A study tested whether giving pregnant women pedometers and encouraging them to walk during labor induction with an extra‑amniotic balloon would speed up delivery or reduce pain. It found no overall benefit—delivery times, pain, and satisfaction were the same as usual care, and more walking was actually linked to slightly longer labor phases. The approach was safe and doable, but it didn’t improve outcomes.

Induction of labor with an extra-amniotic balloon (EAB) is common but may be lengthy and uncomfortable. Evidence on the impact of maternal mobility during EAB induction is limited. To assess whether a mobility-encouragement protocol using pedometers affects induction-to-delivery time, pain, and maternal satisfaction. In this prospective, single center, randomized controlled trial, (Feb 2019 and July 2020), 189 primi and multigravidas undergoing inpatient EAB IOL with singleton pregnancies at 36-42 weeks' gestation and intact membranes were randomized to a mobility-encouragement protocol group (feedback group, n=92) or a routine care protocol (control group, n=97). The EAB was the sole method of cervical ripening; oxytocin augmentation was administered only after balloon expulsion or removal. The feedback group received digital pedometers and personalized walking encouragement at two time-points during IOL, while the control group received standard care. The primary outcome was time from EAB placement to delivery. Sample size was calculated to detect a clinically meaningful 15% reduction in induction-to-delivery time with 80% power and α=0.05. Secondary outcomes included pain scores, labor satisfaction, and labor outcomes. Sub-analyses were conducted to examine the effect of different levels of mobility (within the experimental group) and gravidity on primary and secondary outcomes. No significant differences were found between the feedback and control groups in any of the outcomes assessed including induction-to-delivery time, pain scores, or labor satisfaction, even after accounting for gravidity. Sub-analysis of mobility levels within the feedback group revealed a significantly increased EAB insertion-to-expulsion and EAB insertion-to-active labor times among participants with higher mobility levels (p=0.002 and p=0.008, respectively). Encouraging walking during IOL with an EAB is feasible and well tolerated. While overall mobility did not significantly change time to delivery or active labor, higher levels of mobility may be associated with longer labor duration.