Protocol at Stamford Hospital Reduces Elective Inductions
May 7, 2013
New Orleans, LA -- A hospital policy limiting labor inductions effectively decreases elective inductions before 39 weeks’ gestation and improves the likelihood of vaginal birth, according to new research presented today at the Annual Clinical Meeting of The American College of Obstetricians and Gynecologists.
Like many hospitals nationwide over the past 20 years, Stamford Hospital in Connecticut was experiencing a rise in the rate of labor inductions and related cesareans. In 2009, the hospital implemented a protocol restricting the use of elective labor induction prior to 39 weeks’ gestation and allowing it only in pregnant women whose cervix was favorable for induction.
Paul D. Bobby, MD, and colleagues at Stamford Hospital studied the rate of elective labor inductions and cesarean deliveries related to failed inductions from six months prior to and up to 24 months after the restrictive labor induction policy went into effect.
“Compliance with the policy was very high,” said Dr. Bobby. “No elective inductions were performed prior to 39 completed weeks’ gestation.” The hospital’s rate of elective labor inductions dropped from 7.2% to 3.5% and the rate of cesareans after failed elective inductions dropped from 24.4% to 12.2%.
However, no significant change in the total rate of induction was noted. “We were surprised by that,” Dr. Bobby said. “It means some patients who would have been scheduled for an elective induction in the past ultimately required a labor induction for other reasons, such as hypertension or post-term pregnancy.” Dr. Bobby said his group is collecting data to further examine this finding.
*Tuesday Poster #37: Restricting Elective Labor Induction: A Community Hospital Experience
The American College of Obstetricians and Gynecologists (The College), a 501(c)(3) organization, is the nation’s leading group of physicians providing health care for women. As a private, voluntary, nonprofit membership organization of approximately 57,000 members, The College strongly advocates for quality health care for women, maintains the highest standards of clinical practice and continuing education of its members, promotes patient education, and increases awareness among its members and the public of the changing issues facing women’s health care. The American Congress of Obstetricians and Gynecologists (ACOG), a 501(c)(6) organization, is its companion organization. www.acog.org