Rise in planned births tips risk balance

There is an increasing trend for planned births before due date.  This means that more and more, women are being induced or having a caesarean before labour has started on its own.  This is known as an elective caesarean, because labour has not yet started. An Australian study has shown that this approach is probably doing more harm than good.

Planned births before 40 weeks rose between 2001 and 2009, with increases in neonatal and maternal morbidity (such as complications), but no offsetting reduction in stillbirths.  What this means is that when we induce women or perform a caesarean before labour has started, before a woman reaches 40 weeks, we are causing complications for mother and baby.  The main reason for planning a birth before 40 weeks should be because there is a risk of harm to mother or baby, and so the planned birth (by induction or caesarean) is hoped to reduce the chance of the baby being stillborn.  However, this reseach has not demonstratated a reduction in the number of stillbirths.

The proportion of planned births before 40 weeks increased from 19% to 26%.

Inductions increased from 8.9% to 11.4% between 2001 and 2009, and planned caesareans before labour starts increased from 11.4% to 14.9%.

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