Washington - The prevailing wisdom on healthy pregnancies has long been to just wait it out. Only after reaching the full-term 40-week mark will many consider hurrying a birth along with drugs.
The thinking is that inducing labor increases the risk of complications, which lead to more Caesarean sections, putting both the baby and the mother at risk.
A new study suggests that idea might be wrong.
The research, published in the New England Journal of Medicine, focuses on healthy, first-time mothers. More than 6 000 women in 41 hospitals were enrolled in the study and were randomized into two groups. About half were induced in the 39th week of pregnancy. The others were allowed to let their pregnancies progress beyond that time.
The study's outcome was a surprise: Women induced at 39 weeks were less likely to need a C-section than those who waited to let labour begin spontaneously - 18.6 percent for the induced group, compared with 22.2 percent for the other group. The outcomes for the babies were similar for the two groups: They had statistically equal rates of infection, need for respiratory support, hemorrhage, stillbirth, newborn death or other major complications.
Uma M. Reddy, a doctor with the pregnancy and perinatology branch of the National Institute of Child Health and Human Development (NICHD), which funded the study, said it suggests that "one C-section could be avoided for every 28 women who undergo induction at 39 weeks."
The study's authors characterize the research as a game-changer for women suffering from discomforts of later-term pregnancies and for those who want to be able to schedule their deliveries for convenience's sake or to make sure their loved ones can be present.
But the American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine emphasized that their review of the study showed only that it's now "reasonable" for obstetric-care providers to offer this as an option.
ACOG's guidance remains unchanged: Induction without a medical reason should not be attempted before 39 weeks (when baby's lungs tend to be underdeveloped), and induction should be recommended after 41 weeks (when the risk of problems related to the placenta, amniotic fluid, umbilical cord go up for the baby and the risk of a condition known as preeclampsia goes up for the mother).The Washington Post