Autumn 2020, Volume 29, Issue 3 (33-40) Copyright © 2020 The Author(s); Published by Advances in Nursing and Midwifery. This is an open access article, distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses /by-nc/4.0/) which permits others to copy and redistribute material just in noncommercial usages, provided the original work is properly cited. Advances in Nursing and Midwifery Original Article Comparison Effects of Vaginal Misoprostol with Vaginal Evening Primrose on Ripening Cervix in Nulliparous Women Narges Mirzadeh 1 , Zohre Sheikhan 2,* , Masoumeh Simbar 3 , Yasamin Mehrolhasani 4 , Azam Saffar 5 , Zohreh Yeganeh 6 1 Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2 Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran 3 Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran 4 Department of Obstetrics and Gynecology, Faculty of Medicine, Bam University of Medical Sciences, Bam, Iran 5 Department of Biostatistics, Faculty of Paramedics, Shahid Beheshti University of Medical Sciences, Tehran, Iran 6 Department of Midwifery, Faculty of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran *Corresponding author: Zohre Sheikhan, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail: zsheikhan@sbmu.ac.ir DOI: 10.29252/anm-30286 Submitted: 04 Feb 2020 Accepted: 14 May 2020 Published: 15 Jul 2020 Abstract Introduction: Childbirth requires several changes in the function of the uterus and cervix. Today, various methods are used to prepare the cervix. Ripening of the cervix is one of the most factors in a successful delivery. This study aims to compare the effects of vaginal misoprostol tablet with vaginal evening primrose capsule on cervical ripening in nulliparous women with term pregnancy. Methods: This study was a randomized clinical trial of a sokor conducted on 100 nulliparous women referred to Pasteur Hospital and Prenatal Clinic of University of Medical Sciences of Bam, 40 weeks to 40 weeks±6 days gestational age with Bishop Score less than 4. The women were selected by convenient sampling based on random numbers divided into two groups, evening primrose (1000 mg vaginal evening primrose capsules) and misoprostol (25 micrograms of vaginal misoprostol tablets). The data was collected by demographic and midwifery questionnaire, follow-up form, Bishop's checklist, fetal movement registration form, and daily record. Data were analyzed by SPSS20 software, independent t-test, Mann-Whitney, Chi-square, and Linear by Linear. In all of the tests, P < 0.05 was considered. Results: Bishop’s score at admission in the evening primrose group was 1.84 ± 0.88 versus 0.78 ± 0.66 in the misoprostol group (P < 0.001). The two groups had significant differences in terms of dilatation and cervical consistency during admission. The dilatation in the evening primrose group significantly increased, and cervical consistency was considerably softer in the misoprostol group (P < 0.05). Conclusions: It seems that evening primrose is more effective on cervical ripening and dilatation. Keywords: Cervical Ripening Evening Primrose Misoprostol Bishop Score © 2020. Advances in Nursing and Midwifery How to cite: Mirzadeh N, Sheikhan Z, Simbar M, Mehrolhasani Y, Saffar A, Yeganeh Z. Comparison Effects of Vaginal Misoprostol with Vaginal Evening Primrose on Ripening Cervix in Nulliparous Women. Adv Nurs Midwifery. 2020;29(3):33-40. doi: 10.29252/anm-30286 INTRODUCTION A strong predictor for successful and uncomplicated delivery is a cervix with a high bishop score [1]. Cervical ripening is one of the central labor stages in the final weeks of pregnancy when the cervix begins to soften [2]. Termination of pregnancy in cervical Incompatibility cases results in increased adverse outcomes such as