Doctors’ increasingly frequent decisions to induce labor instead of waiting for nature to take its course have played a significant role in the rise of preterm births over the past two decades, according to new research.
The practice of induction for any number of reasons even appears to be “socially contagious,” says Michael Kramer, M.D., professor of pediatrics, epidemiology and biostatistics at McGill University in Montreal and the author of the study, published recently in BJOG: An International Journal of Obstetrics & Gynaecology.
While doctors might believe they’re erring on the side of caution, it’s possible that they’re being swept into a social phenomenon. In other words, if a doctor’s colleagues are quick to induce labor, the practice seems more acceptable and reasonable.
“People tend to copy and emulate the leaders in their field,” Kramer explains. “But there isn’t very good evidence that doctors who are more likely to induce labor have better outcomes in terms of the health of the mother and child.”
Preterm birth rates in the United States rose by 30 percent between 1992 and 2006. Much of that increase was in preterm births that occur between 34 weeks and 36 weeks. Meanwhile, the rate of medically induced labors nearly doubled during this period.
Even though many inductions are being done only two to three weeks before women’s due dates, they’re not as harmless as previously thought: Research now shows that birth even one or two weeks early can increase the risk of complications and developmental delays. Preterm babies’ organs are not fully developed, so respiratory and digestive tract complications can arise early in life.
Preterm births between 34 weeks and 36 weeks raise the risk of jaundice, hypoglycemia, respiratory distress and even death among newborns, as well as an increased risk of needing intravenous feeding and a longer hospital stay than normal. Later in life, according to numerous studies, these babies have been shown to have lower academic test scores and more behavioral problems compared with children born at full term.