This is because induction later in the pregnancy is a possible outcome with expectant management, just like going into spontaneous labor is a possible outcome. So, with this new understanding, someone in the wait-for-labor group who ends up being induced later in the pregnancy would not be considered inappropriate crossover between groups. The researchers argued that the comparison group must include these people as well. This is a subtle difference, but an important one, because not everyone who waits for labor will actually have a spontaneous labor some will develop complications that lead to an induction and increase their risk for Cesarean. New researchers pointed out that we need to compare people who have elective inductions with the whole group of those who wait for spontaneous labor-whether or not they actually do have spontaneous labor. Previous studies compared cesarean rates of these two groups only: For an example of this earlier flawed research, see this article by Yeast et al. Excluded from these two groups were people who were not electively induced initially, but waited for labor and then ended up having inductions later on, some of which were medically necessary (and, thus, linked to a higher rate of Cesareans). In the earlier studies, elective induction was compared only to spontaneous labor: people who were electively induced versus people who went into spontaneous labor. They argued that earlier studies-where elective induction showed a doubling in Cesarean rates-were flawed. However, in the 2010s, some researchers began to dispute the claim that elective induction doubles the risk of Cesarean. The challenge of choosing the right comparison group to study elective inductionįor many years, the common belief was that elective inductions doubled the Cesarean rate, especially in first-time mothers. In this article, we refer to induction without a medical indication as an elective induction, regardless of gestational age. Some providers consider induction for late and post-term pregnancy alone to be medically indicated because of the increased risks of complications that come with longer pregnancies (Little, 2017). Labor inductions that do not have a clear medical reason (or indication) for taking place are considered “elective” inductions.Įlective inductions might occur for social reasons, like the provider wanting the birth to happen before he or she goes out of town, or other non-medical reasons like the mother wanting to be done with an uncomfortable pregnancy.īut the distinction between elective versus medically indicated induction is not always clear. In general, inductions are considered medically indicated when there are accepted medical problems or pregnancy complications that make it less safe to continue the pregnancy.
Why is there so much controversy about inducing for due dates?
It’s likely that induction of labor is underreported in federal vital statistics (Declercq et al. In the U.S., the Centers for Disease Control (CDC) reported that 27% of pregnant people were induced in 2018 (Martin et al. Another 18% said that they were induced because the health care provider was concerned that the mother was overdue.Out of everyone who was induced, 44% said that they were induced because their baby was full-term and it was close to the due date.The researchers asked mothers to select the reasons that they were induced. said that their care provider tried to induce their labor (Declercq et al., 2013). How often are providers inducing for due dates?Īccording to the 2013 Listening to Mothers III survey, more than four out of ten mothers (41%) in the U.S.
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