Pregnant women ‘should be induced at 41 weeks for safety’ – new guidelines

Pregnant women should be induced at 41 weeks and not 42 to cut the risks to themselves and their baby, according to new draft guidelines.

Until now, women have been offered induction on the NHS between 41 and 42 weeks, but recent evidence shows that babies are more likely to die if the pregnancy goes to 42 weeks or beyond.

As a result, the National Institute for Health and Care Excellence (Nice) has published new draft guidelines saying women should be induced as soon as possible when they hit 41 weeks in a bid to make birth safer for them and their child.

Those women who choose not to be induced at 41 weeks can continue with twice-weekly monitoring, but should be informed that there is no evidence this can prevent poor outcomes for mother or baby.

Experts on the Nice committee looked at a range of evidence to support the shift, including one large study that was stopped early due to the fact more babies were dying or being admitted to intensive care when induction was carried out at 42 weeks compared with 41.

Other possible complications of allowing pregnancies to go beyond 41 weeks include the placenta breaking down and failing to provide the baby with adequate oxygen and nutrients, and the risk of womb infections.

Nice also called for more research on when induction should be offered in the groups of women who may be more likely to experience poor outcomes if their pregnancy continues beyond 41 weeks.

These groups include women of black, Asian and ethnic minority backgrounds, women with a body mass index (BMI) over 30, and those aged over 35.

Dr Paul Chrisp, director of the centre for guidelines at Nice, said: “It’s vitally important that pregnant women faced with the possibility of induced labour are offered advice based on the latest evidence.

“By advising induced labour one week earlier, we can help ensure that women and babies are safer from harm and have the best possible outcomes during birth.”

Dr Pat O’Brien, consultant obstetrician and vice president of the Royal College of Obstetricians and Gynaecologists, said: “We welcome an update to the Nice guidelines around inducing women’s labour.

“It’s been more than 10 years since the previous guidelines were introduced and it’s vitally important the new research published since then is acknowledged and the advice for women updated accordingly.

“This proposed update takes into account the increasing body of evidence that pregnancies that reach, or pass, 41 weeks are associated with a small increase in the risk of stillbirth and perinatal death and that induction of labour reduces this risk.

“Induction of labour is a common and safe procedure, with around one in five labours induced in the UK.

“A woman’s individual needs and preferences should always be taken into account and she must have the opportunity to discuss the options with a healthcare professional so that she can make an informed decision.

“We would also second calls for more research in understanding induction of labour for women from black, Asian and minority ethnic backgrounds who have a higher risk of morbidity and mortality in pregnancy outcomes.

“This is so we can work to reduce health inequalities in maternity outcomes.”