Gomez HB, Hoffman MK, Caplan R, et al. - The shortest time to labor is achieved by combining pharmacologic agents with mechanical ripening. Researchers here examined how time to delivery differs between buccal and vaginal administration of misoprostol along with a Foley catheter for induction of labor. They conducted a randomized clinical trial, named the BEGIN trial for comparing identical doses (25 μg) of buccal misoprostol and vaginal misoprostol along with a Foley catheter for induction of labor among individuals undergoing induction of labor at ≥ 37 weeks with a singleton gestation and requiring cervical ripening. Randomization of a total of 215 women (108 in the buccal drug administration group and 107 in the vaginal drug administration group) was performed. Outcomes revealed superiority of vaginal administration of misoprostol to buccal administration of misoprostol along with a Foley catheter for induction of labor. In addition, the chance of delivering earlier was twice in correlation with vaginal administration of misoprostol vs buccal administration of misoprostol with no difference in cesarean delivery rates. Hence, they emphasize preferring the vaginal route of administration of misoprostol among individuals undergoing a combined pharmacologic and mechanical induction.