In Australia up to 45% of first time mothers have their labour's induced. Now I don't know about you but I fail to believe 45% of women's body's are incapable are going into labour. We know that rates of stillbirth have remained unchanged despite an increase in induction by over 10% in the past 10 years. We also know that our rates of C/S and instrumental birth have increased at the same rates as our induction of labour despite no evidence this improves outcomes for our babies. Now induction of labour is good option for many women when risk factors are present but there are alternative options for many women with low risk pregnancies. Most hospitals recommend offering induction of labour between 40 weeks and 40 weeks plus 10 days. Some women choose induction between those dates and other women choose to continue there pregnancies until there baby is ready. Most hospitals strongly encourage booking in babies birthday before 42 weeks to reduce the risk of stillbirth. Dr Sara Wickham has some excellent evidence based resources on timing of birth (Induction of labour at or before 42 weeks of pregnancy: new evidence - Dr Sara Wickham).
The induction of labour discussion can be stressful, as mothers we want what's best for our babies, to alleviate some of that stress I have provided a guide below of questions to ask that will help you to make an informed decision about what's best for you and your family.
Here are a few questions to ask your doctor at your "induction chat". ♨️ What will happen if we choose to do nothing right now? ♨️ I'd like 24hrs to decide, no I don't want to "pencil the date in". ♨️What are my options if I choose not to be induced? Current WA policy reccomends a well-being scan at 41 weeks (15% -/+ margin for error). Then twice weekly CTGs until birth. ♨️ What is the latest time frame I can wait before being induced? The current WA policies support delaying induction until 41+3 weeks. Current evidence as per renowned obstetric researcher Sara Wickham supports delaying induction until 42 weeks. https://www.sarawickham.com/topic-resources/post-term-pregnancy-and-induction-of-labour-resources/ ♨️ How will my birth plans change if I'm induced? You will probably have an increased need for pain relief and will have a much higher chance of C/S, instrumental birth and episiotomy, you will need continuous monitoring in labour. ♨️What is my bishops score? A bishops score is the assessment of how soft and open and what position your cervix is in. A bishops score of over 8 is recommended for a more successful attempt vaginal birth. You can also ask for a midwife to be present at your chat, they may also be able to give you alternative options for getting labour started if that's what you choose.
Please speak with your maternity provider for information on what your options are.
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