More Proactive Labor Induction Practice Has Been Shown to Reduce Birth Injuries

In 2008 a study was published that focused on uncomplicated pregnancies. The question was whether to induce labor in women whose gestation had reached 41 to 42 weeks. It was revealed that inducing labor in women who have reached 41 weeks of pregnancy and who were otherwise low-risk showed the condition of the baby at birth to be favorable. The goal of obstetricians was to ensure the successful delivery of the baby before 42 weeks of gestation — for the benefit of the baby and mother.

The study suggested that there was an improvement in prenatal outcomes as a result of a more proactive post-term (more than 39 weeks) labor induction practice.

This guideline has shown that there was a significant reduction in the number of stillborn infants at term, 39 weeks of gestation. In addition to this conclusion, it was found or suggested that maternal deaths were also improved with proactive labor induction.

In this study, which was followed by a practice bulletin issued by the American Congress of Obstetricians and Gynecologists in 2009, newborns from 37 weeks of gestation or older were included.

The study was done over a 13-year period looking at a total of hundreds of thousands of children. It was found that induced labor at 37 weeks of gestation increased 9.1% in 2000 to 26% in 2012.

This study — done with Danish women beyond 37 weeks of gestation — showed that stillbirths, when induced, were reduced by half. In addition, there was a finding of significant reduction in newborns who suffered from asphyxia, neonatal death, newborn macrosomia and other peripheral nerve injuries.

Furthermore, the study showed that there was a consistent decrease not just in asphyxia, but also cerebral palsy.

In the conclusion, it was found that the results suggest an overall improvement in prenatal outcomes where babies were born at 37 weeks of gestation. Labor induction is simple and inexpensive as far as interventions go. However, induction also demands closer scrutiny during delivery. It was noted that the reduction of cerebral palsy is supported with the decrease in asphyxia.

Labor induction is the procedure to stimulate uterine contractions before labor begins on its own. Inducing labor comes with risks to both the mother and the unborn baby. This Danish study, published in the BJOG: NAN International Journal of Obstetrics and Gynaecology, suggests that being more proactive in inducing labor, especially in full term pregnancies, improves the outcomes of the newborn.

Further, the United Kingdom had published its own study that recommended late-term induction in weeks 41 and 42 of pregnancy for uncomplicated pregnancies.

One of the well-known risks of labor induction is if it is ordered before 37 weeks of gestation it could result in premature birth. The March of Dimes has recommended that induced pregnancy should not occur until the gestation has reached 39 weeks at the earliest. That would be its recommendations unless there was need that was related to medical reasons. Babies born prematurely have more problems than those born full-term or later. The most common ailments of premature infants are immaturity of the respiratory system, principally the lungs.

According to the Danish study, the risk of neonatal death decreased from 1.9 to 1.0 neonatal death per 1,000 births from 2000 to 2012. The risks of asphyxia also decreased 23%, which also related to the decrease in cerebral palsy by 26% from 2002 to 2010. The risk of a birth weight of more than 4,500 grams (macrosomnia) decreased by 1/3. The risk of peripheral nerve injury decreased by 43%. Shoulder dystocia was reduced by as much as 32% in this study.

The studies have been commented on frequently by others. A few other recent studies showed that there is no link to induced pregnancies by the medication Pitocin to attention deficit disorder or autism. See the Royal College of Obstetricians and Gynaecologists, article titled: “Perinatal outcomes following an earlier post-term labour induction policy: a historical cohort study.” Feb. 18, 2015.

Kreisman Law Offices has been handling birth injury cases for individuals and families who have been harmed, injured or died as a result of the carelessness or negligence of a medical provider for more than 38 years in and around Chicago, Cook County and its surrounding areas, including Tinley Park, Rosemont, Arlington Heights, Lemont, Joliet, Orland Park, University Park, Rolling Meadows, Naperville, Palatine, and Hinsdale, Ill.

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