Elective Inductions and the Risk of Cesarean Section
Induction of labour are the procedures have enabled obstetricians to save the lives of the foetus or unborn and also the mothers when their lives are at risk especially in cases of prolonged pregnancies. In order to provide care which is clinically effective, we must be sure that the procedures used have evidence to support their use and that this evidence forms the basis for policies and guidelines that are made to ensure the safety of the mother and child.
As much as these discoveries were meant to achieve positive results, nowadays such procedures are used for convenience rather than the addressing the issues it was formulated for. The focus of this literature review is on the following issues:
Does the occurrence of caesarean section correlate with induction of labour?
Does the risk outweigh the benefits?
In the ancient times, giving birth was a very dangerous process, both for the mother and infant, due to the lack of medical assistance, knowledge and technology. However, the modern era and its fast paced society have initiated a seemingly never-ending increase in medical intervention during the birthing process. This has in turn, given patients a number of options and avenues to choose from. In an article[i]published in 1999, Anne D. Walling, MD stated that induced labor not only increased the chance of caesarean sections, but actually doubled the chance of having the procedure. The recent study rates show that procedures using induction are about 9.5 to 33.7 annually in the U.S. Research has also been done in order to try to prove that induction of labour might increase the chances of caesarean birth. Between 1997 and 2003, caesarean birth rate in the U.S. has continuously risen by 27.6%
There have been concerns about the increase in the number of obstetric procedures solely for convenience mothers are fully informed of the potential risks, benefits and alternative approaches so that they can make rational decisions and are given evidence on what is expected. These procedures have increased risks of other interventions and complications Common Obstetrical procedures and interventions performed without medical induction. As these risks remain unclear, and the practice of labour induction continues to increase.
-Does the occurrence of caesarean section correlate with induction of labour?
Caesarean section is the procedure done to remove the baby or babies from the mothers abdomen when the mother or baby’s life is at risk. Caesarean section has been found to involve more risk than virginal birth (Simpson & Thoman, 2005). Labor induction is defined by the use of chemical or physical processes in order to bring about uterine contractions earlier than the natural process of labor. Obstetricians view that inducing labor does increase the rate of caesarean deliveries. The phenomenon considered is that by inducing birth by injection of various substances, the natural process of birth is disturbed and leads to more caesarean sections. But some tests have shown that on the contrary reduces the rate of caesarean section example the Hannah trial have shown that no significant heterogeneity was detected across the trials reviewed irrespective of parity, cervical ripeness method of induction or ambient caesarean section rates (Edmonds & Dewhurst, 2007).
-Do the risks of elective induction outweigh the benefits?
The Risks of elective induction are many and vary from patient to patient. There is increased risk of scar rapture especially in women who have undergone c-section. Maternal pyrexia is also a problem that affects the thermoregulating centres in the brain. Artificial Rupture of membranes (ARM) is a method of induction of labour and as a means of augmenting labour and can stimulate unnaturally strong contractions which make it difficult for the mother to cope and has its side effects. The longer the interval between rapture membranes the greater the risk of the mother getting intrauterine infections. ARM like other methods of induction can cause excessive moulding of the baby’s head making it appear misshapen furthermore the baby is at risk of trauma to the scalp during amniotomy.
Elective induction of labour has more risks that are associated with it as compared to the benefits. Elective induction of labor should be avoided at all costs unless the circumstances necessitate its use. Maternal care givers therefore, need to use methods or procedures that have been tested and proven and make sure that the expectant mothers are aware of the decisions they make when delivering. The people who offer maternal services have the responsibility of providing proper health care that is safe both to the mother and the baby.
Edmonds, K. & Dewhurst, J. (2007). Dewhurst’s Textbook of Obstetrics ; Gynaecology.
7th Ed. Published by Blackwell Publishing.
Simpson, K. R. ; Thorman, E. K (2005). Obstetric “Conveniences” Elective Induction
of Labor, Cesarean Birth on Demand, and Other Potentially Unnecessary
Interventions. Vol. 19, No. 2, pp. 134-144. Uppincott Williams ; Wilkins, Inc