[Drug-induced labour--more than just a decision by the obstetrician?]

The induction of labour ist the most frequently indicated measure in obstetrics. In this way a better perinatal result for both mother and infant should be expected than from a wait-and-see policy. In addition, the induction of labour should make vaginal delivery possible and thus spare the mother from the trauma of a Caesarean section. Today obstetrics is positioned in a field of tension between medical indications, the maternal wish for recognition of her sovereign right of decision, confirmed knowledge from evidence-based medicine and other paramedical influences. From the point of view of the clinical obstetrician the individual medical situation is all important, whereby the dynamics of the primary pathology, possibilities for its treatment, particular risks of induction of labour, and the success of a vaginal delivery have to be taken into consideration. A main principle is the more elective ist the induction of labour the more comprehensively must the patient be informed about the risks and benefits of the procedure. Current results about the most frequent indications for the induction of labour reveal a low strength of evidence. This is particularly valid for the increasingly more frequent problem of induction of labour after a previous Caesarean section. In the author's opinion the obstetrician should employ all his/her clinical skill and experience (in the sense of good clinical practice) in the risk-adapted decision making with regard to the induction of labour, especially in cases of previous Caesarean operations and not--a priori--follow the mode to "trendy Caesareanism". In this way, obstetrics will remain a domain demanding individual skill and ability from the future generations of responsible obstetrician and will not degenerate to solely a "surgical performance".