Study of 1000 NZ mums backs ‘more natural’ option to induce labour

Women who need help to induce labour could be routinely offered a “more natural” option that would also allow them to go home before giving birth, new Kiwi research finds. Photo / Natalia Deriabina

Women who need help to induce labour could be routinely offered a “more natural” option that would also allow them to go home before giving birth, new Kiwi research finds.

Around one in four pregnant women in New Zealand, around 15,000 annually, are induced, usually via the use of prostaglandins, a synthetic form of the hormone that starts labour.

In a newly published study that involved more than 1000 women at 10 maternity hospitals, a University of Auckland team alternatively looked at the use of inserted “balloon” catheters.

Designed to gently promote production of the body’s own prostaglandins, they sit at the top of the cervix for 18 to 24 hours, allowing the mother to go home and rest or spend time with family before the onset of labour.

“We hypothesised that offering the balloon catheter would lead to more vaginal births,” said the study’s lead author - and deputy head of the university’s Department of Obstetrics and Gynaecology - Dr Michelle Wise.

Dr Michelle Wise, deputy head of the University of Auckland's Department of Obstetrics and Gynaecology.

While there’d been concerns about their potential to cause “hyperstimulation”, or too many contractions – something that could distress the baby and lead to emergency caesarean birth – their study failed to turn up a single case of that happening.

Importantly, Wise said, there weren’t any observed adverse events when people were at home with the balloon catheter in place.

She now believed there were enough advantages to have them routinely offered.

“The advantages are people get to spend some time out of the hospital - women tend to get more sleep, feel less anxious and more rested and can spend time with whānau,” she said.

“That’s all good for wellbeing during your induction. It’s a more natural way of starting an induction, so you’re avoiding the synthetic prostaglandin hormones.

“I would recommend that the maternity hospitals modify their processes and protocols to offer women the opportunity to use a balloon catheter for their induction and to enable them to go home for part of their induction, if it’s safe to do so.

“Then there is the time saved in the hospital, and that is good for the hospital and means the midwives can then attend to more acute emergencies and assessments, offering care for women who really need that care.”