TUESDAY, June 22 (HealthDay News) -- Inducing labor more than
doubles the risk of having a cesarean delivery, according to a new
study that puts some hard-and-fast numbers to a link that experts
have long suspected.
"Induction of labor doubles the risk of C-section," said study author Dr. Deborah Ehrenthal, director of women's health programs at Christiana Care Health System in Newark, Del., and an assistant professor of family medicine at Jefferson Medical College of Thomas Jefferson University in Philadelphia. The research appears in the July issue of Obstetrics & Gynecology.
Many decisions to induce labor are medically necessary,
including situations in which it's deemed safer to deliver the baby
than to continue the pregnancy. But many inductions are "elective,"
requested typically by a woman or her doctor, Ehrenthal also found
in her study. "There are concerns that deliveries are being
scheduled [and labor-induced] for non-medical reasons."
Among them, she said, are women electing to have labor induced
when their partner is available, such as being back in town from a
business trip.
"We need to understand it's not without risk to be doing this," Ehrenthal said of some elective inductions and the higher risk of C-sections. "There are significant risk to moms for C-sections."
In her study, Ehrenthal focused on 7,804 women giving birth for
the first time who delivered single infants at term, between 37 and
42 weeks.
She found that labor was induced in 43.6 percent of the women,
and 39.9 percent of those were elective inductions.
Then Ehrenthal looked at the women who had C-sections and found
that use of labor induction (whether elective or not) increased the
odds of having a C-section by more than 2.6 times.
Put another way, "20 percent of the cesareans were attributed to
the induction, whether elective or not," Ehrenthal said. "We need
to be a little bit less ready to do an induction."
Of the 43.6 percent of women induced, she said, "it's a very
high rate of induction."
Inductions have been rising, said Dr. Caroline Signore, an
obstetrician-gynecologist at the Eunice Kennedy Shriver National
Institute of Child Health and Human Development at the U.S.
National Institutes of Health, who wrote an accompanying
commentary.
In 1990, just 9.5 percent of U.S. women had labor induced, she
wrote, but it was 22.5 percent by 2006.
The new study, she said, puts a number on what experts suspected
-- that the rise in induced labors is driving the rise in
C-sections -- now at an all-time high of 32 percent of deliveries
in the United States.
Elective inductions should not be done before 39 weeks'
gestation, according to recommendations by the American College of
Obstetricians and Gynecologists, but that guideline is not
rigorously followed, Signore noted. In the study, some of the women
were induced as early as 37 weeks.
In 37 percent of the women induced, the women's cervix was not
sufficiently ready, Ehrenthal found.
Having one C-section also increases the chances of having to
have a C-section in later deliveries. "Emerging evidence shows
increasing risk with increasing cesarean deliveries. Preventing the
primary C-section can stop that cascade," and reducing elective
labor inductions is one way to do that, she said.
More information
To learn more about labor induction, visit
the March of Dimes.