Induction is more likely to succeed when the cervix is ripe, anterior and starting to efface and dilate.

• A. When the cervix is firm and closed
• B. When the cervix is ripe, anterior and starting to efface and dilate
• C. When the cervix is posterior and dilated
• D. When membranes have ruptured

Answer: (B)

Cervical readiness and position determine induction success. A cervix that is ripe means it is soft and eases dilation; an anterior position aligns with the birth canal, making passage and effectiveness of contractions easier; and starting to efface and dilate shows the cervix is already on the path toward opening. When these conditions are present, induction methods such as prostaglandins to further soften the cervix and oxytocin to stimulate contractions are more likely to lead to a successful vaginal delivery. In contrast, a firm, closed cervix resists dilation; a posterior cervix is harder to access and less favorable for induction; rupturing membranes alone does not guarantee success, especially if the cervix isn’t ready. Overall, a ripe, anterior cervix beginning to efface and dilate best predicts a favorable induction outcome.