The National Institute for Health and Care Excellence (NICE) has published new draft guidelines recommending that women should be offered induced labour earlier than previously advised.
The NICE guidelines advise healthcare professionals to consider induction of labour from 39 weeks in women with otherwise uncomplicated pregnancies who are at increased risk, including those aged 35 and over, those with a BMI over 30, and those with Black, Asian and minority ethnic backgrounds.
Commenting on the new draft guidelines, Dr Pat O’Brien, consultant obstetrician and Vice President of the Royal College of Obstetricians and Gynaecologists, said:
“We welcome an update to the NICE guidelines around inducing women’s labour (or “inducing labour in women who have gone past their due date”). It’s been more than 10 years since the previous guidelines were introduced and it’s vitally important the new research published since then is acknowledged and the advice for women updated accordingly.
“This proposed update takes into account the increasing body of evidence that pregnancies that reach, or pass, 41 weeks are associated with a small increase in the risk of stillbirth and perinatal death and that induction of labour reduces this risk.
“Induction of labour is a common and safe procedure with around 1 in 5 labours induced in the UK. A woman's individual needs and preferences should always be taken into account and she must have the opportunity to discuss the options with a healthcare professional so that she can make an informed decision.”
Dr Christine Ekechi, Co-Chair of the Race Equality Taskforce at the Royal College of Obstetricians and Gynaecologists, said:
“There have understandably been concerns about proposed recommendations surrounding inducing labour for women from Black, Asian and minority ethnic backgrounds due to their higher risk of poor perinatal and neonatal outcomes.
“Whilst induction of labour has been shown to safely reduce the incidence of poor perinatal outcomes, especially close to the expected time of delivery, there needs to be a clear appreciation of the benefits as well as the possible disadvantages outside of perinatal outcome.
"Stratifying risk by race alone is a blunt tool to use, and although highlighting higher risk is important, it does not move our understanding further as to why this group of women are at greater risk.
“We support calls for more research in understanding why disparities in outcomes for this group of women exists, so that we can work to better identify at risk pregnancies outside of race and reduce negative outcomes more effectively.
“Women should always be able to make informed decisions about their own health and care based on real evidence. It is vital a person’s individual needs and preferences are taken into account and they have the opportunity to discuss the options with a healthcare professional so they can make a truly informed decision.”
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Notes to Editors
The RCOG is a medical charity that champions the provision of high-quality women’s healthcare in the UK and beyond. It is dedicated to encouraging the study and advancing the science and practice of obstetrics and gynaecology. It does this through postgraduate medical education and training and the publication of clinical guidelines and reports on aspects of the specialty and service provision.