Their goal is to find out if having everyone give birth by 39 weeks results in better birth outcomes than letting people wait for spontaneous labor.
But since only 10% of people go into labor on their own by 39 weeks (Smith 2001; Jukic et al.
In the earlier studies, elective induction was compared only to spontaneous labor: people who were electively induced versus people who went into spontaneous labor.
Excluded from these two groups were people who were not induced, but chose to wait for labor and then ended up having medically indicated inductions later on (and, thus, a higher rate of Cesareans).
In particular, newborns are more likely to die (although the overall risk was still very low) if they are born before 39 weeks, or after 41 weeks.
The chance of a newborn having problems is lowest if he or she is born between 39 weeks and 0 days and 40 weeks and 6 days (Spong 2013).
For many years, the common belief was that elective (not medically indicated) inductions doubled the Cesarean rate, especially in first-time mothers.
Most of the research studies reviewed in this article used the definition of first week of life.According to the study brochure, “The goal of the study is to find out whether coming to the hospital and having your labor started with medicine (induced) at 39 weeks of pregnancy can improve the baby’s health at birth when compared with waiting for labor to start on its own.” The study brochure (used to recruit participants into the study) says that “During labor induction, the same types of complications that can arise during spontaneous labor can occur.” Unfortunately, this statement is not quite true, because risks of inductions include hyper-stimulation of the uterus (where the uterus contracts too frequently, decreasing blood flow to the baby), the use of extra interventions such as continuous fetal monitoring and the need for additional pain relief, and a failed induction leading to a Cesarean (NICE Guidelines, 2008).The researchers are looking at the benefits and risks of elective induction at 39 weeks—including Cesarean rates, serious infant health problems, hospital costs, and patient satisfaction.For an example of this earlier flawed research, see this article by Yeast et al. New researchers pointed out that we need to compare people who have elective inductions with the whole group of those who for spontaneous labor—whether or not they actually do have spontaneous labor.This is a subtle difference, but an important one, because not everyone who chooses to wait for labor will actually have a spontaneous labor; some of them will develop complications that lead to an induction and increase their risk for Cesarean.