Methods	RCT with block randomisation.
Participants	Setting: outpatient clinic in North Carolina USA. 56 women randomised Inclusion criteria: primiparous women at term (39 weeks and 4 days to 41 weeks) with singleton, cephalic, pregnancy and Bishop score < 7 Exclusion criteria: cannot tolerate acupuncture, uncertain dates, breech presentation, placenta praevia, contraindication to vaginal delivery
Interventions	Cervical examination and ultrasound at recruitment. Intervention group: acupuncture + routine care on 3 of 4 consecutive days, visits also included fetal monitoring, treatment by trained acupuncturist to hands, legs and lower back and low voltage stimulation Comparison group: routine care with follow up after 3 or 4 days
Outcomes	Vaginal delivery not achieved in 24 hrs, additional induction agents required. CS, mean time to delivery
Notes
Risk of bias
Item	Authors’ judgement	Description
Adequate sequence generation?	Yes	Computer generated sequence in balanced blocks of 2 or 4.
Allocation concealment?	Yes	Sealed, opaque, sequentially numbered envelopes.
Blinding? Women	No	Blinding not feasible.
Blinding? Clinical staff	No
Blinding? Outcome assessor	No
Incomplete outcome data addressed? All outcomes	Unclear	Data were available for all women randomised but denominators were not clear for some outcomes
Free of other bias?	Unclear	Women receiving acupuncture attended for 3 additional visits where other interventions occurred as well as acupuncture that may have affected outcomes