Neighbourhood Midwives

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The following is a post put out by Sara Wickham about the current Induction debate. We currently have a 32.6% induction of labour (IOL) rate with only 52.2% of women experiencing a spontaneous labour. Read Sara’s piece about how information is being manipulated and women misled.

sarawickham.com
October 6 at 2:25 PM ·
“Although induction at term could prevent rare cases of fetal death,” write Seijmonsbergen‐Schermers et al (2019) in the BJOG, “all induced women will be exposed to potential disadvantages. Women whose labours are induced have a higher risk of postpartum haemorrhage, uterine rupture, hyperstimulation resulting in fetal distress, and perineal injuries (Miller et al. Lancet 2016;388:2176–92). Furthermore, more women need pain medication and have limited freedom of movement, a longer labour, and a negative birth experience. There is increasing evidence that suggests negative consequences of synthetic oxytocin administration. This may influence maternal–fetal bonding, the maternal psyche, and neonatal preparation on being born. A large cohort study found higher rates of jaundice, feeding problems, infections, metabolic disorders, and eczema up to 5 years of age among children born after induced labour (Peters et al. Birth 2018;45:347–57).”
This is just the beginning of half of a debate about whether or not induction should be offered to all women at term. It’s fascinating to see that the publishers have made the “pro” induction paper freely available, and yet one can only see the “against” argument, which begins with the paragraph above, by either paying or having academic access. That’s why I’m sharing this today.

Women deserve better than this. The evidence on which pro-induction arguments are based is not as sound as it could be. We need to understand that waving a research finding around isn’t good enough. These days, “evidence” is cheap. We need analysis and careful thinking, especially when the issues are as complex as they are here. And I am constantly meeting practitioners who work on labour wards who laugh at the finding that ‘induction reduces caesarean rates’. Not in their experience it doesn’t.

Induction will be the right decision for some, and not for others. Some women regret agreeing to induction, and others are happy.

We need to share the viewpoints that are being suppressed. And spend more time helping people see that there is always more than one perspective.

https://obgyn.onlinelibrary.wiley.com/…/10.…/1471-0528.15887