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The issue with the proposed NICE guideline changes for induction of labour


If you’re pregnant you may have noticed a lot of those of us who work in the birth world up in arms about the proposed changes in recommendations for induction of labour by the National Institute of Clinical Excellence (NICE). The proposed changes mean that all pregnant people regardless of medical indication or need will be offered an induction of labour earlier, and those who fit a certain demographic (ie anyone over 35, with a higher BMI or from an black, Asian or ethnic minority) will be offered induction from 39 weeks.


So what IS the fuss about? Well, induction of labour carries its own risks, risks which are not always clearly explained to a pregnant person. Many people will not realise they can decline the recommended induction, or worse are coerced, fear mongered or bullied in to an induction. A recent research study (Hannah Dahlen et al 2021) found higher instances instrumental vaginal births, caesarean birth, episiotomy, vaginal damage needing repair and postpartum haemorrhage (PPH) among women who were induced versus those with spontaneous onset of labour. They found higher instances for admission to NICU/SCN, asphyxia, birth trauma, resuscitation and respiratory disorders among babies who were induced vs those with spontaneous onset of labour. Among the 474 146 children included in the study who were induced for non-medical reasons, higher instances were found for hospitalisation for all types of infection (ie, ear, nose and throat, respiratory infections and other infections) compared with those born following a spontaneous onset of labour.


The damage of unnecessary induction of labour is quite clear.


As for the demographics who will be offered induction even earlier at 39 weeks, the recommendation is even more ludicrous. Yes ethnic minorities are at higher risk of perinatal morbidity, but inducing earlier is merely a sticking plaster and doesn’t address the institutional racism that is at the root cause of these poorer and tragic outcomes.


But the NICE guidelines must be based on research right? Well no. By their own admission (see the last 2 screenshots) the evidence to justify induction of labour early is shaky at best.


So how can you make your views heard and oppose these changes? You can submit the following form and protest against the changes: https://www.nice.org.uk/guidance/gid-ng10082/documents/comments-form


You only have until 5pm on Tuesday 6th July to submit your comments.

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