Not Before 39 Weeks
The nation's largest association of obstetricians and gynecologists issued new guidelines today to reduce the number of induced labors now at “epidemic” numbers.
The American College of Obstetricians and Gynecologists (ACOG) is advising doctors not to induce labor when there is no medical reason before 39 weeks into a pregnancy.
Labor is induced to artificially stimulate uterine contraction so the woman can deliver vaginally.
For the past two decades, inducing labor has been done increasingly for the convenience of either the mother or the doctor. If a doctor is going out of town or a labor occurs in the early morning hours, a woman might agree to induce to have her doctor there instead of someone unfamiliar deliver the baby. She might have a limited time off of work.
While the new guidelines don’t address those “soft reasons” they do stress that fetal lungs are fully mature at 37 weeks only 90 percent of the time, increasing health risks for the baby.
And inducing increases the risk of Caesarean section, which involves a longer hospital stay and higher cost.
The March of Dimes, in a report last year found preterm birth – delivery before 37 weeks of pregnancy – increased the risk of death in the first month of life.
Prematurity, especially those babies born sooner than 34 weeks, is associated with a wide host of health problems that include delays in development, neurological problems, increased mortality, and lower IQs.
Rates have gone up from 90 per 1,000 births in 1990 to 225 per 1,000 births in 2006, or approximately one in five. The Houston Chronicle reports in one Houston hospital labor is induced 50 percent of the time.
Dr. Damla Dryden, an ob-gyn with the Women's Specialists of Houston at Texas Children's Hospital, says the trend has been for people to push for an earlier delivery before something goes wrong with the baby.
“The new guidelines stress the issue a little more clearly than previously, but journal articles and studies have pointed out the trend for a while now and doctors still feel a lot of pressure from patients for it," she said to the Chronicle
According to ACOG, there are health conditions that may warrant inducing labor including the maternal and infant condition, the cervical status, gestational age, hypertension, preeclampsia, eclampsia, and diabetes, among others.
The organization stresses that when a woman is induced, a physician capable of performing a cesarean section should be readily available in case the induction does not result in a vaginal delivery. #