Source: The Conversation (Au and NZ)
Around one in three women in Australia now have their labours induced rather than starting naturally, or spontaneously.
The rate of induction increased from 25% in 2010 to 33% in 2023. For first-time mothers, it rose from 30.6% to 39.7% in 2023.
Labour can be induced using the synthetic hormones such as prostaglandin or oxytocin. A balloon-shaped catheter can also be placed in the woman’s cervix to open it up. Additionally, midwives or obstetricians can break the bag of water around the baby.
Induction of labour can be life-saving when medically recommended. This might mean a sudden increase in blood pressure or fetal distress during labour, or going beyond 41 weeks’ gestation.
But induction of labour is linked to an increased risk of some complications and poor birth experiences, our new research shows.
When is labour induced?
Induction is often recommended when:
- pregnancy has gone over 41 weeks (to reduce the risk of stillbirth)
- the mother has high blood pressure or diabetes
- there is another significant issue threatening the health of the mother or baby.
The World Health Organization recommends advising healthy pregnant mothers to be induced after 41 weeks of pregnancy due to the risk of stillbirth.
What has our research shown?
Our research, based on data from the national Birth Experience Study, compared the experiences of 5,230 women in Australia whose labour began spontaneously and 2,561 whose labour was induced. We adjusted for demographic, medical, obstetric and mental health factors.
We found induction of labour was associated with higher odds of forceps or vacuum births, emergency caesarean, episiotomy and reported fetal distress during labour.
The differences extended beyond the birth room. Women whose labours were induced were significantly more likely to report:
- excessive post-natal pain
- poorer physical health
- reliving negative birth events
- birth trauma
- regret
- diagnosed post-traumatic stress disorder
- experiences of disrespect and mistreatment by staff caring for them (known as obstetric violence).
Women who were induced were less likely to have immediate skin-to-skin contact with their baby or receive a postnatal home visit from a midwife.
Their babies were more likely to experience jaundice or receive formula when their mothers had intended to breastfeed.
There was no statistically significant difference in major perineal injury, which included major tears between the vagina and anus and episiotomy, ongoing pelvic-floor problems, admission to special care or neonatal intensive care, or the baby needing extra medical care after birth.
Women cared for through midwifery continuity of care models in this study had the lowest rates of induction out of all the models. Our previous study found this remains the case when differences in risk factors between models are taken into account.
Read more:
Seeing the same midwife or doctor in pregnancy and labour reduces the risk of birth trauma
There are limitations to our study
This study cannot prove induction caused the outcomes but rather is associated with them. This means something else may have caused or contributed to the outcome, such as the reason for the induction that women may not have mentioned.
Continuity of care relationships mean those things may also be picked up earlier, not just in the birthing moment.
The study was based on an observational, self-report survey. This means women decided to answer it or not. So it does not represent all women’s experiences.
We did not look specifically at stillbirth in this study; 28 women stated their baby died either during the labour and birth or after birth. As women are often induced when experiencing a stillbirth, and women who lose a baby are less likely to respond to surveys like this one, we have not reported further on this.
While we adjusted for characteristics and risk factors to make the two groups as similar as possible, we had to rely on women’s reports rather than having access to clinical reports.
What does this mean for women?
Induction can be beneficial and life-saving, but it’s not consequence-free.
Women need balanced information about potential benefits, interventions, physical effects and psychological experiences to make genuinely informed decisions.
Yet women aren’t always involved in decision-making during labour.
When might an induction not be indicated?
My previous research found Australian hospitals are inducing women at earlier gestations than previously. And we are doing this more often for no medical reason.
Our previous study found the induction rates tripled for women who were 37 and 39 weeks pregnant in NSW in the 16 years to 2016. And 15% of new mothers were induced without a medical reason listed.
This may have increased even more in the intervening ten years considering the rise in the induction rate.
There is now clear advice for women and clinicians that “every week counts” when it comes to the timing of birth. Unless there is a significant clinical reason, this should not happen before 39 weeks, as the baby’s brain is still undergoing significant development in the last weeks of pregnancy.
In our previous research, over 90% of women who had previously been induced said they would try to increase the chance of spontaneous labour next time.
What do women need to make an informed decision?
It’s not ethical or legal to simply tell the woman that induction is required.
Better approaches are clearly outlined in national and international guidelines. Discussions must involve:
- what the treatment is
- why it is being recommended
- how, when and where it would happen
- what the alternatives are
- if it will impact the woman physically and mentally.
- what the actual increase in stillbirth risk is, such as one in 500 or one in 1,000.
Recent birth trauma inquiries in NSW, Tasmania and now in the ongoing Select Committee on Women’s Health show how ignoring women’s right to informed consent contributes to physical and mental trauma.
Women need balanced information about both its potential benefits and consequences before agreeing to induction.
Hannah Dahlen receives funding from National Health and Medical Research Council, Australian Research Council and Medical Research Future Fund.
Hazel Keedle receives funding from MRFF.
Kingsley Emwinyore Agho does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
Original source: https://analysis1.mil-osi.com/2026/11/09/1-in-3-births-are-induced-it-can-be-life-saving-but-its-also-linked-to-more-complications/