Induction for older women

The induction of mothers aged 35 and over does not impact on cesarean rates or adversely affect mothers and newborns, according to researchers.

The randomised controlled study of just over 600 older first-time mothers in the UK was carried out by a research team at The University of Nottingham and Nottingham University Hospitals NHS Trust to explore whether induction is an effective and safe intervention that is perhaps currently underused.

Pregnant volunteers were randomly assigned to either labour induction at 39 weeks or to ‘expectant care’  (i.e. waiting until the spontaneous onset of labour or the development of a medical problem that warranted intervention).  Of the 619 women who took part, there were no significant differences between the two groups in how many ended up having cesarean sections or in the percentage of women who had a vaginal delivery with forceps or vacuum-assisted delivery.  There were no maternal or infant deaths and no significant differences between the groups in the women’s experience of delivery or in the frequency of adverse outcomes for mother and baby.

Professor of obstetrics and gynaecology at The University of Nottingham, Jim Thornton,said “Some people say why not just induce everyone at 39 weeks and prevent some stillbirths. Others say that would medicalise many normal pregnancies, increased intervention rates and may have long-term unintended harms…The results support the “induce more women” advocates, although there are still reasons for caution. Our trial was not set up to test induction as a way of avoiding stillbirth, but it does prove the safety of performing a much larger trial to test this further”.

For more on this story see the RCM article here