Too much induced labour leading to skyrocketing caesarean sections

The last 48 hours have been very intense with my coverage of one of the busiest maternity in a premier public teaching and referral hospital in Nairobi. Amid the flooding and awful weather, there were over 50 deliveries including nearly 30 caesarean sections. An interesting statistic was that, nearly 50% of the women in labour had been induced. Majority of whom was because they had passed “due date”

Still in the triage room, a very large number of women presented with concerns about having passed their due date.

The number of women who have labor induced has skyrocketed. Some women are tired of being pregnant, and an increasing number are being encouraged by their physicians to have labor induced. Threats of “your baby is getting too big” or “your blood pressure is a bit high” or “going past your due date is dangerous” and seduction with “your baby is ready, let's get on with it” are almost routine.

Induction of labour is not a straightforward predictable science. A large number fails and leads to unnecessary caesarean deliveries. This is expensive strain on the limited resources.

What can we do to help women resist the threat and the temptation of induction and wait for labor to begin on its own?

Involvement of patients and consideration of their preferences in the treatment decision has been demanded for care options with unclear outcomes. However, the management of pregnancy at and beyond term has been a topic of debate worldwide within the medical and mid-wifery community for many decades. The controversial discussion concerns the pros and cons of induction of labour in the light of the medicalization of the “natural” birth, the difficulties to identify the appropriate length of human gestation and the definition whether or not a pregnancy is “overdue”, “post-date” or “prolonged.

Although due date might seem to have magical qualities, it's simply an educated guess about when the baby is most likely to arrive. It's perfectly normal to give birth one to two weeks before — or after — due date.

Relevant literature shows a diversity of opinions on how and to which extent pregnant women should be informed of conflicting evidence on treatment options they will have to decide on.

I advocate and promote nature's plan and normal birth. Nature is not perfect. However, when it comes to babies and birth, unless there is a clear medical indication that induction of labor will do more good than harm, nature beats science hands down. For both mothers and babies, it is safe and wise to wait patiently until labor begins on its own.