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Saturday, August 22, 2009

Less Cesareans with Induction of Labor? Read the Fine Print!

Cross-post from ICAN-Blog:

Media reports this past week have hyped a recent study claiming that induction of labor may actually reduce the need for cesarean. These findings appear to contradict previous research and generally held opinion.

However, these reports have underplayed and underreported the substantial caveats offered by the researchers about their findings. Although the authors do report a 22% reduction in cesareans in women who had elective inductions after 41 weeks, they temper their findings with the following:

1) These findings may not translate to many, if any, hospitals in the U.S. because of how obstetricians tend to practice in reality. According to the press release, “Prior research has indicated that doctors often tend to proceed from starting an induction to cesarean fairly quickly.” Thus, in order for these findings to be relevant, doctors must have patience to allow inductions to work. (Which begs the question: Why not just wait for spontaneous labor to occur?)

2) Induction of labor, on the whole, remains vastly understudied and further analysis is needed. As one of the lead researchers on the study states, "It’s pretty surprising that something obstetricians do all the time hasn’t been studied all that well."

With these substantial caveats in mind, it’s far too soon to rush to the conclusion that induction of labor is “safer” than spontaneous labor, even in post-dates pregnancies. The fact remains that women must be aware of the risks associated with any obstetrical intervention and have the freedom to make choices that they believe are best for themselves and their babies, not doctors’ protocols and hospital time clocks.

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