Which level of risk justifies routine induction of labor for healthy women?

AE Seijmonsbergen-Schermers, LL Peters, Bahareh Goodarzi, Monica Bekker, Marianne Prins, Maaike Stapert, Hannah G. Dahlen, Soo Downe, Arie Franx, Ank de Jonge

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Abstract

Although induction of labor can be crucial for preventing morbidity and mortality, more and more women (and
their offspring) are being exposed to the disadvantages of this intervention while the benefit is at best small or even
uncertain. Characteristics such as an advanced maternal age, a non-native ethnicity, a high Body Mass Index, an
artificially assisted conception, and even nulliparity are increasingly considered an indication for induction of
labor. Because induction of labor has many disadvantages, a debate is urgently needed on which level of risk
justifies routine induction of labor for healthy women, only based on characteristics that are associated with
statistically significant small absolute risk differences, compared to others without these characteristics. This
commentary contributes to this debate by arguing why induction of labour should not routinely be offered to all
women where there is a small increase in absolute risk, and no any other medical risks or complications during
pregnancy. To underpin our statement, national data from the Netherlands were used reporting stillbirth rates in
groups of women based on their characteristics, for each gestational week from 37 weeks of gestation onwards.
Original languageEnglish
Article number100479
JournalSexual and Reproductive Healthcare
Volume23
Early online dateNov 2019
DOIs
Publication statusPublished - Mar 2020

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