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Published: Monday, February 21, 2011 - 17:16

Expectant mothers have been reminded of potential risks that may be associated with elective labour induction in the absence of a medical reason.

Inducing labour without a medical indication is associated with negative outcomes for the mother, including increased rates of caesarean delivery, greater risk of postpartum haemorrhage and an extended length of stay in the hospital, and does not provide any benefit for the newborn.

The new findings, published in the February 2011 issue of the Journal of Reproductive Medicine, only apply to women having their first child, and may not apply to women having their second or third child.

More likely to have a caesarean

Researchers found that approximately 34 percent of women who opted for elective induction of labour ultimately had a caesarean section, while only 20 percent of women who laboured naturally underwent a caesarean delivery. Naïvely, like with elective labour induction, caesarean delivery may be seen by some as routine and risk-free, when in fact it is a major surgery and like all surgeries increases the risk of infection, respiratory complications, the need for additional surgeries, and results in longer recovery times.

Induction and Postpartum haemorrhage

Additionally, women who were induced had more bleeding - even after taking caesarean deliveries into account - and stayed in the hospital longer than women who delivered vaginally. Study authors calculate that for every 100 women who undergo elective induction, they spend an additional 88 days in the hospital compared to the same number of women who labour spontaneously. Although this may translate into only a matter of hours for some women, it represents increased costs for both the mother and the hospital when multiplied by large numbers of induced labours.

"The benefits of a procedure should always outweigh the risks. If there aren't any medical benefits to inducing labour, it is hard to justify doing it electively when we know it increases the risks for the mother and the baby," said Christopher Glantz, M.D., M.P.H., study author and professor of Maternal Fetal Medicine at the University of Rochester Medical Center.

In the past decade, scheduled deliveries have become commonplace, with physicians making elective inductions part of their routine obstetric care. Study authors cite social reasons, such as convenience and patient requests to deliver with "their" physician, for the ongoing increase in purely elective inductions.

While physicians and patients alike may assume that inducing labour is harmless, it does not work as well as natural labour: Since you are essentially starting the birthing process from ground zero, 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," said Loralei Thornburg, M.D., an assistant professor who specializes in maternal fetal medicine. "Why put you and your newborn at risk if you don't have to?"

Induction of Labour: There may be risks

By Dr Joe Kabyemela, MD