Rise in induced births worries doctors

Interested in home birth, hospital birth or private midwifery care? Questions or comments? Email Melissa Maimann or call 0400 418 448. Link

ONE in three pregnant women in NSW has her labour induced - a rise of at least 15 per cent in the past 10 years - with almost half of inductions done without a medical reason.

The World Health Organisation recommendds that inductions may be necessary in up to 10-15% of women. Clearly, our induction rate is two to three times higher than it ought to be ... or alternatively, 50% - 67% of the inductions that are currently performed are not strictly necessary.

Inducing labour, where women are given drugs such as oxytocin or prostaglandin to stimulate the cervix and start contractions, can increase the chances of a caesarean delivery or cause complications for both mother and baby.

Both drugs also make labour more painful because contractions are stronger and longer, leading women to require more analgesia and more time to recover after the birth.

In a study of more than 730,000 births between 1998 and 2007, researchers ... were alarmed to find that half of those having inductions were pregnant with their first baby, a move which could change the way any subsequent births were handled if the induction resulted in a caesarean delivery.

... one-quarter of women given both oxytocin and prostaglandin had caesareans , compared with 19 per cent of those given prostaglandin alone and 15 per cent who had oxytocin.

The main reasons cited for induction were pregnancies of 41 weeks ... hypertension and diabetes, but 45 per cent of women had no medical reason for being induced.

In the past decade the number of inductions carried out on women with hypertension or diabetes rose from 6 per cent to 22 per cent, a result which could be attributed to Australia's the obesity epidemic, an increase in older mothers and better antenatal screening.

... inductions in private hospitals had increased from 18 per cent to 27 per cent.

... too many inductions were being performed on pre-term women in hospitals that lacked neonatal respiratory support facilities, despite most premature babies needing help with breathing ...

... doctors in Queensland ... predicted surgical births would soar in the next decade because one-third of women having their first babies were having [a caesarean] ...

I believe that if the role of the midwife in primary materntiy care was widely supported, we would see a dramtic reversal of the induction and caesarean rates.

Melissa Maimann, Essential Birth Consulting 0400 418 448