Health & Medicine - Posted by Emily Boynton-Rochester on Monday, February 21, 2011 15:09 - 3 Comments    
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‘Social’ inductions risky for moms-to-be

Scheduling deliveries for "social reasons" rather than medical ones raises health risks for the mother and has no benefit for newborns. (Credit: iStockphoto)

U. ROCHESTER (US) — Inducing labor without a medical reason often results in negative outcomes for the mother—including increased rates of cesarean delivery, greater blood loss, and an extended length of stay in the hospital.





A new study, published in Journal of Reproductive Medicine, also finds the procedure doesn’t provide any benefit for the newborn.

The research only applies to women having their first child, and may not pertain to women having their second or third child.

“The benefits of a procedure should always outweigh the risks. If there aren’t any medical benefits to inducing labor, it is hard to justify doing it electively when we know it increases the risks for the mother and the baby,” says Christopher Glantz, professor of maternal fetal medicine at the University of Rochester and the study’s author.

Scheduled deliveries have become commonplace in the past decade, with physicians making elective inductions part of their routine obstetric care. Social reasons, such as convenience and patient requests to deliver with “their” physician, are often cited for the ongoing increase in elective inductions.

Because the birthing process is being started from ground zero, inducing labor does not work as well as natural labor and more problems are likely to arise.

“As a working professional and a mother, I know how tempting it can be to schedule a delivery to try to get your life in order, but there is a reason that babies stay in the womb for the full term,” says Loralei Thornburg, assistant professor specializing in maternal fetal medicine. “Why put you and your newborn at risk if you don’t have to?”

Approximately 34 percent of women who opted for elective induction of labor ultimately had a cesarean section, considered major surger, increasing the risk for infection, respiratory complications, the need for additional surgeries, and results in longer recovery times.

Additionally, women who were induced experience more bleeding—even after taking cesarean deliveries into account—and stayed in the hospital longer than women who delivered vaginally.

For every 100 women who undergo elective induction, an additional 88 days are spent in the hospital compared to the same number of women who labor spontaneously.

“Counseling women to steer clear of an elective induction can be challenging, but the bottom line is that medical reasons trump social reasons,” says Eva Pressman, M.D., director of Maternal Fetal Medicine at the Medical Center.

“If physicians are armed with information about the risks associated with elective induction they have a better chance of convincing their patients to avoid this route.”

Scheduled deliveries do not improve the health of newborns either. When women were induced, babies were more likely to need oxygen immediately following delivery and were more likely to require specialized attention from members of the neonatal intensive care unit (NICU).

The study included 485 women who delivered their first child between January and December of 2007. Researchers reviewed each mother’s and baby’s medical chart, as opposed to relying on medical coding.

Evaluating each chart allowed researchers to figure out exactly why women were induced and what the complications were, catching subtle details that may have otherwise been overlooked.

As opposed to women having their first baby, women who have already had a child may actually respond more favorably to induction. “If you’ve delivered once before, your body knows the drill and can do it again,” Glantz says.

“Past research has shown that inducing labor early without a legitimate medical reason is risky, and this study further validates these findings” adds Thornburg.

More news from University of Rochester: www.rochester.edu/news

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3 Comments

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Karen
Feb 22, 2011 13:56

this makes a lot of sense, especially in light of the fact that calculating gestational age is really a bunch of guesswork. I got three different estimates (my own calc, GYN’s calc, calc based on ultrasound) for my first child and he was later than all three. People aren’t always good a remembering when their last period was, and time from menses to ovulation varies for women, so why not let you body and the baby decide when it’s time to deliver? And why introduce medications into the process when they’re not necessary? Having a baby is never ‘convenient’…don’t know why people can’t deal with the unknown…

Cat
Feb 22, 2011 14:34

It would be more helpful in this release if “medical condition” was given more detail. What does that mean exactly? I was one of those women who was induced during the time period in the study, and it was wonderfully successful. Pitocin worked, epidural worked, I couldn’t have been happier. It was only when the baby popped out did the hell and shock of sleep deprivation over the next six weeks bring me to my knees. My “medical condition” was that I was 39 years old and slightly high risk, but I had no complications during the entire pregnancy. Pregnancy was great, delivery was great, infancy was miserable. I really wanted to just put her back inside!

kristi
Feb 23, 2011 2:40

Cat: you were one of the lucky ones, I’ve had several friends who were induced because they were “sick of being pregnant.” And go figure, all four of them ended up with c-sections. This isn’t the only study to show the unnecessary medical interventions lead to more interventions and much higher risk. I encourage you to do more research on the “meds of labor” including epi’s and pit.

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