A little medical research

So...doing research for your own medical decisions...not fun. I had so many people exclaim about how early 41 weeks is to be induced that I decided to actually read about why one might want that to happen. I suppose there was also some concern for me and the baby involved.

My grand conclusion...

I still don't know what would really be best, and I'm not sure anyone else does either.

If you are interested, here is a summary of what I have read. The main rationale for inducing women at 41 weeks, which has become a very common thing to do, seems to come from a 2003 article summarizing a whole bunch of randomized controlled trials. These trials for the most part compared women who were induced at 41 weeks or later to women whose pregnancies went past 41 weeks but were not induced. It found that women who were induced at 41 weeks had significantly lower c-section rates and lower perinatal mortality (babies dying right before or after birth) rates.

For me there are two problems with this. One, while the induced group did have statistically lower rates of c-sections and perinatal mortality, the actual differences were small (20% vs 22% for c-sections and .09% vs .33% for perinatal mortality). Two, the comparison of induction at 41 weeks to no induction at all is not really what I'm interested in. There seems to be a lot less doubt that pregnancy complications increase after 42 weeks than after 41 weeks. So what I need is a study directly comparing induction at 41 weeks to 42 weeks.

I have only found one such study, from China in April 2006. This study suggests that induction at 41 weeks compared to 42 weeks "is associated with a significantly higher risk of use of medical interventions and associated complications, with no observable benefits." But that's only one study, and there are a few problems with it. In general it seems like there may not be a lot of convincing reasons to be induced at 41 instead of 42 weeks.

Maybe I'll just go into labor before this comes up.