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    Find out what other moms-to-be are asking. Join in the discussion with Henci Goer, whose expertise is determining what the research tells us best promotes safe, healthy birth. If you would like to contact Henci outside of the Ask Henci forum, send an email to Goersitemail@aol.com.

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    Sep 13
    2013

    Induction reducing risk of cesareans

    Rebecca Meinke
    [Positively Beautiful Birth Service]

    Hello Henci,
     
              As I was looking through facebook today I saw this --> http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828158/ ...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.
    Sincerely,
    Rebecca Meinke

    Henci Goer

    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 


    All Times America/New_York

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