Induction With Misoprostol: Oral Mucosa Versus Vaginal Epithelium (IMPROVE)

Inclusion Criteria: * A medical indication for induction of labor at a gestational age between 37 +0 and 38 +6 weeks OR an elective or medical indication for induction of labor at a gestational age greater than or equal to 39 + 0 completed weeks * Participant age of greater than or equal to14 years old * Singleton pregnancy * Modified Bishop score of less than or equal to 6 * Vertex fetal presentation by examination or ultrasound * Any membrane status Exclusion Criteria: * Elective inductions between 37 +0 and 38 +6 completed weeks are specifically excluded * Known intrauterine fetal demise * Any uterine scar including prior cesarean section and myomectomy * Known major fetal congenital malformations that may impact neonatal health * Other evidence of fetal compromise (such as Category 2 or 3 tracing) before the induction begins * Prior induction/cervical ripening methods utilized during this pregnancy * Allergy to misoprostol * Known untreated cervical infection (e.g. Gonorrhea, Chlamydia) * Planned cesarean section due to maternal or fetal condition * Any other contraindication to labor induction or misoprostol therapy