Which level of risk justifies routine induction of labor for healthy women?

Although induction of labor can be crucial for preventing morbidity and mortality, more and more women (and their offspring) are being exposed to the disadvantages of this intervention while the benefit is at best small or even uncertain. Characteristics such as an advanced maternal age, a non-nativ...

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Bibliographic Details
Published in:Sexual & reproductive healthcare 2020-03, Vol.23, p.100479-100479, Article 100479
Main Authors: Seijmonsbergen-Schermers, Anna E., Peters, Lilian L., Goodarzi, Bahareh, Bekker, Monica, Prins, Marianne, Stapert, Maaike, Dahlen, Hannah G., Downe, Soo, Franx, Arie, de Jonge, Ank
Format: Article
Language:English
Subjects:
Adult
Cesarean Section - statistics & numerical data
Female
Humans
Induced
Labor
Labor, Induced - mortality
Medical overuse
Netherlands
Population characteristics
Pregnancy
Pregnant women
Risk
Risk Factors
Stillbirth - epidemiology
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Summary:Although induction of labor can be crucial for preventing morbidity and mortality, more and more women (and their offspring) are being exposed to the disadvantages of this intervention while the benefit is at best small or even uncertain. Characteristics such as an advanced maternal age, a non-native ethnicity, a high Body Mass Index, an artificially assisted conception, and even nulliparity are increasingly considered an indication for induction of labor. Because induction of labor has many disadvantages, a debate is urgently needed on which level of risk justifies routine induction of labor for healthy women, only based on characteristics that are associated with statistically significant small absolute risk differences, compared to others without these characteristics. This commentary contributes to this debate by arguing why induction of labour should not routinely be offered to all women where there is a small increase in absolute risk, and no any other medical risks or complications during pregnancy. To underpin our statement, national data from the Netherlands were used reporting stillbirth rates in groups of women based on their characteristics, for each gestational week from 37 weeks of gestation onwards.
ISSN:1877-5756
1877-5764
DOI:10.1016/j.srhc.2019.100479