Induction reducing risk of cesareans

Rebecca Meinke

Induction reducing risk of cesareans

Hello Henci,
          As I was looking through facebook today I saw this --> ...and I have to say I am completely shocked. I am not great at analyzing research on my own, but with the small sample size, differences in caregivers, and, I assume, unreal methods of induction (the article states they used a LOT of prostaglandins in the induction group and most caregivers in my area don't usually take their sweet time ensuring a favorable cervix), there is no way these studies are applicable to the real world. I am also ghastly surprised that they are inducing labor sometimes at 38 weeks of pregnancy; not because of a medical indication, but because of a score on their AMOR-IPAT chart.
          Is this backlash for the recent studies showing a possible correlation with Pitocin and autism or the increased rates of NICU admission? I am sure you have already read the ACOG journal article and  are investigating, but can't resist asking: What's the real evidence Henci? And what implication, if any, do you see these studies having on current maternity care practices?
Thanks for all you do.
Rebecca Meinke

Henci Goer

RE: Induction reducing risk of cesareans
(in response to Rebecca Meinke)

The study you cite is from 2009. I debunked Active Management of Risk in Pregnancy at Term in the "Understanding Evidence" section of this forum. You can find my analysis here. The AMOR-IPAT proponents subsequently conducted a randomized controlled trial that also purported to find benefits for AMOR-IPAT compared with standard care. I deconstructed the RCT in the induction chapter in Amy Romano's and my book, Optimal Care in Childbirth: The Case for a Physiologic Approach. Unfortunately, the passage is several paragraphs long. If you have the book or know someone who does, you can read what we have to say there. 

~ Henci 

Forum Disclaimer

Please note that this Forum is intended to help women make informed decisions about their care. The content is not a substitute for medical advice.