1 in 3 births are induced. It can be life-saving but it’s also linked to more complications

In Australia, roughly one in three women now undergo labour induction instead of allowing the process to begin naturally. This rate has risen significantly over the past decade, jumping from 25% in 2010 to 33% in 2023. For first-time mothers, the rate of induction has climbed from 30.6% to 39.7% during the same period.

Labour induction involves the use of synthetic hormones like prostaglandin or oxytocin, insertion of a balloon-shaped catheter into the cervix, or breaking the bag of water surrounding the baby. While induction can be life-saving in certain situations, such as when blood pressure spikes or fetal distress occurs, it is also associated with a higher risk of certain complications and less than ideal birth experiences, according to new research.

Our study, based on data from the national Birth Experience Survey, compared the experiences of 5,230 women whose labour began spontaneously to those of 2,561 women whose labour was induced. After accounting for various factors, we found that induction was linked to higher odds of forceps or vacuum deliveries, emergency C-sections, episiotomies, and reported fetal distress during labour.

Moreover, women who underwent induction were more likely to report postpartum pain, poorer physical health, negative birth memories, birth trauma, post-traumatic stress disorder, and instances of disrespect or mistreatment from medical staff (obstetric violence).

These women also experienced less immediate skin-to-skin contact with their newborns, fewer postnatal home visits from midwives, and a higher likelihood of their babies developing jaundice or receiving formula when breastfeeding was intended. Importantly, women cared for through midwifery continuity of care models had the lowest rates of induction compared to other models.

While our study cannot prove that induction caused these outcomes, it suggests an association. This study cannot guarantee causation, as the outcomes may be linked to other factors. Our research was based on an observational survey, and women chose whether or not to participate, which may not represent all women's experiences. We did not specifically investigate stillbirth in this study, as women are often induced when experiencing a stillbirth, and those who lose a baby are less likely to respond to surveys, resulting in limited reporting.

In summary, induction of labour can be beneficial and life-saving, but it's not without consequences. Women need balanced information about potential benefits, interventions, physical effects, and psychological experiences to make informed decisions. However, evidence shows that induction rates are increasing at earlier gestations without a clear medical reason, which may contribute to the rising rates of complications and negative birth experiences.