This is an archived article that was published on sltrib.com in 2004, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.
Women in their last weeks of pregnancy understandably might want to end their discomfort and sleeplessness by having their doctors induce labor - but a new study warns against it.
Researchers at Intermountain Health Care, Utah's largest health provider, found that inducing deliveries before the 39th week resulted in a higher complication rate, most notably respiratory problems.
"Women's uncomfortableness with the pregnancy is a big issue for them, and more women are wanting early induced labor for different reasons," said Bryan Oshiro, medical director for the Women's and Newborn Program at IHC.
''They might want to induce early because they have moms coming in town to help them on a specific date, or their doctor will be on vacation" when they go into labor, he said. "However, the data shows that there is a definite health advantage to the baby by waiting until it reaches 39 weeks [of] development.''
IHC came up with new guidelines for inducing labor after studying 85,000 births in Utah in 2002 and 2003. IHC has asked its physicians to not electively induce labor before the 39th week, a move that could make them unpopular with some women.
Babies are big business in Utah, which has the highest birthrate in the nation - 21.9 per 1,000 residents, translating to 49,182 births in 2002.
Even if the rules upset some mothers, IHC officials say they are justified because they have seen a drop in complications and related costs. Since 2001, when it informally asked physicians to restrict early inductions, IHC has cut the number of elective induced deliveries from 30 percent, which mirrored the national average, to about 5 percent.
Full gestation is 40 weeks.
By waiting until the 39th week, the study found, babies have fewer admissions to the newborn intensive care unit, dropping from 6.7 percent at 37 weeks to 2.5 percent at week 39. Babies in the unit needing a ventilator to breathe dropped from 1.19 percent at 37 weeks to 0.25 percent at 39 weeks.
IHC also frowns on scheduling cesarean sections early, Oshiro said.
Women's reasons for wanting to induce vary; some mistakenly believe their baby is growing too large to carry to full term, Oshiro said.
There are valid medical reasons to induce, such as the rupture - before labor - of membranes holding the amniotic fluid, high blood pressure, a serious infection, diabetes, or a baby who is growing too slowly.
Many doctors will induce labor in women who go two weeks past their due date, a tactic IHC supports.
Labor is induced by using oxytocin - the brand name is Pitocin - which starts contractions. Doctors administer oxytocin through a vein, and it starts to work in one to two hours.
Some women will experience harder contractions with oxytocin, making labor even more painful.
Doctors can also induce labor by rupturing the membranes that hold the amniotic fluid.
Marissa Burridge felt the temptation to induce early but carried her second child, Alma, to full term. She gave birth to the 8-pound, 9-ounce girl at LDS Hospital in Salt Lake City this week.
"I think you always get to that point of your pregnancy, but I knew it was best to wait until full term," she said. "My midwives offered to induce at 39 weeks, but I wanted to wait."