Women are not given adequate information about induction

Another survey has identified a continuing problem with women not being able to get clear information about induction of labour (PIF 2021).

This study was conducted by the Patient Information Forum in collaboration with a number of birth charities. It is important to note at the outset that it was sponsored by a pharmaceutical company which makes induction drugs. This means that we should interpret the recommendations with caution. But the results make interesting reading and confirm what many of us already know about women’s concerns.

The research

This research was an online survey. The survey was shared on social media and the researchers received more than 2,000 responses in less than two weeks. In total, 2,325 responses were received. All respondents had given birth in the past three years or were currently pregnant (PIF 2021).

One downside of this type of survey is that it may attract those who feel particularly strongly. This means that the sample may not be representative of all women. This is why some researchers take a different approach and try to gather data more widely. But even studies which ask everyone do not get a high response rate, so this is a difficult problem to solve. It’s also worth noting that some women feel very positively about induction of labour, and some feel very negatively. So attracting people who feel strongly doesn’t necessarily mean that the results are skewed in one direction or another. But it’s important to always be aware of the pros and cons of different approaches to research.

The results

The results show that many women do not get the information they need about induction of labour. The results included the findings that:

Only 50% of women (one in two) felt they had received enough information on induction.
40% of women felt the information provided was not detailed enough.
65% did not have enough risk benefit information to make an informed decision.
Only 18% of women (about one in five) were provided with a number or statistics to help them decide.
Just under a third of the women (32%) felt they had a supportive conversation with a doctor or midwife.
Only one in four (25%) felt the information they received prepared them for induction.
Around half of the woman (52%) felt they had the birth that met their and their baby’s needs. (PIF 2021)

In Your Own Time was written to help parents and professionals better understand the issues and the evidence relating to the current induction epidemic. Looks at the evidence relating to due dates, ‘post-term’, older and larger women, suspected big babies, maternal race and more.

It is disappointing but not surprising to see further confirmation that many women undergo induction of labour without having received adequate information about the pros and cons of this. Induction is absolutely the right decision for some women and not right for others. We need to ensure that women and families can get better information about induction. This includes the actual numbers and not just a professional’s assessment of their risk.

What Women Want

This research contains a useful section exploring what women want. The top-ranked suggestion doesn’t surprise me at all. It’s the one thing that I have consistently heard in more than twenty years of researching induction, and I’ve already mentioned it above. Women want to be given the actual numbers. Not just a professional’s assessment of their risk.

“Women want statistics on risks, benefits and alternatives to induction and what would happen if they waited for birth to start naturally for pregnancy beyond 42 weeks and the impact of factors including:
• Babies small and large on growth scans
• Mother’s age
• Health conditions
• Pregnancy related conditions
They also wanted data on side effects of induction for mother and baby and success rates of induction. The study also highlighted that children born after induction had a higher chance of problems, both around and after the time of birth.” (PIF 2021)

The survey also highlighted ongoing communication problems.

“Women want to know they have a choice about induction and the right to informed consent. The word ‘told’ featured as one of the most common words in this section, used in the context ‘I was told I was being induced’. More than 70 comments included stronger language including ‘coerced’, ‘harassed’ and ‘bullied’.” (PIF 2021)

Sara Wickham’s bestselling book explains the process of induction of labour and shares information from research studies, debates and women’s, midwives’ and doctors’ experiences to help women and families become more informed and make the decision that is right for them.

What’s Right For You?

There are pros and cons to everything. If there are genuine medical reasons for induction of labour, then the benefits can outweigh the risks and possible downsides. Induction of labour is absolutely the right decision for some woman and families, regardless of these risks. But many people think it is being offered too often at the moment, and that women and families aren’t being given enough information about the downsides.

The key is in getting informed, and figuring out what’s right for you.

I have written two bestselling books on inducing labour which many people have found helpful. One is called Inducing Labour: making informed decisions. It’s written for people who want more information on the process of induction and on the pros and cons of induction in different situations.

More recently, I have written In Your Own Time: how western medicine controls the start of labour and why this needs to stop. That book explains how we have reached a point where one in three women have their labour induced. It looks at the benefits of spontaneous labour and details the research around due dates, post-term pregnancy, suspected big babies and the offer of induction to women perceived to be at higher risk. This includes older women, larger woman and those who are Black, Brown, Asian or of mixed race.

And here are some more induction resources on my website.