Our philosophy has always been safety of mom and baby first, centering a woman’s own choices around her labor experience next and avoiding intervention when possible. Our group prides ourselves on our patience as physicians allowing us to focus on education, giving women the tools to make the most informed decisions possible and giving them and their bodies the time to deliver in the healthiest way possible.
In a groundbreaking study published last month, the NIH was able to randomize 6000 low risk women in their first pregnancies to either be watched until they went into labor (or induced before 42 weeks) OR to be induced in the 39th week.
In the group that was induced at 39 weeks:
- Need for respiratory support in the infant went from 4% to 3%
- Overall neonatal complications dropped from 5% to 4% (not statistically significant)
- Cesarean rate dropped from 22% to 18%
- Risk of preeclampsia or gestational hypertension dropped from 14% to 9%
This is the first, large study to establish that not only does induction of labor at 39 weeks NOT increase the risk of cesarean, but both reduces that risk as well as the risk of other complications of pregnancy and delivery.
It’s important to understand that waiting for your body to go into labor, in a low-risk pregnancy, is still considered safe until 42 weeks. However, this information should be included in every woman’s personal decisions around if and how long to wait before scheduling an induction.
It may also change decisions women make around stripping membranes in the 38th and 39th weeks of pregnancy. Many physician offices may soon start to offer ways to soften the cervix (cervical ripening) as an outpatient, to help “induce” labor while keeping women out of the hospital for the early part of inductions. Check with your OBGYN office if outpatient cervical ripening is available to you.
***Updated on 2/13/2021: Post previous stated that a woman’s GBS status must be negative to be a candidate for membrane stripping, this was incorrect based on all published and available data.
El Camino Women’s Medical Group offers the latest Minimally Invasive Solutions for gynecologic problems. Drs. Amy Teng, Erika Balassiano, and Pooja Gupta, all members of AAGL (American Association of Gynecologic Laparoscopy) are highly trained and experienced in the field of Minimally Invasive Gynecgologic Surgery. Dr. Erika Balassiano is also a graduate of the Minimally Invasive Gynecologic Surgery Fellowship at Stanford University, under the supervision of world-renowned Dr. Camran Nezhat.
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