Martin 1989.

Study characteristics
Methods	RCT
Participants	Number of women randomised: 22 Setting: Jackson, USA Study date: women recruited 1 July 1987 to 31 January 1988 Inclusion criteria GA: 41 completed weeks Reliable dates Primiparous and multiparous women Exclusion criteria Oligohydramnios with < 1 cm pocket of amniotic fluid in any dimension A non‐reactive NST Positive concentration stress test Bishop score > 5 State of cervix: unripe (Bishop score 5 or less) included
Interventions	Induction group (n =12): laminaria tents followed by oxytocin versus EM group (n = 10): weekly ultrasound for amniotic fluid assessment and NST
Outcomes	Mother: mode of birth; length of labour; type of analgesia; length of hospital stay; labour‐associated morbidity Baby: birthweight; Apgar score; perinatal deaths; neonatal course; meconium staining
Notes	Funding: Vicksburg Hospital Medical Foundation Declarations of interest: not reported
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Unclear risk	The method of sequence generation was not reported.
Allocation concealment (selection bias)	Unclear risk	Allocation in sealed envelopes but no mention of opaqueness, numbering and sequential opening of envelopes.
Blinding of participants and personnel (performance bias) All outcomes	High risk	Blinding was not feasible.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	Blinded outcome assessment was not mentioned.
Incomplete outcome data (attrition bias) All outcomes	Low risk	No apparent losses to follow‐up or exclusions.
Selective reporting (reporting bias)	High risk	No outcomes were prespecified in the methods; a number of outcomes reported without measures of variance (e.g. birthweight, length of labour, hospital stay), and thus these outcomes could not be used in the meta‐analyses. No access to protocol to further assess selective reporting
Other bias	Low risk	Appeared to be free of other bias