Does a combination of fluid restriction and the use of oxytocin in a pulsatile fashion (intermittent boluses) for women requiring an induction, result in a reduction in the duration of labour, defined by the commencement of oxytocin until the birth of the neonate, when compared to a regime of fluid restriction with continuous oxytocin?

Pregnant females who require an induction and/or augmentation of their labour, will be randomised to either an intravenous continuous oxytocin infusion (which is commenced at 2 mls/hour from a stock solution of 500 mls of Hartmann's solution containing 30 IU of oxytocin), with the rate increased every 30 minutes until there are 4 uterine contractions within 10 minutes, as per Safer Care Victoria's maternity e-handbook, as opposed to the same concentration of oxytocin, but given in a pulsatile fashion. As per Institutional policy and as per Safer Care Victoria's maternity e-handbook, using a stock solution of 10 IU oxytocin in 1000 ml crystalloid, oxytocin is commenced at an initial infusion rate of 12 ml/hr, which is then increased in a stepwise fashion, every 30 minutes, until 4 uterine contractions occur within 10 minutes. The maximum allowable rate of infusion to allow the uterus to contract 4 times within 10 minutes is 192 ml/hr. For this study, the stock solution of oxytocin to be used is the Queensland concentration of 30 IU oxytocin in 500 ml crystalloid, which is 6x greater the concentration of the Victorian stock solution. Therefore, for the continuous arm of the study, rather than initially commencing at 12 ml/hr, the equivalent volume would be 2 ml/hr and the maximum allowable rate of infusion would be 32 ml/hr. For the pulsatile arm of the study, rather than a continuous infusion of 12 ml/hr the equivalent 'pulse' is 0.1 ml every 3 minutes. For the maximum allowable rate of 32 ml/hr, this equates to a 'pulse' of 1.6 ml every 3 minutes. A table showing the rates of infusion for both the continuous and pulsatile arms of the study will be provided to the midwife caring for the woman having an induction of labour and the table will also be attached to the pump used to deliver the oxytocin in either a continuous or pulsatile fashion. The initial programming of the pumps and education of the midwife caring for the woman having an induction of labour, will be provided by Darren Lowen, after the participant has been consented to the study. This will ensure that the intervention protocol is adopted and all participant's medical records will be audited to confirm that this is the case.