Thursday, 6 October 2011

Is a 37% Induction rate for healthy women normal?

Induction of Labour Audit, Power Point Presentation 2011  
Airedale Maternity Services did an audit on various aspects of their Induction of Labour practice and presented it to the local MSLC.  Key statistics included:

Parity 24% nul par, 19% 1 par ( the majority of women induced are first time mums, or with one previous pregnancy that was 'viable' whether or not the baby lived beyond 20 weeks gestation).

45% of those induced are 41 weeks gestation and 37% of the women induced are for postdates only.  This means that nearly half the women are being induced within the recognised normal range for gestation, and

37% of those induced are entirely healthy and normal, the arbitary line of induction policy is the only reason for this intervention.

The other shocking thing is that in this Trust 73% of women induced are put on Electronic Foetal Monitoring, not intermittent auscultation. The reasons we were told are 'historical' ie not evidence based.

Comment: As women and midwves we need to ask whether we have got our sums right on length of pregnancy if 37% of healthy women need to be induced for postdates alone. A Stats textbook called Supercrunchers by Ian Ayres demonstrates how our clinicians have got their sums WRONG in calculating the length of preganncy.  Also check out Ann Frye' fantastic textbook of Holistic Midwifery.  She quotes Professor Carol Woods method of calculating length of pregnancy - based on research into the actual lengths of pregnancy groups of women have.  We should not accept high induction rates of health women for postdates as normal and acceptable maternity care.

1 comment:

Muddling Along said...

Post dates induction is one of my greatest irritants

If I have heard one mother say 'I had to be induced' I've heard a million - what has happened to expectant management? What has happened to giving it until 42 weeks? Why don't people challenge these 'rules' and take responsibility for not starting a cascade of interventions?