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June 27, 2016

NICE guidelines issued on induction of labour

The National Institute for Health and Clinical Excellence (NICE) and the National Collaborating Centre for Women’s and Children’s Health have just issued updated guidance to doctors and midwives on how to support and care for women being offered and undergoing induction of labour.
It recommends that midwives and doctors provide women with evidence-based information about a range of key issues such as why induction is being offered, the risks and benefits of induction and different pain-relief options, so they can make decisions that are right for them and their baby.

Key recommendations from the guidelines include:
* Women should be informed that most women will go into labour spontaneously by 42 weeks. At the 38-week antenatal visit, all women should be offered information about the risks associated with pregnancies that last longer than 42 weeks, and their options.
Healthcare professionals should explain the following points to women being offered induction:
* The reasons for induction being offered
* When, where and how induction should be carried out
* The arrangements for support and pain relief
* The alternative options if the woman chooses not to have induction of labour
* The risks and benefits of induction of labour in specific circumstances and the proposed induction methods
* That induction may not be successful and what the woman’s options will be
* Women with uncomplicated pregnancies should usually be offered induction of labour between 41 and 42 weeks to avoid the risks of prolonged pregnancy
* If a woman has preterm rupture of the membranes after 34 weeks, the maternity team should discuss the following factors with her before a decision is made about whether to induce labour, using vaginal prostaglandin E2 (PGE2)
* Risks to the woman (e.g. sepsis, possible need for caesarean section)
* Risks to the baby (e.g. problems relating to pre-term birth)
* Local availability of neonatal intensive care facilities.