Outpatient Foley catheter Vs inpatient Prostin gel for induction of labour

Aims of study are 1) To compare: a) Clinical effectiveness b) Patient acceptability c) Safety of the use of Foley catheter in the outpatient setting with intravaginal PGE2 (Prostin) gel in the inpatient setting for induction of labour. 2) To assess the cost-effectiveness of intracervical Foley catheter in the outpatient setting to intravaginal PGE2 (Prostin) gel in the inpatient setting for use in induction of labour. The hypothesis is that for induction of labour in women with an unfavourable cervix, use of the catheter on an outpatient basis (women have catheter inserted, then go home until the following morning) will be at least as clinically effective and safe as use of gel as an inpatient (staying in hospital), and that outpatient catheter use will be both acceptable to women and cost-effective. Currently, most pregnant women who need cervical ripening as part of an induction of labour stay in hospital from the time the gel or catheter is inserted until the cervix is ready for the rest of the induction. This means many women stay 12-24 hours in hospital while they are not in labour, but are waiting for the gel or catheter to work. Most women and their babies needing cervical ripening are otherwise very well, and could stay at home during this time if a safe and effective way to do this was available.