My mother was expecting her first child. She was due in late July. Her OB was due to be on vacation. So he induced labor July 9.
That was 65 years ago. But the story, and the disconnect between the body’s wisdom and medical practice is not out of date.
Induction of labor became more and more common, despite increasing evidence of the risks of preterm birth; 23 years later, my labor was induced. The doctor said it was time. Over the last 20 years, the induction rate increased every year to 23.8% in 2010.
Finally, practice is beginning to follow the evidence. New data show the national rate of inductions began inching down in 2011 to 23.5% in 2012, the latest available figure.
The good news is in induction rates for “late preterm” (34-36 weeks gestation) and “early term” births (37-38 weeks). Those rates started downward in 2006, with the greatest improvement (decrease) at 38 weeks. In 36 states and DC, inductions at 38 weeks have been reduced by 5% to 48%.
The national rate is down 12%. The number births at >39 weeks gestation is up 9%.
The bad news is disparities continue. Induction rates at 38 weeks are down 19% for whites, 7% for Hispanics, and only 3% for blacks.
Questions for research: How did the state that reduced its rate by nearly half do that? What is different about the states that reduced their rate by 30% or more —UT, ND, SD and NE— and states where the rate continues to increase—AK, NY and NC?
Source: Osterman MJK, Martin JA. Recent declines in induction of labor by gestational age. NCHS data brief, no 155. Hyattsville, MD: National Center for Health Statistics. 2014.