Findings from a new study have prompted researchers to call for fewer instances of induction of labour among healthy pregnant women.
Rosalie Grivell and colleagues at the University of Adelaide, Australia, looked at the outcomes for natural and induced labours at various time points.
They used figures on 28,626 women whose labour was either spontaneous, induced for recognised indications such as going past 42 weeks, pre-eclampsia, or waters breaking early, or induced for non-recognised indications including "social" reasons, e.g. choosing a preferred date.
The team found that induction for non-recognised indications was linked with a significantly increased risk of a range of outcomes. For example, the Caesarean rate was increased by 67 per cent and the chance of the baby needing neonatal intensive care was 64 per cent higher.
In the journal Acta Obstetricia et Gynecologica Scandinavica, they report that the best outcomes for mother and baby followed spontaneous births. The lowest risk of needing an epidural or spinal block occurred with spontaneous birth at or after 41 weeks, and the lowest risk of a severe perineal tear was spontaneous delivery after 37 weeks. Labour complications were at their lowest after 38 weeks.
The authors conclude: "Induction of labour for non-recognised indications at term is associated with an increased risk of adverse outcomes. Caution is warranted with a liberal policy of induction of labour at term in an otherwise uncomplicated pregnancy."
Ms Grivell says: "Our research relates to the optimal timing and management of labour and birth at term for women with an uncomplicated pregnancy. We hope our findings will increase awareness of potential complications related to the common use of induction of labour in situations where there is no serious maternal or foetal problem."
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