For those of you struggling with the news sweeping the internet that a trial has definitively established that women should be routinely induced at 39 weeks, a new study offers push back. (FYI: I deconstructed the ARRIVE trial and its hidden assumptions for Science & Sensibility.) A large, well-conducted study takes a fresh look at […]
The American Academy of Pediatrics (AAP) issued a press release highlighting a study finding that planned cesarean or induction before 39 completed weeks increases the odds of developmental deficits at school age. Let’s look at the study in more detail, but let’s look too at the medical-model assumptions hidden between the lines and compare them […]
“Our evidence suggests that mainstream obstetric science follows mainstream obstetric practice. A patient and expectant approach to birth…where all is considered normal until proved otherwise, produces a science that proves intervention to be unnecessary. Alternatively, an aggressive approach to birth…, where birth is regarded as normal only in retrospect, generates a science that demonstrates the […]
The Leapfrog Group, which collects data on a voluntary basis from hospitals and compares results with national standards in order to evaluate quality of care, opens its 2015 report on U.S. maternity care with: “[T]here is substantial evidence that U.S. hospitals overuse medical interventions, exposing mothers and babies to unnecessary health risks from C-Sections, episiotomies, […]
Once again the internet is abuzz over a study concluding that inducing labor doesn’t increase the cesarean rate, this time in week 39 in 1st-time mothers age 35 or older. The justification for the study is that the stillbirth rate in older women at 37 wks and beyond is the same as the rate for […]
Some months ago, Henci deconstructed the prepublication manuscript of a systematic review concluding that elective induction at 40 weeks had benefits and didn’t increase the cesarean rate for Science & Sensibility. Now the study has been published and is once again receiving favorable press, so her post might come in handy.
A Medscape article reporting on a randomized controlled trial claims that induction with an unfavorable cervix doesn’t increase cesarean rates, but let’s look closer. Investigators randomly allocated 162 1st-time mothers with a Bishop score of 5 or less (a 1-10 scale measuring cervical readiness for labor) to elective induction at 40 wk or expectant management. […]
In a new Science & Sensibility post, “Elective Induction at 40 Weeks? ‘Decision-Based Evidence Making’ Strikes Again,” Henci deconstructs a systematic review claiming that elective induction at 40 weeks improves outcomes without increasing cesarean rate.
German investigators explored the relationship between labor induction and fetal death between 2005 and 2012 in 5,300,000 births in order to determine whether a policy of late term induction decreased fetal death rates. The induction rate rose over the time period from 17% to 22% of all deliveries (induction rate in women who labored not reported). The […]