Induction of labour

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Selected women

Selected women include those aged between 20 and 34 years, whose baby’s gestational age at birth was between 37 and 41 completed weeks, whose baby was a singleton and whose baby’s presentation was vertex.

Comparison of ‘selected’ groups of women allows for an indication of standard practice. Selected women, for this indicator, refers to a cohort of mothers who are expected to have reduced labour complications and better birth outcomes. The proportion of selected women is approximately one-third of all women who gave birth in 2016

Clinical commentary

Induction is an intervention to stimulate the onset of labour. When induction of labour is indicated on medical grounds it is undertaken when the risks of continuing the pregnancy are greater than the risks associated with being born (McDonnell 2011). For the woman to make a fully informed decision, she should be given clear information regarding the risks of continuing the pregnancy and awaiting the spontaneous onset of labour versus the risks of the intervention of induction.

Maternal factors such as wellbeing, cervical assessment, parity and previous mode of delivery, and fetal factors such as gestational age, growth and wellbeing of the fetus need to be considered when deciding whether labour should be induced (McCarthy & Kenny 2013). These factors also assist in determining the method of induction, which can be surgical (including artificial rupture of membranes) and medical (including use of prostaglandins and/or oxytocin) (AHMAC 2012; Queensland Health 2017).

There are numerous indications for induction of labour. Prolonged pregnancy is the most common indication, with births after 42 weeks associated with an increased risk for the baby and a greater number of perinatal deaths (Gϋlmezoglu et al. 2012). It is widely recommended that induction should be offered for women of 41–42 weeks gestation (Gϋlmezoglu et al. 2012; NICE 2008; Queensland Health 2017).

Indicator specifications and data

Excel source data tables are available from the Data tab.

For more information see Specifications and notes for analysis in the technical notes.

References

  • AHMAC (Australian Health Ministers’ Advisory Council) 2012. Clinical practice guidelines: antenatal care—module 1 (PDF) . Viewed 10 April 2013.
  • Gulmezoglu AM, Crowther CA, Middleton P & Heatley E 2012. Induction of labour for improving birth outcomes for women at or beyond term. Cochrane Database of Systematic Reviews, 6:CD004945.
  • McDonnell R 2011. Induction of labour. O&G Magazine 13(3):62–4.
  • McCarthy FP & Kenny LC 2013. Induction of labour. Obstetrics, Gynaecology and Reproductive Medicine, 24(1):9–15.
  • Mozurkewich E, Chilimigras J, Koepke E, Keeton K & King V 2009. Indications for induction of labour: a best-evidence review. BJOG: An International Journal of Obstetrics and Gynaecology, 116:626–36.
  • NICE (National Institute for Health and Clinical Excellence) 2008. Induction of labour: NICE clinical guideline 70. Manchester: NICE.
  • Queensland Maternity and Neonatal Clinical Guidelines Program 2011. Queensland maternity and neonatal clinical guideline: induction of labour. Brisbane: Queensland Government.