“The vast majority of inductions are done because the fetus is not growing well in utero, the mother has difficulty controlling diabetes or high blood pressure or the mother is sensing that the fetal movements are reduced and there is fear of a stillbirth,” Kramer says. “But there isn’t clear evidence that inducing labor early resolves problems or improves anything.”
The American College of Obstetricians and Gynecologists has identified specific conditions in which labor should be induced before 39 weeks, including preeclampsia, eclampsia and premature rupture of membranes. But as recognition of the risks associated with preterm births sinks in, some hospitals are implementing new detailed guidelines for doctors to assess medical need before inducing.
In Ohio, for example, the Central Ohio Hospital Council has reduced preterm rates by identifying women at higher risk, such as older or low-income women, and pairing them with a nurse who makes weekly home visits during the latter half of the pregnancy to check on them and address their concerns. And, Kramer notes, “They have been successful without any obvious adverse effects.”