The pros and cons of inducing labor

Researchers have found that inducing labor after 37 weeks of pregnancy can lower the risk of perinatal mortality without increasing caesarean section rates. However, babies born to mothers who are induced are more likely to be admitted to a special care baby unit. The study is published in BMJ (British Medical Journal). Women over 41 weeks pregnant are often induced by physicians in order to lower the risk of perinatal mortality. In addition, inducing labour after 37 weeks also lowers the risk of complications, especially when a mother has existing health problems like hypertension. In this study, Scottish researchers used birth and death records in Scotland in order to examine data on more than 1.2 million women with single pregnancies who gave birth after 27 weeks gestation between 1981 and 2007. The team compared rates of maternal complications and perinatal mortality after elective induction (induction of labor with no recognized medical indication) and expectant management (spontaneous labour, induction, or caesarean section at a later date). The researchers adjusted outcomes for factors, such as mothers age at delivery, birth weight, deprivation and whether the mother had previously given birth. Results from the study showed that compared with expectant management, elective induction of labour was linked with lower mortality rates and did not increase the need for caesarean sections. In the induction group, 37 of the 44,764 (0.08%) babies died at 40 weeks gestation vs. 627 of the 350,643 (0.18%) in the expectant management group. Furthermore, babies were more likely to be admitted to a special care baby unit in the induction group (8%) than those in the expectant management group (7.3%). According to the researchers, for every 1,040 women induced at 40 weeks, 1 perinatal death may be prevented. However, this would result in 7 more admissions to a special care baby unit. Even though there is a possibility that these results may be explained by other factors, the researchers state that inducing labor at term "has the potential to reduce perinatal mortality in developed countries without increasing the risk of operative delivery."