Article: More mums prefer to induce birth
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More mums prefer to induce birth
By Julie Robotham Medical Editor
January 14, 2006
THE birth of one in 12 babies in NSW is now induced for no obvious medical reason, according to statistics that show private obstetricians are leading the trend.
In some private hospitals more than a quarter of all births occur after the mother has been given drugs to initiate labour.
But doctors say that is the way some women want it, especially if they have been cared for during their pregnancy by a private obstetrician, and do not want to risk the possibility that he or she may be unable to attend the birth.
"Some women, with their eyes open, say, 'I would prefer to be induced at a time when you can deliver me'," said Robert Ford, the immediate past president for NSW of the Royal Australian and New Zealand College of Obstetrics and Gynaecology.
"The concern that will inevitably be raised is, 'Are some of these being done for convenience?' And certainly some are done for convenience," he said.
Dr Ford said there was no suggestion that the health of mothers or babies was being compromised by the trend, which hit a new height in 2004, according to the latest annual statistics on births published yesterday by NSW Health.
In 2000 one in 14 babies was induced in the absence of a medical reason, such as the mother's diabetes or high blood pressure, foetal distress or being a week or more overdue.
Current methods of inducing birth, including changed drug regimes, had made the practice safer, Dr Ford said. Women treated privately were often older and more likely to expect to make active decisions about their delivery.
At the public Royal Hospital for Women in Randwick inductions for reasons outside defined medical criteria have risen from 3.8 per cent to 5.8 per cent of all births.
Rob Buist, an obstetrician who is also president of the body Women's Hospitals Australasia, said women had a right to choose when they gave birth, and treating doctors were obliged to respect the choice.
"I induced a woman earlier this week because her husband was going [overseas] on business," he said. "I explained the small increased risk … and she was happy to go ahead."
Dr Buist said he would attempt to talk women out of having a first baby induced without a medical reason, because he believed it significantly raised the chances she would require a caesarean. But for subsequent births any extra risk was minimal, he said.
As well, the list of defined medical reasons for induction was probably outdated, Dr Buist said. It did not acknowledge the move towards inducing babies with known abnormalities, so that they could receive early treatment.
The highest rates of non-medical inductions in NSW were at Kareena Private Hospital in Caringbah, at 26.7 per cent of all births, followed by The Hills Private Hospital in Baulkham Hills, with 25.6 per cent.
Michael Coglin, medical director of Healthscope Ltd, which runs The Hills Private and Prince of Wales and Nepean Private, said the hospitals were not responsible for their induction rates.
"The doctor isn't employed by us. They are engaged by the patient," Dr Coglin said.
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