Large Danish Study: Induction not related to Higher C section rates

Sara - posted on 06/21/2011 ( 11 moms have responded )




I thought this was really interesting, since the population studied was quite large, and there were many factors that they took into account when analyzing the data.

Labor induction has been a topic of debate amongst the medical community during recent years. The concern was that labor induction increased the chances of needing an emergency cesarean section. These concerns, according to a recent study conducted by Ole Bredahl Rasmussen , MD, of Herning Hospital in Denmark and Steen Rasmussen from the Danish Medical Birth Registry, can be laid to rest.

The study was published in the Nordic Journal Acta Obstetricia et Gynecologica Scandinavica (AOGS). Data from one of the largest birth registries in the world, the Danish Medical Birth Registry, was used to conduct the study. This study would include much larger population-base than other similar studies. The researchers evaluated data from women with different stages of pregnancy, lifestyles, and ages. They looked at women who had delivered in large hospitals and small clinics. They even considered women that were having their first baby as well as women who were having a subsequent child. Overall, the data included 230,528 different women that had delivered between 2004 and 2009.

The goal was to determine if a labor induction performed around term would cause an increase in cesarean birth when compared to the C-section rates of women that waited past term for a spontaneous labor or had an induction. At first, the data did not look very promising. According to the initial numbers, women who were induced were showing an increase of 15% for cesarean births when compared to women that had waited for a spontaneous labor or waited until well after their due date to have an induction. This wasn’t the end of the study, however.

The researchers started to take other varying factors into consideration. They compared women based on their gestational week. They considered age, whether or not the woman was a smoker, and if she had received an epidural. Once the adjustments were made, the research told a different story than the initial data had indicated. They found that women who were induced around their term date, during gestational weeks 39, 40, and 41, did not have an increased risk of cesarean birth.

Ramussen did state, however, “The rate of cesarean section differs in different gestational weeks. Our study thus shows that it is necessary to take gestational length into account when induction of labor and expectant management are being compared.”

The significance of the study does, however, show that there is little to no benefit to waiting past term to induce labor. This could change the way that medical practitioners look at the overall prognosis and treatment plan of a woman when she is reaching her due date.


Sara - posted on 06/23/2011




Well, I think you have to wonder too about the difference in practice here in the US and in Denmark or other countries. I get the feeling if they had done the study in the US, it may have different results, just like that article you posted, Erin.


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Minnie - posted on 06/23/2011




Perhaps they also didn't include in this study the use of contraindicated drugs for induction. Like cytotec, which definitely does increase the possibility of emergency c-section.

Rosie - posted on 06/21/2011




that is pretty interesting sara. i do wonder about the bishop score thing too. i was induced with my last 2 and i don't know my bishop score, i was never really told it, but i was 3-4 cm, and at least 50% effaced each time. didn't have any problems with either. first one i was 40 wk 1 day, 2nd induction i was 39 weeks 1 day.

Emily - posted on 06/21/2011




i was 41 weeks and 2 cm and only 30 effaced. I was induced at... 11 am and had my son vaginally (9 lb 7 oz 21 inches) at 5 17 pm that same night. It was completely painless. Though I did tear a little, I am getting arond great and mostly healed.

Sara - posted on 06/21/2011




Yeah, Erin, I assume there are more factors considered than what is mentioned in this article. I'd like to see the study myself to see what factors they did take in consideration when they analyzed the data.

Ez - posted on 06/21/2011




There's no mention of favourability (Bishop's score). That's the biggest indicator as to whether an induction will be successful (more so than gestational week). Inducing at 39 weeks when the cervix is already 3cm dilated, soft and effaced is going to be more successful than attempting it at 41 weeks on a high, closed cervix.

And even if this data is accurate (I would love it if it is!), there are other issues to consider when assessing the benefit of induction. Like whether or not you want to subject yourself and your baby to hours of bone-crushing Pit contractions.

Elfrieda - posted on 06/21/2011




That's very interesting. I was terrified during the 5 days I was going overdue, fearing that if the baby waited much longer to come out, I might have to get an induction and go straight to the operating table! Yes, it was a little irrational, but that's how very pregnant women think. :)

I hope they do another study leaving out the overdue inductions, and compare that.

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