March of Dimes Praises New ACOG Guidelines on the Induction of Labor

August 20, 2009

The March of Dimes praised new guidelines from the American College of Obstetricians and Gynecologists (ACOG) that updates the practice guidelines on induction of labor and clarifies how and when doctors may safely induce labor in pregnant women.

“The new criteria for confirming a term pregnancy provides clear and clinically relevant parameters to accurately document when inductions might be considered and cautions against inductions before 39 weeks in the absence of a medical indication,” says Diane Ashton, M.D., MPH, an ob-gyn and deputy medical director of the March of Dimes.

The new guidelines update 10-year-old criteria, and recommends using ultrasound imaging technology before 20 weeks gestation to establish accurate gestational age of the fetus. Also, before an induction is considered, the new ACOG guidelines recommend documenting fetal heart tones by 30 weeks using Doppler ultrasonography or confirming that it has been 36 weeks since a positive pregnancy test was obtained. The guidelines make clear that even mature lung development is not a reason to induce delivery for logistical reasons if the fetus is not at least 39 weeks old, unless it is medically necessary.

The ACOG Practice Bulletin on Induction of Labor states that doctors should warn women having their first baby that their risk of having a cesarean section doubles if labor is induced and their cervix is not ready.

“ACOG has long been our partner in the fight to prevent preterm birth and these new guidelines stress the importance of those last few weeks of pregnancy, when a baby’s brain and other vital organs are rapidly developing,” said Dr. Ashton.

Labor inductions are an option when the benefits of birth outweigh the risks of continuing the pregnancy and they must be weighed against the potential maternal and fetal risks, Dr. Ashton said.

Preterm birth (before 37 completed weeks gestation,) is a serious health crisis that costs the United States more than $26 billion annually. It is the leading cause of newborn death, and babies who survive an early birth often face the risk of serious and sometimes lifelong health problems such as breathing problems, mental retardation, jaundice, developmental delays, vision loss and cerebral palsy. Babies born just a few weeks too soon (34-36 weeks gestation, also known as late preterm birth) have higher rates of death and disability than full-term babies. Even infants born at 37-38 weeks have an increased risk for problems compared to infants born at 39 weeks.