College of Medicine & Veterinary Medicine

Study looks at benefits of inducing labour

Babies born when labour is induced around their due date may have better survival rates than those whose birth is not induced.

Researchers found that stillbirths and new born baby deaths were less likely to occur when labour was induced at 40 weeks compared to births where the pregnancy was allowed to continue.

Inducing labour

Doctors worry that inducing healthy pregnant women before 41 weeks increases the risk of caesarean section. Our study suggests that there is no increased risk of caesarean with induction at any time from 39 weeks onwards.

Dr Sarah StockTommy's Centre for Maternal and Fetal Health

Women whose labour was artificially triggered at 40 weeks were also less likely to need a Caesarean section than those who waited to go into labour.

The study from the University of Edinburgh looked at elective inductions - those carried out by choice.

Thus, it did not include births where labour was bought on due to medical complications, such as high blood pressure in the mother or fetal distress.

Stillbirths and neonatal deaths

Stillbirths and neonatal deaths occurred in 0.08 per cent of cases after labour was electively induced.

This compared to 0.18 per cent of births when the pregnancy was allowed to continue.

Researchers estimated that there would be one less stillbirth or neonatal death for every 1,040 births electively induced at 40 weeks compared to births that were not induced.

Increased admissions to neonatal units

However, while survival rates were better for babies when labour was induced, admission to neonatal care units was slightly higher in these pregnancies.

The research, published in the British Medical Journal, looked at survival rates for more than 1 million births that took place between 37 and 41 weeks of pregnancy.

Researchers stress that their findings are not a reason for all women to be induced at 40 weeks.

Whilst further studies are needed, our study suggests that the risks for women and their babies of induction at around 40 weeks are less than we thought, and the benefits may be greater. So clinicians should perhaps not be as concerned about agreeing to a request from a pregnant woman to be induced at around 40 weeks of pregnancy. Women who make this request should however be warned of the small increase in the risk of neonatal unit admission associated with induction.”

Dr Sarah StockTommy's Centre for Maternal and Fetal Health

Current guidelines

Current guidelines from the National Institute for Clinical Excellence (NICE) suggest that healthy pregnant women should be offered induction at 41 weeks of pregnancy.

Statistics show that stillbirths and neonatal mortality increase from after 38 weeks of pregnancy.

They show that that inducing labour improves survival rates for babies when pregnancy has lasted more than 42 weeks.

Until now there has been little research that looks at the impact of inducing labour on births for shorter pregnancy terms.

Data

Data analysed for the study included more than 900,000 births when labour was not induced and more than 175,000 births when labour was induced.

The research was funded by the Chief Scientist Office of the Scottish Health and Care Directorate.

It looked at data collected from births that took place in Scotland between 1981 and 2007.

Experts hope to follow up their research with a clinical trial, comparing births with elective induction of labour with births where labour occurs naturally.