Inductions: Up or down?

According to a recent report from the Centers for Disease Control and Prevention, the number of women undergoing induced labor is finally on the decline after many decades on the rise. One benefit is that the number of deliveries before 39 weeks has similarly fallen.

From 1981 to 1986 the number of births at 39 weeks or more declined by more than 20% and the number of births at 39 weeks or less increased by nearly 60%. The trend started to change in 2006 and now births at 39 weeks or more are up 9%, while those before 39 weeks have declined by 12%. Induction rates declined for weeks 35 through 38, with week 38 seeing the biggest decline (16%). Week 34 was the only week to see an increase during the reports period of 2006 to 2012.

Induction rates for all maternal age groups under 40 years declined at week 38 from 13% to 19%. For women in their 20s and 30s, induction rates at week 35 declined by 4% for women aged 25 to 29 and 7% for women aged 35 to 39. In mothers aged under 20 years, the induction rates at 35, 36, and 37 increased by 5% to 10%. For women older than age 40, the induction rates were essentially unchanged for weeks 35 to 38 during the study period.

In each racial or ethnicity group, the rate of induction was down at 38 weeks: non-Hispanic whites by 19%; non-Hispanic blacks by 3%; and in Hispanics by 7%. For weeks 35 to 27, the rate of induction decreased 6% to 11% across all 3 gestational weeks for non-Hispanic white women. While the rates were unchanged at 36 weeks for non-Hispanic black women, the rate increased by at least 5% for weeks 35 and 37. Hispanic women’s rate of inductions at weeks 35, 36, and 37 remain unchanged from the last report.

Only 3 states-New York, North Carolina, and Alaska-saw an increase in the rate of induction at 38 weeks. A decrease of 30% or more was reported in five states: Nebraska, North Dakota, South Dakota, Utah, and West Virginia.

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