Induction of labor is a measure never to be taken lightly. One reason to think twice before inducing is the health of the baby. Another reason is the widely accepted belief that inducing labor increases the need for a cesarean-section (C-section) delivery. A new study from London debunks the belief, finding instead that induced labor lowers the risk of C-section delivery by as much as 12%.
Babies do best when they come naturally but even so, there are a number of reasons why induction is more beneficial than waiting. Diabetes, fetal distress, preeclampsia, and preterm rupture of placental membranes often make induction a necessity. Some babies seem reluctant to come out on their own, making induced labor a necessity when a baby is overdue. Induction is done in about 20% of all pregnancies, for whatever reason.
Professor Khalid Khan and his research team wanted to see if, indeed, induced labor is more likely than not to require C-section delivery. His team analyzed data from 157 randomized controlled trials (RCTs) encompassing 31,085 childbirths to determine the rate of C-sections related to induced labor and to expectant management. Expectant management is a “wait and see” approach to delivery after induction. All deliveries included in the study involved singleton births.
Working from his headquarters at the Queen Mary University of London in the United Kingdom (UK), Khan and his team analyzed medical records from the UK, the United States, and Canada. The team’s findings are “contrary to prevalent beliefs and information from consumer organizations, guidelines and textbooks,” according to Khan. The researchers discovered that when labor is induced rather than managed expectantly, there is:
- 12% reduced risk of C-section delivery in babies carried to full term or longer.
- Lower risk of C-section in both low-risk and high-risk pregnancies.
- Lower risk of complications, including fetal death.
The method of induction seems to make a difference, too:
- When prostaglandin E2 is used to induce labor, it significantly reduced the risk for C-section delivery.
- When oxytocin and amniotomy were used, the risk of C-section did not decrease.
The researchers write that “our meta-analysis has provided a robust answer to the disputed question of risk of cesarean delivery associated with induction of labor.” Their research indicates induced labor is actually less likely to end in C-section delivery than expectant management. Even more significant is that “the risk of fetal death and admission to neonatal intensive care unit were decreased in the induction group.”
Khan’s team suggests the findings of its study could help doctors decide which patients are better candidates for induced labor and provide the doctors with the tools to better explain risks associated with induction.
Source: Khan, Khalid S, et al. “Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis.” CMAJ. Canadian Medical Association. Apr 28, 2014. Web. Jun 3, 2014.