Inducing Labor for Convenience, not Safety
The Los Angeles Times has a lengthy piece today on the induction of labor, a controversial practice that may not be medically necessary nearly as often as it is performed. The reporter indicates:
Fewer than 10% of women underwent induction in 1990, but more than 21% did so in 2004, according to federal government statistics. No one knows how many of those inductions were prompted by legitimate medical concerns. But various studies have put the number of inductions for convenience at 15% to 55% of the total number.
Some seem to put the blame for unnecessary inductions on women, saying, “People want to schedule their birth like they schedule their nail appointments,” and regarding one hospital that has tightened their induction guidelines, “Hospital administrators no longer see sudden spikes in deliveries before major holidays, three-day weekends and Jazz basketball playoff games.”
The assumption seems to be that unnecessary inductions are all being performed at the women’s request. However, what I’ve heard from the women I know who have given birth recently is that they were told, “If you’re not in labor by X (despite due dates being estimates and being variable), we’re inducing.” I’d be interested in knowing just how many women actually asked for an induction with no suggestion from their providers, and why it was granted if there was no medical need. Induction is thought to increase the risk of complications, including the need for c-section.
A midwife interviewed for the story hits on this point, that physicians may actually be suggesting induction to women who don’t realize it’s not necessary.
Women who “haven’t slept well in weeks, have swollen ankles and sore backs” are vulnerable to the suggestion of elective induction. “People look at the doctor as the expert and will do whatever he or she suggests.”
But, she says, “once you do an intervention, it begets more interventions, and many women feel they are led down a road they didn’t understand. Women tell me, ‘I didn’t know it was going to end up like this.’ Women need to be given all the information on what they are signing up for, not just told, ‘You’re going to have your baby today.‘ “
One physician is also skeptical of recent research suggesting that induction does not cause complications when conducted appropriately.
“This is another study saying to women, ‘You can’t survive without us making things better; nature is completely off-track,’ ” says Klein. “And there is a huge reservoir of practitioners out there who want to hear this message.”
There are several studies referenced in the article; I try to dig those up and have more information later in the week.