In this episode of the Birthful podcast, I talk with Professor Gene Declercq about the complex realm of inductions. Are there good and not so good reasons for inductions? What are the risks? Do inductions lead to other interventions? Let’s see what the numbers say.
What we talked about:
- Why inductions: convenience, physiology, or somewhere in between?
- Are most babies really born between Tuesday and Friday during the day?
- What about if you’re “over due”?
- The myth of the big baby!
- What do mothers want to know?
- Inductions and prematurity
- The need to control
- Low amniotic fluid? Water breaking prematurely?
- Inductions and the cascade of interventions
- Choose wisely: it always comes back to your care provider
Induction resource links and more:
- Birth by the Numbers – where you can see all of Gene’s slides
- Childbirth Connection -to find out a lot more about inductions
- The Listening to Mothers III report
- Elective inductions and the Bishop Score – what makes an induction likely to work or not?
- Ten things Physicians and Patients should question – ACOGs thoughts on non-medically indicated inductions (from Choosing Wisely)
- Scheduling Early Delivery of Your Baby: Why scheduling early delivery is not a good idea, from Choosing Wisely (Developed in cooperation with the American Academy of Family Physicians and the American College of Obstetricians and Gynecologists.)
- Inducing Labor – the whys and hows (or check out the Birthful episode specifically on the induction process)
- Definition of Term Pregnancy – ACOG’s Committee Opinion (re-defined in 2013, and reaffirmed in 2017)
- What Your Labor Nurse Wish You Knew About Inductions
And because the ARRIVE trial is out there (suggesting that low-risk 1st-time pregnancies have a lower cesareans rate and babies would be slightly better off if they underwent routine induction at 39 weeks), here’s are two important reads from Science & Sensibility:
- Neel Shah, Health-Care Innovator, Speaks Out on the ARRIVE Trial Examining 39-Week Inductions to Reduce Cesareans
- Parsing the ARRIVE Trial: Should First-Time Parents Be Routinely Induced at 39 Weeks?
Related Birthful episodes:
- The Induction Process, with Toni Golen
- Elective Inductions to Reduce the Cesarean Rate?, with Sharon Muza
About Dr. Eugene Declercq
If you’ve heard of or read any of the three Listening to Mothers national reports or the New Mothers Speak Out report, you’ll be interested to know that Gene Declercq served as lead author of these valuable documents on women’s experiences in childbirth, and in the postpartum period. He was a technical advisor to the film documentary, The Business of Being Born, and is also the founder of the website BirthByTheNumbers.org where you can dig deep into birth data, and see a fantasic video – also called “Birth by the Numbers,”- which examines outcomes associated with current US birth practices.
Gene combines formal training in political science with almost twenty years of experience as a certified childbirth educator to examine policy and practice related to childbirth in the US and abroad. He is Professor of Community Health Sciences and Assistant Dean for DrPH Education at the Boston University School of Public Health and professor on the faculty of Obstetrics and Gynecology at the Boston University School of Medicine. His recent work in examining cesarean sections in the US and overseas has focused on maternal and infant morbidity associated with low risk cesareans and with repeat cesareans as well as the programmatic and policy influences on practices related to childbirth practices.
He is one of the Principal Investigators for the Massachusetts Outcomes Study of Assisted Reproductive Technologies (MOSART) an NIH funded study of infant and maternal outcomes associated with assisted reproductive technologies, and is one of the founders of the Pregnancy to Early Life Longitudinal (PELL) data system that links vital statistics, hospital, and administrative data on almost 900,000 births in Massachusetts since 1998. He’s also been active in a variety of public health projects in his hometown of Lawrence, Massachusetts, including a current effort to develop a free volunteer based clinic to serve those without access to care. As an educator, he is a past president of the Association of Teachers of Maternal and Child Health and has been a recipient of the Norman Scotch Award for outstanding teaching at BUSPH. In 2013, he was awarded the Martha May Eliot award from the American Public Health Association for service to maternal and child health in the U.S.
Learn more about the data at BirthByTheNumbers.org
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