Induction of labour—the debate

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.