Elective induction of labour: The problem of interpretation and communication of risks

Abstract

First paragraph: Induction of labour is one of the most commonly performed procedures in maternity care in developed countries, experienced by over 20% of pregnant women (approximately 160,000 women annually in the UK (UK National Statistics)). Current guidelines suggest that it should be used in situations where the risks to mother or baby of continuing pregnancy outweigh the risks of artificially bringing the pregnancy to an end (NICE, 2008). Where medical complications (for example, pregnancy hypertension, renal or liver disease or diabetes) are present the dangers are relatively clear and thus the balancing of risks is reasonably straightforward. However, around 50% of labour inductions are performed in the absence of recognised medical complications ( [Grivell et al., 2011] and [Stock et al., 2012]). In these situations uncertainty persists about the appropriate timing, risks and benefits of induction, leaving significant room for both professional debate and maternal concern.