New medical guidelines will allow for inductions for pregnant women when they are only one week late. This is to reduce the chance of stillbirths.
Babies are due at 40 weeks. Currently, women can get induction on the NHS if their waters break after 42 weeks.
Yesterday, however, the health watchdog said that this should be reduced to 41 weeks in order to reduce the risk of death or complications.
The National Institute for Health and Care Excellence (Nice) said discussing inductions at an earlier stage is likely to ‘increase the number of women who undergo induction’.
But they stressed that the ultimate decision should still rest with individual women, and they will be given ‘every opportunity to go into spontaneous labour’.
Currently, around one in five labors in the UK is induced. This refers when contractions can be artificially initiated by drugs.
Evidence suggests that induction may reduce the death rate, as pregnancies that last beyond 41 weeks are at greater risk for complications.
Induction will be offered to pregnant women who are one week overdue, according to new medical guidelines. This is in order to reduce the chance of stillbirths.
The guidelines say NHS staff should inform women of risks associated with a pregnancy continuing beyond 41 weeks including ‘increased likelihood of Caesarean birth, increased likelihood of the baby needing admission to a neonatal intensive care unit and increased likelihood of stillbirth and neonatal death’.
However, they stated that there is not enough evidence for a blanket policy favoring inducing pregnancies at 42 weeks. Women should be able talk about all options.
Guidelines state that women who decide not to be infused should be asked if extra monitoring of their fetal health is required starting at 42 weeks.
Nice also said that stillbirths are twice the rate in black babies, and about 50 percent higher in Asian babies than in white babies.
The watchdog has now reversed its earlier proposal that women most at-risk of pregnancy complications should be offered an induction starting at 39 weeks.
Induction should be considered beginning at 39 weeks for women who are black, Asian, or from other minority backgrounds. This is in addition to those who are over-35 or obese.
But was scrapped in the final guidelines published yesterday – a move welcomed by campaigners who stressed ‘one size does not fit all’.
Amy Gibbs, chief executive of the charity Birthrights, said: ‘Birthrights is delighted that Nice has listened to our concerns — shared by so many women and birthing people, healthcare professionals, and birth workers — and removed the draft proposals to single out black and brown women, alongside other groups more likely to face adverse outcomes, for induction even earlier at 39 weeks.
‘We are pleased to see Nice acknowledge the lack of evidence that induction improves outcomes for these women and their babies, and that one size does not fit all.
‘Conversations around induction must be balanced, evidence-based and respect each individual’s right to make their own choice about what is best for them and their baby.
‘This is well reflected throughout the new Nice guideline, so we now need urgently to close the gap between these principles and what happens in practice.’
Sarah Siguine, from pregnancy charity Tommy’s, said: ‘With almost 5,000 stillbirths and neonatal deaths a year in the UK, this new guidance is a welcome step forward in efforts to change these unacceptable statistics and save babies’ lives.
‘However, the Government won’t reach its goal to halve these rates by 2025 without urgent action to understand and address the disproportionate risks facing some mothers who come from minority ethnic backgrounds or live in deprived areas.
‘Earlier induction of labour could play an important part in reducing the risks for some of the most vulnerable families, alongside other things we already know make pregnancy safer, like having the same midwife throughout the journey to parenthood with ongoing risk assessments and frequent check-ups if needed.
‘Mothers should always get a clear explanation of why they’re being offered induction, and be supported to compare the risks and benefits, so it’s reassuring that NICE guidelines emphasise the importance of such open communication and decision-making.’
Elizabeth Duff is senior policy advisor at National Childbirth Trust. She stated: “It’s great news that NICE dropped its draft proposal for induction at 39 weeks of gestation to groups at greater risk of complications, such as Black, Asian and minority ethnic women.
“This was in response to NCT and other bodies representing mothers who used maternity services pointing out that there was no evidence to support such an opinion. It is encouraging that voices have been heard, and that action has been taken.
“However, induction is still a frequent intervention and there is insufficient information about the longer-term effects on parents and babies.
“While current guidance states that women should be able to ask questions, it is highly doubtful that the staffing levels for maternity care will allow for this.
“At NCT, it is important that pregnant women feel in control of their care. Although induction is often a good course of action, it does not eliminate the possibility of spontaneous labour.
“In addition, as the guidance says, there will be no home birth or water birth. Such restrictions can have a severe impact on parents’ autonomy and confidence.