Watchdog U-turns on recommendation to induce pregnant women at 41 weeks

Pregnant women should be left to give birth naturally rather than induced when they reach 41 weeks, an NHS watchdog has advised in a U-turn on its advice around childbirth.

The National Institute for Health and Care Excellence (Nice) initially recommended in draft guidance in May that mothers-to-be should be induced at 41 weeks, to help reduce stillbirths and other complications.

But the advisory body dropped the plan from revised guidance it issued on Thursday.

It is now recommending to hospitals in England instead that women who have reached 41 weeks should be told that carrying on with a pregnancy beyond that point involves some risk, including a higher chance they will have a caesarean birth, that the baby will end up in a neonatal intensive care unit and that their child could die.

Doctors should “discuss with women that induction from 41+0 weeks may reduce these risks, but that they will also need to consider the impact of induction on their birth experience”, Nice added.

In a second rethink it has also abandoned advice it originally proposed that any women of black, Asian or minority-ethnic heritage, with a body mass index of at least 30 or already identified as at higher risk of developing complications in childbirth.

Charities including the parenting organisation NCT and Birthrights welcomed the move. Both had told Nice that there was no evidence to suggest that that approach would reduce stillbirths.

“Birthrights is delighted that Nice has listened to our concerns – shared by so many women and birthing people, healthcare professionals and birth workers – and removed the draft proposals to routinely offer induction at 41 weeks and to single out black and brown women alongside other groups more likely to face adverse outcomes, for induction even earlier at 39 weeks,” said Amy Gibbs, the chief executive of Birthrights.

NCT voiced concern about the growing use of induction in later-stage pregnancies. Elizabeth Duff, its senior policy adviser, said: “Induction of labour is still an intervention that has been used much more frequently in recent years and as yet there is inadequate information about longer-term impact on babies and parents.”

Comments are closed.