Inducing labor at 39 weeks’ gestation may reduce the need for cesarean section, a randomized trial has found.
Common practice has been to avoid induction of labor between 39 and 41 weeks, especially in first-time mothers. Evidence from observational studies had suggested that induction during this period, generally considered “full term,” might increase the risk for complications or the need for a C-section.
In this trial, published in the New England Journal of Medicine, 6,106 healthy first-time mothers with uncomplicated pregnancies were randomly assigned to either labor induction at 39 weeks or regular care with induced delivery no later than 42 weeks.
The frequency of cesarean delivery was 16 percent lower in the induced group than in the regular care group, and there was no difference between groups in adverse consequences to either mother or child. There was a slightly lower incidence of death or severe complications in the induced group, although that difference did not reach statistical significance.
“There are women who say ‘I don’t want induction no matter what,’ and you have to support that,” said the lead author, Dr. William A. Grobman, a professor of obstetrics and gynecology at Northwestern. “But what is absolutely not right is to make a decision without information. The right thing is to provide that information and then honor the woman’s choice.”
