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  1. #1
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    Default *spinoff* Pretty shocking stats re inductions

    A recent Australian study found that nearly 1/3 of inductions in first-time mums end in c-section.

    Shocking eh!

    The study also found that induction rates have exploded in the past decade, with no change in the rate of stillbirth.

    ie - more inductions, but with no obvious benefits.

    The study is recommending hospital policy changes on elective inductions (or inductions for social reasons) and on inductions without demonstrated benefit ie inducing for GD (now shown not to have benefit)

    Can't say I've ever heard a doctor or midwife explain that an induction came with a higher risk of c-sec, let alone a 1 in 3 chance!

    http://onlinelibrary.wiley.com/doi/1...339.x/abstract

    Aim:  To determine induction trends and delivery, maternal and neonatal health outcomes by gestational age following induction at term for women having a first baby.

    Methods:  Linked birth and hospital data were used to examine the rates of adverse maternal and neonatal health outcomes for the period 2001–2007, among the 212 389 nullipara with singleton cephalic-presenting fetuses delivering between 370 and 416 weeks of gestation. Rates of caesarean delivery, neonatal transfers and overall severe neonatal and maternal adverse outcomes were determined by gestational age.

    Results:  Between 1990 and 2008, nulliparous term inductions as a proportion of all births increased from 5518 (6.8%) to 11 166 (12.5%). More than 60% of these inductions are performed before 41 weeks. Among induced nullipara, 30.4% delivered by caesarean section. Adverse neonatal outcomes and transfer rates were lowest at 39–40 weeks (overall 2.1 and 0.5%, respectively), regardless of labour onset. Maternal morbidity increased at 40 weeks (from 1.1 to 1.3%) for women in spontaneous labour, was relatively stable in those undergoing induction of labour between 37 and 40 weeks (1.8%) and decreased with gestational age until 40 weeks in those undergoing a prelabour caesarean delivery (from 3.1 to 0.8%).

    Conclusion:  NSW has high rates of both induction and caesarean section following induction. This study highlights the changes to clinical practice that may help reduce the rate of caesarean births in nullipara.

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    Thanks for this info. Trying for my first atm and scared it will end in an unwanted induction/section. This is very interesting!

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    Chew the Mintie  (25-01-2012)

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    yes def something ppl should be aware of i thnk

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    I think that there are worse things than a c-section that an induction can cause. Like ruptured uterus, prolapsed vagina, babies death etc. I don't know why induction with the drugs and IV method are standard procedure

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    Lumpy Melon  (25-01-2012)

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    headoverfeet is offline The truth will set you free, but first it will **** you off. -Gloria Steinem
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    OP have you seen this? http://theconversation.edu.au/forget...-sections-4986

    20 January 2012, 1.38pm AEST
    Forget ‘too posh to push’ – doctors are behind the rise in c-sections

    The proportion of Queensland women giving birth via caesarean section has increased by a staggering 74% in the past 20 years. This wouldn’t be of concern if more babies' lives were saved as a result but the evidence suggests otherwise.

    There’s a belief among some in the health industry and wider community that women who are “too posh to push” are driving the increase. But this myth has been consistently busted, most recently with a study from the University of Queensland’s Centre for Mothers & Babies (QCMB), which surveyed more than 22,000 Queensland mums about their maternity experience.

    Of women who gave birth in Australian hospitals in 2009, around a third (32.6%) had a caesarean section delivery. The caesarean section rate of 42.5% for women in private hospitals was higher than for women in public hospitals (28.4%).

    The overall caesarean section rate for women giving birth in Queensland hospitals (public or private) was 33.9%, which isn’t much higher than the national average. But Queensland tops the list for the highest rate of caesarean section deliveries in private hospitals, accounting for almost half of all births (47.9%), followed by Western Australia (41.8%) and Northern Territory (41.0%).

    Best start to life
    We have long known the health ramifications of caesareans for the mother. Compared with women who give birth naturally, she is at greater risk of:

    dying during childbirth
    acquiring an infection
    losing her uterus
    having the placenta grow into the uterus or in front of the baby in future pregnancies
    rupturing her uterus in future pregnancies and labours
    having a stillborn baby in the pregnancy following a caesarean
    needing to stay longer in hospital.
    And we are increasingly beginning to realise the health harms of caesareans on the baby. A 2011 review published in Biological Reviews analysed all the literature to date and found growing evidence of a link between caesarean birth and future disease in the child, including type 1 diabetes, asthma, allergies, gastroenteritis, obesity and some cancers.

    The authors conclude that “normal vaginal delivery is an important programming event with life long-health consequences.”

    Not too posh
    When it comes to caesarean sections, the increase seems largely driven by the recommendations of doctors, particularly in Queensland’s private hospitals.

    Perhaps the biggest surprise in the QCMB study was that only half (52.4%) of all women birthing in public and private facilities reported making an informed decision to have a planned caesarean before going in to labour. Only one-fifth (19.9%) of women made an informed decision to have a caesarean section when the procedure was unplanned.

    This isn’t just a local problem. During the United Kingdom’s 2001 National Sentinel Caesarean Section Audit, British women said they would prefer more information about the risks (48%) and benefits (43%) of caesarean section. Nearly all wanted a birth that was safest and least stressful for the baby. Women’s own safety and a quick recovery from the birth that wouldn’t impede on breastfeeding were also priorities.

    In the United States, a 2006 nation-wide survey of mothers found that only one of the 1,314 respondents requested a planned caesarean section for her first pregnancy without a medical reason (0.08%). Yet more than 30% ended up with a caesarean. One quarter of survey participants who had a caesarean reported pressure from a health professional to make this choice.

    Despite having one of the highest rates of caesarean sections in the developed world, the United States has one of the highest maternal and infant mortality rates. The authors of the study concluded that despite public perception, women weren’t free to choose how they gave birth.

    Other factors?
    When we’re not using the “too posh to push” or “asking for it” explanation for rising caesarean rates, health professionals resort to the “too old, too sick and too fat” mantra to explain away our responsibility for the rise. In other words, women are giving birth at older ages, they have more health complications and are increasingly overweight.

    All of this is true on one level – women are older and more likely to be overweight and this all increases the chance of complications – but caesareans are rising among all groups, regardless of age, risk factors and weight.

    In fact, there is a greater correlation between your postcode and private insurance status and the caesarean section rate than being older, overweight, sick or asking for it. And the healthiest, wealthiest women who are least likely to be obese, smoke or have poor health (women giving birth in private hospitals with private obstetricians) are nearly twice as likely to have a caesarean section.

    When a healthy first-time mother in this country has less chance than not of having a normal birth, then something is seriously wrong.

    It’s time to abandon the “too old, too fat, too sick and asking for it" mantra and stop blaming women for the high rates of caesarean births. Instead, we need to address the real problem: we health providers are too often scared, impatient and inadequately informed to give women a real choice.


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    I was induced with DS last April and I was warned on several occasions that it could end in c-section, I think they said 1/5 chance.
    I did have a c-section, it was generally a pleasant experience as they were all SO lovely and patient.
    The recovery however
    It's sad really that induction happens so regularly, but for me, I chose to do whatever it took to finally have a baby after a lot of heartache!

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    I wanted an induction and pushed for it. I have a history of very large babies soi wanted to be induced a week early. I had to see a specialist ob for this t to get permission. He made me well aerate if all the risk and I could end up with a ceaser if thinks went wrong.

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    Thermolicious - the study showed that the majority of inductions are happening before 41 weeks and that private care is a strong correlating factor.

    Incidentally - i hire out tens machines and usually maybe 1 in 20 come back unused? due to a c-sec being scheduled late in the pregnancy sort of thing.

    Around Christmas time about 1 in 4 were coming back unused.

    Really got me thinking..

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    Also, good to see some PP were told about the c-sec chance.

    I know I've had 2 inductions and wasnt mentioned at either of them. The first one i was clueless, but for the second one (my third baby) I was pretty up on it all anyway.

    Inductions are much more likely to be successful if it isnt your first baby. The big concern of course is that if you are a first time mama and you are induced, you then have a 1 in 3 chance of a c-sec and that's going to really weigh in on your future childbearing if you have a c-sec for your first baby


 

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