Using the drug misoprostol in combination with a Foley balloon catheter to induce labor can lead to a speedier delivery, with women delivering several hours earlier than either method alone, according to research from the University of Pennsylvania. The team’s work was published in Obstetrics & Gynecology.

Nearly 1 million women who deliver in the U.S. each year undergo labor induction, but the process is still costly and doctors do not agree on 1 common practice.

The research team at UPenn touted its study as the largest-ever clinical trial of labor induction methods, enrolling 500 women who needed to undergo labor induction at the Hospital of the University of Pennsylvania. The participants were randomly split into 4 different treatment arms to induce labor: misoprostol alone, the Foley balloon catheter alone, the 2 methods combined, or the Foley balloon catheter with a synthetic version of oxytocin.

Using just misoprostol or the catheter, the average time between treatment and delivery was slightly over 17 hours. But when the 2 were combined, the average time between treatment and delivery dropped to 13 hours. The Foley-ocytocin combination induced labor in an average 14.5 hours.

“Previous studies comparing labor-induction methods, have looked at a small patient population, few induction methods, and have produced conflicting results. Our results clearly show that the misoprostol-Foley combination method could significantly reduce the total time mothers spend in the delivery room – potentially leading to a reduction in labor-associated healthcare costs and risks to mothers and their babies,” lead author Dr. Lisa Levine said in prepared remarks.

“Using combination methods in every case of labor induction in America would spare pregnant women more than 100,000 days of labor annually,” Levine said. “That in turn would reduce hospital costs, reduce the health risks to mother and child that come with prolonged labor, and reduce the stress that mothers experience while awaiting delivery.”