Lobbying maternity organisations have convinced the National Institute for Health and Care Excellence (Nice) to remove the choice for patients to consider induction of labour from 39 weeks gestation. Nice has also downgraded an offer to induce labour at 41 weeks gestation to a “discussion” (Watchdog U-turns on recommendation to induce pregnant women at 41 weeks, 4 November).
This is deeply concerning. The evidence shows that inducing labour at 39 weeks gestation reduces the chance of a caesarean birth and may lead to an easier birth (Arrive trial). There is also evidence that stillbirth increases after 41 weeks of gestation (Swepis and Index trials).
The possibility of inducing labour at 39 weeks is now only available on request, for those in the know. And will a discussion balancing the risks of stillbirth with concerns about the “birth experience” at 41 weeks convey the information parents need about prolonged pregnancy to make informed decisions about their care?
Organisations such as the NCT and Birthrights, which celebrated the changes, are neither clinical organisations nor service user groups. They should not be viewed as the voice of parents, nor be deemed qualified to comment on clinical matters. By not insisting that parents are informed of all birth options and by bowing to the agenda of maternity activists, Nice has failed parents.
Catherine Roy, Susanna Haddon and Dr Ruth-Ann Harpur
