Labour is induced in one in four pregnant women in Australia. Sometimes this is performed because of pregnancy complications, however, a significant proportion of inductions occur without any maternal or foetal indication, Blackmores naturopath Stephanie Hamilton explains.
Of course, there are circumstances where inducing labour can save the mother and/or child’s life. Some recognised indications for induction of labour include gestational and pre-exisiting diabetes, premature rupture of the membranes, high blood pressure, foetal growth restriction, foetal distress, foetal death, and antepartum haemorrhage.
However, in South Australia, the proportion of induction procedures that were done without any of the above recognised indications has increased from 35.2% in 1998, to 50% in 2008.
It is well known that an induced labour can be more difficult than a labour that started spontaneously. Inducing labour can also result in a cascade of interventions, including an increased risk of cesarean sections and complications for the mother.
A team of researchers in South Australia have studied the maternal and infant outcomes following induction of labour. They studied almost 29,000 women with a single pregnancy, cephalic presentation at gestational age 37 weeks or more. They found the following results:
- Women were more likely to require epidural or spinal analgesia with induction for both recognised and non-recognised indications when compared with spontaneous labour
- Women were more likely to have complications following induction for non-recognised indications compared with spontaneous labour
- Women were less likely to achieve vaginal birth following induction for recognised and non-recognised indications compared with spontaneous labour
- Women had an increased risk of cesarean sections when induced for non-recognised indications
- Induction of labour for non-recognised indications significantly increased the chance of the infant requiring medical treatment when compared with spontaneous labour.
The study also showed as the number of weeks into pregnancy increased, labour complications and maternal health outcomes improved. There was a greater risk of requiring medical treatment with birth that occurred at earlier gestational ages compared with birth at 40 weeks.
Clearly caution is warranted when making a decision for an elective induction. In Australia, women may be offered induction of labour at 41 weeks, but this does not mean that they have a recognised indication for induction. Remember that the timing of birth will be different for each woman and baby and if you have had an otherwise uncomplicated pregnancy trust that the wisdom of your baby and body will know when the time is ripe.
References available upon request