What is the truth about Induction of Labour at 42 weeks?

How often have you heard women say “I had to be induced “or my baby might have been stillborn. This statement implies that the balance of power lies in the hands of the Midwives and Doctors whom we have to gain permission from when it comes to how we give birth.

 A woman has to give their consent before any procedure or treatment can be carried out however the area of informed consent is very contentious. So many times in order to gain consent the “Your baby could die” argument is used, when the possibilities of this actually happening statistically is extremely rare. It is very hard to stay true to your core beliefs and inner voice when you are being told “Your baby may die” by a Consultant, a professional who is hugely influential and respected. So even when you feel that your choice feels right for you and your baby, you do not wish to up set your midwife or doctor who is so negative and hostile to your choices so you agree to the treatment and thus you consent.

The evidence that Dr’s are using to talk you into having an Induction of labour at 42 weeks comes from the Cochrane review “Induction of labour for improving birth outcomes for women at or beyond term.” Gulmezoglu AM, Crowther CA, Middleton P. In this review, researchers pooled data from 19 trials with 7,984 low risk women who were randomized to either “Watchful waiting” or induction, There were protocol violations in both groups: 30% of women assigned to induction ended up delivering spontaneously, and some women in the “watchful waiting” group ended up being medically induced.

The number of perinatal deaths was statistically significant between the 2 groups– 1 death out of 3285 births in the labour induction group vs. 11 deaths out of 3238 births in the “watchful waiting” group. However, it is important to note that the majority of these studies were carried out more than 20 years ago—between 1969 and 1992. Furthermore, many of these studies were conducted in India and Thailand. In the 7 studies that were conducted more recently (after 1992), only 1 stillbirth occurred (in the watchful waiting group) reported out of 1817 women. There are 10 newer trials that were not included in this Cochrane review but are “awaiting assessment,” and the authors caution that when these results are included in the next review, it could change the overall conclusions.

If you want to have choice about your birth then you have to be alert to the fact that the Medical model of care  is based on will adopt the “just in case “ policy  which exposes you to a cascade of interventions that can in themselves be detrimental to you and your baby.

Midwives follow rules as set out by the Nursing and Midwifery Council which state:

 “A midwife should work in partnership with the woman and her family. Should enable the woman to make decisions about her care based on her individual needs, by discussing matters fully with her. Should respect the woman’s right to refuse any advice given.”

 Having a midwife who is listening to you and your choices is a very important factor in whether or not you perceive that you have a positive birth. Working for Private Midwives has enabled me to support women who have make choices outside local Maternity services guidelines so if you are reading this and feel you are having to make some tough choices about your care then contact us and talk it through . We are here to provide you with alternatives!