Whether to induce labor for babies at or beyond full term is a difficult decision.
Waiting to give birth after 41 weeks’ gestation may slightly increase the risk that the baby will die before or shortly after birth. But there are also risks in inducing labor, including lowering the baby’s heart rate and an increased likelihood of infection for both mother and baby.
Now a review in the Cochrane Library of 30 randomized trials involving more than 12,000 women with normal pregnancies in the United States and 13 other countries has found that induction at or beyond 41 weeks of gestation is safer than waiting.
The analysis found that compared with waiting for labor to begin, induction was associated with fewer perinatal deaths, stillbirths and cesarean sections.
The incidence of perineal trauma, postpartum bleeding or the need to admit babies to a neonatal intensive care unit was the same whether a woman was induced or not, and the amount of time mothers had to stay in the hospital did not differ between groups.
“We’re moderately confident that inducing women at or after 41 weeks will reduce perinatal deaths, especially stillbirths,” said the lead author, Philippa Middleton, an associate professor at the South Australian Health and Medical Research Institute. “There aren’t many interventions that do this. This is one of them.”