induction: IG: 26.9% CG: 26.3% P = 0.5	IG: 45.7% CG: 8.6% P < 0.001	IG - VBAC: 65.7% IG - RLTCS: 34.3% CG - VBAC: 48.6% CG - RLTCS: 51.4% P (VBAC) = 0.1 P (RLTCS) = 0.1	IG: 39.4 ± 0.4 weeks CG: 39.8 ± 0.3 weeks P < 0.001	IG stage 1: 7.9 ± 2.4 IG stage 2: 0.9 ± 0.5 CG stage 1: 8.4 ± 2.3 CG stage 2: 1 ± 0.4 P (stage 1) = 0.5 P (stage 2) = 0.5
Boel et al (2009) [27]	Required induction: IG: 9.3% CG: 7.6% P > 0.05	IG: 18.6% CG: 19.9% P > 0.05	IG - C-sec: 1.2% CG - C-sec: 1.4% P > 0.05	-	-
DeMaria et al (2018) [28]	Spontaneous labor: IG total: 67.8% CG: none	-	IG - NSVD: 90.7% IG - C-sec: 9.2% P (NSVD) = 0.01 P (C-sec) < 0.01	-	IG stage 1: 8.6 ± 5.8 IG stage 2: 1.5 ± 1.4 IG stage 3: 11.2 ± 5.4
Gilad et al (2018) [29]	-	IG: 42.1% CG: 34.9% P = 0.16	IG - C-sec: 16.2% CG - C-sec: 9.1% P = 0.332	IG: 284.9 days CG: 284.7 days P = 0.86	-
Neri et al (2018) [30]	Required induction: IG: 45% CG: 90% P < 0.001	IG: 47.5% CG: N/A	IG - NSVD: 47.5% IG - C-sec: 20% CG - NSVD: 7.5% CG - C-sec: 37.5% P (NSVD) < 0.001 P (C-sec) > 0.05	IG: 287.8 ± 6.0 days CG: 298.9 ± 3.9 days P > 0.05	-

↓ Table 3. Castor Oil for Induction of Labor

Study

Labor initiation

Timing

Delivery method

Gestational age

Labor duration

Labor initiation: rate of spontaneous labor or rate of requiring induction; Timing: percent of patients with labor onset within 24 h of intervention; Gestational age: gestational age of baby at time of delivery; Labor duration: in hours; IG: intervention group; CG: control group; NSVD: normal spontaneous vaginal delivery; VBAC: vaginal birth after cesarean section; C-sec: cesarean section; RLTCS: repeat low-transverse cesarean section.

Azhari et al (2006) [25]

Spontaneous labor:
IG: 54.2%
CG 4.3%
P < 0.001

IG - NSVD: 79.2%
CG - NSVD: 52.2%
P > 0.05

Bayoumi et al (2022) [26]

Required induction:
IG: 26.9%
CG: 26.3%
P = 0.5

IG: 45.7%
CG: 8.6%
P < 0.001

IG - VBAC: 65.7%
IG - RLTCS: 34.3%
CG - VBAC: 48.6%
CG - RLTCS: 51.4%
P (VBAC) = 0.1
P (RLTCS) = 0.1

IG: 39.4 ± 0.4 weeks
CG: 39.8 ± 0.3 weeks
P < 0.001

IG stage 1: 7.9 ± 2.4
IG stage 2: 0.9 ± 0.5
CG stage 1: 8.4 ± 2.3
CG stage 2: 1 ± 0.4
P (stage 1) = 0.5
P (stage 2) = 0.5

Boel et al (2009) [27]

Required induction:
IG: 9.3%
CG: 7.6%
P > 0.05

IG: 18.6%
CG: 19.9%
P > 0.05

IG - C-sec: 1.2%
CG - C-sec: 1.4%
P > 0.05

DeMaria et al (2018) [28]

Spontaneous labor:
IG total: 67.8%
CG: none

IG - NSVD: 90.7%
IG - C-sec: 9.2%
P (NSVD) = 0.01
P (C-sec) < 0.01

IG stage 1: 8.6 ± 5.8
IG stage 2: 1.5 ± 1.4
IG stage 3: 11.2 ± 5.4

Gilad et al (2018) [29]

IG: 42.1%
CG: 34.9%
P = 0.16

IG - C-sec: 16.2%
CG - C-sec: 9.1%
P = 0.332

IG: 284.9 days
CG: 284.7 days
P = 0.86

Neri et al (2018) [30]

Required induction:
IG: 45%
CG: 90%
P < 0.001

IG: 47.5%
CG: N/A

IG - NSVD: 47.5%
IG - C-sec: 20%
CG - NSVD: 7.5%
CG - C-sec: 37.5%
P (NSVD) < 0.001
P (C-sec) > 0.05

IG: 287.8 ± 6.0 days
CG: 298.9 ± 3.9 days
P > 0.05

↓ **Table 4.** Physical Activity for Induction of Labor
Study	Groups	Labor initiation	Labor duration	Delivery method
Labor initiation: rate of spontaneous labor or rate of requiring induction; IG: intervention group; CG: control group; NSVD: normal spontaneous vaginal delivery; C-sec: cesarean section.
Baena-García et al (2023) [33]	IG: Exercise CG: Standard	Required induction: IG: 29.2% CG: 32.3% P = 0.54	IG - stage 1: 241.9 ± 172.4 min IG - stage 2: 93 ± 65.4 min CG - stage 1: 202 ± 137.2 min CG - stage 2: 95.7 ± 69.2 min P (stage 1) = 0.26 P (stage 2) = 0.93	IG - NSVD: 61.2% IG - C-sec: 18.4% CG - NSVD: 57.7% CG - C-sec: 29.6% P (ALL) = 0.46
Barakat et al (2018) [34]	IG: Exercise CG: None	Spontaneous labor: IG: 79.0% CG: 77.2% P = 0.69	IG - stage 1: 409.15 ± 185.74 min IG - stage 2: 33.23 ± 22.53 min CG - stage 1: 462.83 ± 208.37 min CG - stage 2: 36.21 ± 25.93 min P (stage 1) = 0.01 P (stage 2) = 0.68	-
Bolanthakodi et al (2018) [35]	IG: Yoga CG: None	Required induction: IG: 17.33% CG: 36% P = 0.044	IG - stage 1: 10.13 h IG - stage 2: 0.96 h IG - total: 11.26 h CG - stage 1: 11.95 h CG - stage 2: 1.04 h CG - total: 13.18 h P (stage 1) < 0.001 P (stage 2) = 0.31 P (total) < 0.001	IG - NSVD: 82.66% IG - C-sec: 10.66% CG - NSVD: 68% CG - C-sec: 22.66% P (NSVD) = 0.037 P (C-sec) = 0.048
Ferreira et al (2019) [36]	IG: Exercise CG: Standard	Required induction: IG: 20.2% CG: 34.0% P = 0.003	IG - active phase: 2.9 ± 2.0 h IG - stage 2: 35.8 ± 35.6 min CG - active phase: 3.1 ± 2.1 h CG - stage 2: 33.4 ± 21 min P (active phase) = 0.584 P (stage 2) = 0.701	IG - C-sec: 27.3% CG - C-sec: 32.1% P (C-sec) = 0.418
Ghandali et al (2021) [37]	IG: Pilates CG: Standard	-	IG - active phase: 110 ± 70.94 min IG - stage 2: 33.49 ± 24.51 min CG - active phase: 164 ± 99.81 min CG - stage 2: 50.36 ± 38.59 min P (active phase) = 0.61 P (stage 2) = 0.52	IG - NSVD: 88.2% IG - C-sec: 11.8% CG - NSVD: 80.8% CG - C-sec: 19.2% P (ALL) = 0.296
Haakstad et al (2020) [38]	IG: Exercise CG: Standard	Required induction: IG: 11.5% CG: 5.7% P = 0.291	IG - active phase: 9.5 ± 6.7 h IG - stage 2: 51.2 ± 31.9 min CG - active phase: 9.8 ± 5.4 h CG - stage 2: 49.3 ± 27.1 min P (active phase) = 0.029 P (stage 2) = 0.987	IG - NSVD: 69.2% IG - C-sec: 9.6% CG - NSVD: 62.3% CG - C-sec: 22.6% P (NSVD) = 0.051 P (C-sec) = 0.197
Maharana et al (2013) [39]	IG: Yoga CG: Standard	Required induction: IG: 5% CG: 11% P > 0.05	IG - stage 1: 283.62 ± 35.11 min IG - stage 2: 23.41 ± 7.68 min CG - stage 1: 371.11 ± 47.17 min CG - stage 2: 55.19 ± 10.87 min P (stage 1) = 0.001 P (stage 2) = 0.001	IG - NSVD: 86% IG - C-sec: 14% CG - NSVD: 60% CG - C-sec: 40% P (NSVD) = 0.23 P (C-sec) = 0.17
Perales et al (2016) [40]	IG: Exercise CG: Standard	-	IG - stage 1: 399.1 ± 322.1 min IG - stage 2: 40.6 ± 42.8 min CG - stage 1: 537.4 ± 409.3 min CG - stage 2: 37.4 ± 44.7 min P (stage 1) = 0.01 P (stage 2) = 0.87	IG NSVD: 83.1% CG NSVD: 85.5% P (ALL) = 0.66
Pereira et al (2022) [41]	IG: Exercise CG: Standard	Required induction: IG: 17.5% CG: 33.3% Adjusted: OR = 0.28 (0.14–0.87)	IG - Active phase: 7.8 ± 5.2 h CG - Active phase: 7.7 ± 5.4 h Adjusted: OR = 0.83 (0.71–1.16)	IG - C-sec: 14.3% CG - C-sec: 14.3% Adjusted: OR = 1.09 (0.84 - 1.41)
Rodríguez-Blanque et al (2019) [42]	IG: Exercise CG: Standard	Required induction: IG: 21.5% CG: 29.7% P > 0.05	IG - stage 1 median: 260.00 min IG - stage 2 median: 90.00 min CG - stage 1 median: 405.00 min CG - stage 2 median: 152.50 min P (stage 1) < 0.001 P (stage 2) = 0.007	IG - NSVD: 63.07% IG - C-sec: 12.30% CG - NSVD: 56.25% CG - C-sec: 14.06% P (NSVD) > 0.05 P (C-sec) > 0.05
Rong et al (2021) [43]	IG: Yoga CG: Standard	-	IG - stage 1: 469.57 ± 158.04 min IG - stage 2: 33.26 ± 13.74 min CG - stage 1: 578.47 ± 123.79 min CG - stage 2: 43.41 ± 11.59 min P (stage 1) = 0.012 P (stage 2) = 0.001	IG - NSVD: 87.5% IG - C-sec 12.5% CG - NSVD: 65.6% CG - C-sec: 34.4% P (ALL) = 0.039
Shojaei et al (2021) [44]	IG: Walking CG: Standard	Required induction: IG: 20.4% CG: 47.1% P = 0.005	IG - stage 1: 422.91 ± 370.11 min IG - stage 2: 33.30 ± 34.47 min CG - stage 1: 612.45 ± 680.58 min CG - stage 2: 45.96 ± 47.50 min P (stage 1) = 0.132 P (stage 2) = 0.242	IG - NSVD: 83.7% IG - C-sec: 10.2% CG - NSVD: 43.1% CG - C-sec: 49.0% P (ALL) < 0.001

↓ Table 4. Physical Activity for Induction of Labor

Study

Groups

Labor initiation

Labor duration

Delivery method

Labor initiation: rate of spontaneous labor or rate of requiring induction; IG: intervention group; CG: control group; NSVD: normal spontaneous vaginal delivery; C-sec: cesarean section.

Baena-García et al (2023) [33]

IG: Exercise
CG: Standard

Required induction:
IG: 29.2%
CG: 32.3%
P = 0.54

IG - stage 1: 241.9 ± 172.4 min
IG - stage 2: 93 ± 65.4 min
CG - stage 1: 202 ± 137.2 min
CG - stage 2: 95.7 ± 69.2 min
P (stage 1) = 0.26
P (stage 2) = 0.93

IG - NSVD: 61.2%
IG - C-sec: 18.4%
CG - NSVD: 57.7%
CG - C-sec: 29.6%
P (ALL) = 0.46

Barakat et al (2018) [34]

IG: Exercise
CG: None

Spontaneous labor:
IG: 79.0%
CG: 77.2%
P = 0.69

IG - stage 1: 409.15 ± 185.74 min
IG - stage 2: 33.23 ± 22.53 min
CG - stage 1: 462.83 ± 208.37 min
CG - stage 2: 36.21 ± 25.93 min
P (stage 1) = 0.01
P (stage 2) = 0.68

Bolanthakodi et al (2018) [35]

IG: Yoga
CG: None

Required induction:
IG: 17.33%
CG: 36%
P = 0.044

IG - stage 1: 10.13 h
IG - stage 2: 0.96 h
IG - total: 11.26 h
CG - stage 1: 11.95 h
CG - stage 2: 1.04 h
CG - total: 13.18 h
P (stage 1) < 0.001
P (stage 2) = 0.31
P (total) < 0.001

IG - NSVD: 82.66%
IG - C-sec: 10.66%
CG - NSVD: 68%
CG - C-sec: 22.66%
P (NSVD) = 0.037
P (C-sec) = 0.048

Ferreira et al (2019) [36]

IG: Exercise
CG: Standard

Required induction:
IG: 20.2%
CG: 34.0%
P = 0.003

IG - active phase: 2.9 ± 2.0 h
IG - stage 2: 35.8 ± 35.6 min
CG - active phase: 3.1 ± 2.1 h
CG - stage 2: 33.4 ± 21 min
P (active phase) = 0.584
P (stage 2) = 0.701

IG - C-sec: 27.3%
CG - C-sec: 32.1%
P (C-sec) = 0.418

Ghandali et al (2021) [37]

IG: Pilates
CG: Standard

IG - active phase: 110 ± 70.94 min
IG - stage 2: 33.49 ± 24.51 min
CG - active phase: 164 ± 99.81 min
CG - stage 2: 50.36 ± 38.59 min
P (active phase) = 0.61
P (stage 2) = 0.52

IG - NSVD: 88.2%
IG - C-sec: 11.8%
CG - NSVD: 80.8%
CG - C-sec: 19.2%
P (ALL) = 0.296

Haakstad et al (2020) [38]

IG: Exercise
CG: Standard

Required induction:
IG: 11.5%
CG: 5.7%
P = 0.291

IG - active phase: 9.5 ± 6.7 h
IG - stage 2: 51.2 ± 31.9 min
CG - active phase: 9.8 ± 5.4 h
CG - stage 2: 49.3 ± 27.1 min
P (active phase) = 0.029
P (stage 2) = 0.987

IG - NSVD: 69.2%
IG - C-sec: 9.6%
CG - NSVD: 62.3%
CG - C-sec: 22.6%
P (NSVD) = 0.051
P (C-sec) = 0.197

Maharana et al (2013) [39]

IG: Yoga
CG: Standard

Required induction:
IG: 5%
CG: 11%
P > 0.05

IG - stage 1: 283.62 ± 35.11 min
IG - stage 2: 23.41 ± 7.68 min
CG - stage 1: 371.11 ± 47.17 min
CG - stage 2: 55.19 ± 10.87 min
P (stage 1) = 0.001
P (stage 2) = 0.001

IG - NSVD: 86%
IG - C-sec: 14%
CG - NSVD: 60%
CG - C-sec: 40%
P (NSVD) = 0.23
P (C-sec) = 0.17

Perales et al (2016) [40]

IG: Exercise
CG: Standard

IG - stage 1: 399.1 ± 322.1 min
IG - stage 2: 40.6 ± 42.8 min
CG - stage 1: 537.4 ± 409.3 min
CG - stage 2: 37.4 ± 44.7 min
P (stage 1) = 0.01
P (stage 2) = 0.87

IG NSVD: 83.1%
CG NSVD: 85.5%
P (ALL) = 0.66

Pereira et al (2022) [41]

IG: Exercise
CG: Standard

Required induction:
IG: 17.5%
CG: 33.3%
Adjusted: OR = 0.28 (0.14–0.87)

IG - Active phase: 7.8 ± 5.2 h
CG - Active phase: 7.7 ± 5.4 h
Adjusted: OR = 0.83 (0.71–1.16)

IG - C-sec: 14.3%
CG - C-sec: 14.3%
Adjusted: OR = 1.09 (0.84 - 1.41)

Rodríguez-Blanque et al (2019) [42]

IG: Exercise
CG: Standard

Required induction:
IG: 21.5%
CG: 29.7%
P > 0.05

IG - stage 1 median: 260.00 min
IG - stage 2 median: 90.00 min
CG - stage 1 median: 405.00 min
CG - stage 2 median: 152.50 min
P (stage 1) < 0.001
P (stage 2) = 0.007

IG - NSVD: 63.07%
IG - C-sec: 12.30%
CG - NSVD: 56.25%
CG - C-sec: 14.06%
P (NSVD) > 0.05
P (C-sec) > 0.05

Rong et al (2021) [43]

IG: Yoga
CG: Standard

IG - stage 1: 469.57 ± 158.04 min
IG - stage 2: 33.26 ± 13.74 min
CG - stage 1: 578.47 ± 123.79 min
CG - stage 2: 43.41 ± 11.59 min
P (stage 1) = 0.012
P (stage 2) = 0.001

IG - NSVD: 87.5%
IG - C-sec 12.5%
CG - NSVD: 65.6%
CG - C-sec: 34.4%
P (ALL) = 0.039

Shojaei et al (2021) [44]

IG: Walking
CG: Standard

Required induction:
IG: 20.4%
CG: 47.1%
P = 0.005

IG - stage 1: 422.91 ± 370.11 min
IG - stage 2: 33.30 ± 34.47 min
CG - stage 1: 612.45 ± 680.58 min
CG - stage 2: 45.96 ± 47.50 min
P (stage 1) = 0.132
P (stage 2) = 0.242

IG - NSVD: 83.7%
IG - C-sec: 10.2%
CG - NSVD: 43.1%
CG - C-sec: 49.0%
P (ALL) < 0.001

↓ **Table 5.** Membrane Sweeping for Induction of Labor
Study	Spontaneous labor	Timing	Delivery method
Spontaneous labor: percent of patients with spontaneous labor; Timing: duration from intervention to labor onset, measured as percent delivered within 24 h or percent delivered within 72 h; IG: intervention group; CG: control group; NSVD: normal spontaneous vaginal delivery; C-sec: cesarean section.
Ali et al (2021) [45]	IG: 88.33% CG: None	-	-
Butt et al (2021) [46]	IG: 50.6% CG: 33.3% P = 0.051	-	IG - NSVD: 22.6% CG - NSVD: 28% P (NSVD) = 0.075
Hassan (2023) [47]	IG - 1 sweep: 38.8% IG - 2 sweeps: 47.6% CG: None	Within 24 h: IG: 41.5%	IG - NSVD: 86.4% IG - C-sec: 10.9%
Ugwu et al (2014) [48]	IG: 56.5% CG: 31.1% P = 0.007	Within 72 h: IG: 48.4% CG: 23.0% P = 0.006	IG - NSVD: 84.6% CG - NSVD: 73% P (NSVD) = 0.19

↓ Table 5. Membrane Sweeping for Induction of Labor

Study

Spontaneous labor

Timing

Delivery method

Spontaneous labor: percent of patients with spontaneous labor; Timing: duration from intervention to labor onset, measured as percent delivered within 24 h or percent delivered within 72 h; IG: intervention group; CG: control group; NSVD: normal spontaneous vaginal delivery; C-sec: cesarean section.

Ali et al (2021) [45]

IG: 88.33%
CG: None

Butt et al (2021) [46]

IG: 50.6%
CG: 33.3%
P = 0.051

IG - NSVD: 22.6%
CG - NSVD: 28%
P (NSVD) = 0.075

Hassan (2023) [47]

IG - 1 sweep: 38.8%
IG - 2 sweeps: 47.6%
CG: None

Within 24 h:
IG: 41.5%

IG - NSVD: 86.4%
IG - C-sec: 10.9%

Ugwu et al (2014) [48]

IG: 56.5%
CG: 31.1%
P = 0.007

Within 72 h:
IG: 48.4%
CG: 23.0%
P = 0.006

IG - NSVD: 84.6%
CG - NSVD: 73%
P (NSVD) = 0.19

↓ **Table 6.** Primrose Oil for Induction of Labor
Study	Route	Bishop score	Labor initiation	Labor duration	Timing	C-section rate
Labor initiation: percent requiring induction of labor; Timing: duration from intervention to labor onset; PV: per vagina primrose oil; PO: per oral primrose oil; IG: intervention group; CG: control group.
Ariana et al (2024) [49]	PV	IG: 5.83 ± 1.68 CG: 5.19 ± 1.52 P = 0.002	IG: 10.4% CG: 31.3% P = 0.012	IG - latent phase: 14.7 ± 4.05 h IG - active phase: 2.47 ± 1.41 h CG - latent phase: 17.37 ± 4.05 h CG - active phase: 3.65 ± 1.62 h P (latent) = 0.001 P (active) < 0.001	-	-
Azad et al (2022) [50]	PV	IG: 6.96 ± 0.18 CG: 3.67 ± 0.25 P = 0.01	-	IG - latent phase: 7.31 ± 2.13 h IG - active phase: 3.67 ± 1.08 h IG - second stage: 68.31 ± 12.13 h CG - latent phase: 9.81 ± 1.08 h CG - active phase: 3.42 ± 1.16 h CG - second stage: 70.31 ± 11.03 h P (latent) = 0.031 P (active) = 0.244 P (stage 2) = 0.531	-	IG: 26.13% CG: 29.88% P = 0.149
Diansuy & Aguilar (2017) [51]	PV	Percent changed after 4 h: IG: 85% P = 0.001	-	-	-	-
Hashemnejad et al (2019) [52]	PV	-	-	IG - active phase: 60.68 h CG - active phase: 73.83 h P (active) = 0.150	IG: 13.4 h CG: 19.06 h P = 0.168	-
Heydari et al (2022) [53]	PO, PV	IG - PO: 6.85 ± 1.62 IG - PV: 7.86 ± 1.24 CG: 5.62 ± 1.62 P (ALL) = 0.001 P (PO vs. PV) > 0.05	IG - PO: 72.5% IG - PV: 55.8% CG: 68.29% P (ALL) = 0.26	IG - PO stage 2: 48.71 ± 28.96 h IG - PV stage 2: 40.83 ± 20.06 h CG - stage 2: 56.18 ± 21.78 h P (ALL, stage 2) = 0.033	-	IG PO: 12.2% IG PV: 18.6% CG: 26.2% P (ALL) = 0.267
Jahdi et al (2016) [54]	PO	IG: 3.60 ± 1.75 CG: 4.35 ± 2.34 P = 0.11	-	-	-	-
Poor et al (2023) [55]	PO, PV	After 2 h: IG - PO: 5.47 ± 1.67 IG - PV: 6.28 ± 1.91 CG: 4.09 ± 1.61 P (PO vs. CG) < 0.001 P (PV vs. CG) < 0.001 P (PO vs. PV) = 0.067	-	IG - PO phase 1: 255 min IG - PO phase 2: 15 min IG - PV phase 1: 190 min IG - PV phase 2: 10 min CG - phase 1: 450 min CG - phase 2: 30 min P (ALL, phase 1) < 0.001 P (ALL, phase 2) < 0.001	IG PO: 300 min IG PV: 210 min CG: 487.50 min P (ALL) < 0.001	IG PO: 19.3% IG PV: 10.7% CG: 12.3% P (ALL) = 0.373
Shahraki et al (2023) [56]	PV	IG: 9.05 ± 0.91 CG: 8.67 ± 0.094 P = 0.03	IG: 74.5% CG: 87.3% P = 0.09	-	IG: 19.85 ± 2.47 h CG: 20.57 ± 1.91 h P = 0.09	IG: 45.5% CG: 65.5% P = 0.03

↓ Table 6. Primrose Oil for Induction of Labor

Study

Route

Bishop score

Labor initiation

Labor duration

Timing

C-section rate

Labor initiation: percent requiring induction of labor; Timing: duration from intervention to labor onset; PV: per vagina primrose oil; PO: per oral primrose oil; IG: intervention group; CG: control group.

Ariana et al (2024) [49]

IG: 5.83 ± 1.68
CG: 5.19 ± 1.52
P = 0.002

IG: 10.4%
CG: 31.3%
P = 0.012

IG - latent phase: 14.7 ± 4.05 h
IG - active phase: 2.47 ± 1.41 h
CG - latent phase: 17.37 ± 4.05 h
CG - active phase: 3.65 ± 1.62 h
P (latent) = 0.001
P (active) < 0.001

Azad et al (2022) [50]

IG: 6.96 ± 0.18
CG: 3.67 ± 0.25
P = 0.01

IG - latent phase: 7.31 ± 2.13 h
IG - active phase: 3.67 ± 1.08 h
IG - second stage: 68.31 ± 12.13 h
CG - latent phase: 9.81 ± 1.08 h
CG - active phase: 3.42 ± 1.16 h
CG - second stage: 70.31 ± 11.03 h
P (latent) = 0.031
P (active) = 0.244
P (stage 2) = 0.531

IG: 26.13%
CG: 29.88%
P = 0.149

Diansuy & Aguilar (2017) [51]

Percent changed after 4 h:
IG: 85%
P = 0.001

Hashemnejad et al (2019) [52]

IG - active phase: 60.68 h
CG - active phase: 73.83 h
P (active) = 0.150

IG: 13.4 h
CG: 19.06 h
P = 0.168

Heydari et al (2022) [53]

PO, PV

IG - PO: 6.85 ± 1.62
IG - PV: 7.86 ± 1.24
CG: 5.62 ± 1.62
P (ALL) = 0.001
P (PO vs. PV) > 0.05

IG - PO: 72.5%
IG - PV: 55.8%
CG: 68.29%
P (ALL) = 0.26

IG - PO stage 2: 48.71 ± 28.96 h
IG - PV stage 2: 40.83 ± 20.06 h
CG - stage 2: 56.18 ± 21.78 h
P (ALL, stage 2) = 0.033

IG PO: 12.2%
IG PV: 18.6%
CG: 26.2%
P (ALL) = 0.267

Jahdi et al (2016) [54]

IG: 3.60 ± 1.75
CG: 4.35 ± 2.34
P = 0.11

Poor et al (2023) [55]

PO, PV

After 2 h:
IG - PO: 5.47 ± 1.67
IG - PV: 6.28 ± 1.91
CG: 4.09 ± 1.61
P (PO vs. CG) < 0.001
P (PV vs. CG) < 0.001
P (PO vs. PV) = 0.067

IG - PO phase 1: 255 min
IG - PO phase 2: 15 min
IG - PV phase 1: 190 min
IG - PV phase 2: 10 min
CG - phase 1: 450 min
CG - phase 2: 30 min
P (ALL, phase 1) < 0.001
P (ALL, phase 2) < 0.001

IG PO: 300 min
IG PV: 210 min
CG: 487.50 min
P (ALL) < 0.001

IG PO: 19.3%
IG PV: 10.7%
CG: 12.3%
P (ALL) = 0.373

Shahraki et al (2023) [56]

IG: 9.05 ± 0.91
CG: 8.67 ± 0.094
P = 0.03

IG: 74.5%
CG: 87.3%
P = 0.09

IG: 19.85 ± 2.47 h
CG: 20.57 ± 1.91 h
P = 0.09

IG: 45.5%
CG: 65.5%
P = 0.03

↓ **Table 7.** Sexual Intercourse for Induction of Labor
Study	Labor initiation	Timing	Gestational age	C-section rate
Labor initiation: rate of spontaneous labor or rate of requiring induction; Timing: duration from intervention/counseling to delivery; Gestational age: gestational age of the baby at the time of delivery; IG: intervention group; CG: control group.
Atrian et al (2015) [57]	-	-	IG: 268 ± 10 days CG: 273 ± 8 days P = 0.005	P = 0.820
Foumane et al (2014) [58]	Spontaneous labor: IG: 94.4% CG: 88.9% P = 0.18 Required induction: IG: 5.6% CG: 11.1% P = 0.18	-	Before 41 weeks: IG: 90.3% CG: 81.9% P = 0.22	IG: 6.9% CG: 20.8% P < 0.02
Omar et al (2013) [59]	Spontaneous labor: IG: 87.6% CG: 86.3% P = 0.278 Required induction: IG: 22.0% CG: 20.8% P = 0.666	IG: 3.2 ±1.4 days CG: 3.3 ± 1.3 days P = 0.417	IG: 39.4 ± 1.2 weeks CG: 39.5 ± 1.2 weeks P = 0.112	IG: 8% CG: 17.6% P > 0.05
Schaffir (2006) [60]	Required induction: IG: 25.5% CG: 10.9% P = 0.106	IG: 2.3 ± 1.1 weeks CG: 1.5 ± 0.9 weeks P < 0.001	IG: 39.9 ± 0.9 weeks CG: 39.3 ± 0.9 weeks P = 0.001	IG: 17% CG: 4.4% P = 0.091
Tan et al (2006) [61]	Required induction: IG - frequent: 9.8% IG - infrequent: 1.3% CG: 23.8% P (IG infrequent vs. CG) = 0.41 P (IG frequent vs. CG) = 0.06	> 41 weeks: IG - frequent: 4% IG - infrequent: 12.2% CG: 29.8% P (IG infrequent vs. CG) = 0.41 P (IG frequent vs. CG) = 0.06	IG - frequent: 39.1 ± 1.1 weeks IG - infrequent: 39.7 ± 1.0 weeks CG: 39.9 ± 1.2 weeks P (ALL) < 0.001	-
Tan et al (2007) [62]	Spontaneous labor: IG: 55.6% CG: 52% P = 0.68	IG: 4.3 ± 3.2 days CG: 5.2 ± 3.6 days P = 0.65	-	IG: 25% CG: 20.6% P = 0.75
Tan et al (2009) [63]	Spontaneous labor: IG (2+/week): 36.8% IG (1/week): 58.3% CG: 60.6% P (ALL) = 0.012 P (trend) = 0.006	IG: 5.7 ± 3.8 days CG: 3.8 ± 2.6 days P < 0.001	-	IG: 24.8% CG: 69.5% P = 0.73

↓ Table 7. Sexual Intercourse for Induction of Labor

Study

Labor initiation

Timing

Gestational age

C-section rate

Labor initiation: rate of spontaneous labor or rate of requiring induction; Timing: duration from intervention/counseling to delivery; Gestational age: gestational age of the baby at the time of delivery; IG: intervention group; CG: control group.

Atrian et al (2015) [57]

IG: 268 ± 10 days
CG: 273 ± 8 days
P = 0.005

P = 0.820

Foumane et al (2014) [58]

Spontaneous labor:
IG: 94.4%
CG: 88.9%
P = 0.18
Required induction:
IG: 5.6%
CG: 11.1%
P = 0.18

Before 41 weeks:
IG: 90.3%
CG: 81.9%
P = 0.22

IG: 6.9%
CG: 20.8%
P < 0.02

Omar et al (2013) [59]

Spontaneous labor:
IG: 87.6%
CG: 86.3%
P = 0.278
Required induction:
IG: 22.0%
CG: 20.8%
P = 0.666

IG: 3.2 ±1.4 days
CG: 3.3 ± 1.3 days
P = 0.417

IG: 39.4 ± 1.2 weeks
CG: 39.5 ± 1.2 weeks
P = 0.112

IG: 8%
CG: 17.6%
P > 0.05

Schaffir (2006) [60]

Required induction:
IG: 25.5%
CG: 10.9%
P = 0.106

IG: 2.3 ± 1.1 weeks
CG: 1.5 ± 0.9 weeks
P < 0.001

IG: 39.9 ± 0.9 weeks
CG: 39.3 ± 0.9 weeks
P = 0.001

IG: 17%
CG: 4.4%
P = 0.091

Tan et al (2006) [61]

Required induction:
IG - frequent: 9.8%
IG - infrequent: 1.3%
CG: 23.8%
P (IG infrequent vs. CG) = 0.41
P (IG frequent vs. CG) = 0.06

> 41 weeks:
IG - frequent: 4%
IG - infrequent: 12.2%
CG: 29.8%
P (IG infrequent vs. CG) = 0.41
P (IG frequent vs. CG) = 0.06

IG - frequent: 39.1 ± 1.1 weeks
IG - infrequent: 39.7 ± 1.0 weeks
CG: 39.9 ± 1.2 weeks
P (ALL) < 0.001

Tan et al (2007) [62]

Spontaneous labor:
IG: 55.6%
CG: 52%
P = 0.68

IG: 4.3 ± 3.2 days
CG: 5.2 ± 3.6 days
P = 0.65

IG: 25%
CG: 20.6%
P = 0.75

Tan et al (2009) [63]

Spontaneous labor:
IG (2+/week): 36.8%
IG (1/week): 58.3%
CG: 60.6%
P (ALL) = 0.012
P (trend) = 0.006

IG: 5.7 ± 3.8 days
CG: 3.8 ± 2.6 days
P < 0.001

IG: 24.8%
CG: 69.5%
P = 0.73