References

Coates R, Cupples G, Scamell A, McCourt C Women's experiences of induction of labour: Qualitative systematic review and meta synthesis. Midwifery. 2019; 17:17-28 https://doi.org/10.1016/j.midw.2018.10.013

Grobman WA, Rice MM, Reddy UM, Tita ATN, Silver RM, Mallett G, Hill K, Thom EA, El-Sayed YY, Perez-Delboy A, Rouse DJ, Saade GR, Boggess KA, Chauhan SP, Iams JD, Chien EK, Casey BM, Gibbs RS, Srinivas SK, Swamy GK, Simhan HN, Macones GA Labour induction versus expectant management in low-risk nulliparous women. The New England Journal of Medicine. 2018; 379:(6)513-523 https://doi.org/10.1056/NEJMoa1800566

Hedegaard M, Lidegaard Ø, Skovland CW, Mørch LS, Hedegaard M Reduction in stillbirths at term after new birth induction paradigm: results of a national intervention. BMJ Open. 2014; 4 https://doi.org/10.1136/bmjopen-2014-005785

Middleton P, Shepherd E, Crowther CA Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database of Systematic Reviews. 2018; 5 https://doi.org/10.1002/14651858.CD004945.pub4

Miller S, Abalos E, Chamillard M, Ciapponi A, Colaci D, Comandé D, Diaz V, Geller S, Hanson C, Langer A, Manuelli V, Millar K, Morhason-Bello I, Castro CP, Pileggi VN, Robinson N, Skaer M, Souza JP, Vogel JP, Althabe F Beyond too little, too late and too much, too soon: a pathway towards evidence-based, respectful maternity care worldwide. The Lancet. 2016; 388:(10056)2176-2192 https://doi.org/10.1016/S0140-6736(16)31472-6

Muglu J, Rather H, Arroyo-Manzano D, Bhattacharya S, Balchin I, Khalil A Risks of stillbirth and neonatal death with advancing gestation at term: a systematic review and meta-analysis of cohort studies of 15 million pregnancies. PLOS Medicine. 2019; 16:(7)1-16 https://doi.org/10.1371/journal.pmed.1002838

NHS Digital. NHS maternity statistics, England 2017–18. 2018. https://digital.nhs.uk/data-and-information/publications/statistical/nhs-maternity-statistics/2017-18 (accessed 14 January 2020)

Rydahl E, Declerq E, Juhl M, Maimburg RD Routine induction in late-term pregnancies: follow-up of a Danish induction of labour paradigm. BMJ Open. 2019; 9 https://doi.org/10.1136/bmjopen-2019-032815

Wennerholm UB, Saltvedt S, Wessberg A, Alkmark M, Bergh C, Wendel SB, Fadl H, Jonsson M, Ladfors L, Sengpiel V, Wesström J, Wennergren G, Wikström A, Elden H, Stephansson O, Hagberg H Induction of labour at 41 weeks versus expectant management and induction of labour at 42 weeks (SWEdish Post-term Induction Study, SWEPIS): multi-centre, open label, randomised, superiority trial. BMJ. 2019; 367:(16131)1-13 https://doi.org/10.1136/bmj.l6131

Does induction really reduce the likelihood of caesarean section?. 2015. https://www.sarawickham.com/articles-2/does-induction-really-reduce-the-likelihood-of-caesarean-section/ (accessed 15 January 2010)

Induction of labour—the debate

02 March 2020
4 min read
 Data released by the NHS has revealed a decrease in the number of women experiencing spontaneous labour
Volume 28 · Issue 3

Abstract

Rising rates of induction of labour are a concern amongst midwifery practitioners. Emma Spillane discusses the research and her views on this debated topic

Induction of labour is currently a topical issue in midwifery. This month, I am risking controversy by discussing my thoughts on the debate over increasing induction of labour. Over the past two years, I have noted in my clinical setting a reduction in the number of births in the midwifery led setting. I have often tried to understand this phenomenon, particularly with what actually feels like much higher rates of activity within the maternity unit. I audit the birth centre data and have noted a decline in the number of mothers attending the midwifery led setting each month.

On reviewing hospital policies and current evidence that may have affected this decline, I noticed the change in recommendations and guidelines for induction of labour for post-ter m pregnancies. It seems everyone is being induced. Despite there being an abundance of evidence that supports induction of labour in relation to reducing stillbirth rates, why do I sense that this is not the right path to be taking, yet again it is being medicalised as a normal physiological process. Is this another case of ‘too much too soon’ as described by Miller et al (2016) whereby the intervention, that is induction of labour, has been shown to improve outcomes by reducing the stillbirth rate, but potentially causes more harm when used indecorously or customarily.

Register now to continue reading

Thank you for visiting British Journal of Midwifery and reading some of our peer-reviewed resources for midwives. To read more, please register today. You’ll enjoy the following great benefits:

What's included

  • Limited access to our clinical or professional articles

  • Unlimited access to the latest news, blogs and video content

  • Monthly email newsletter