Background
In New Zealand, the proportion of women who experience an induction of labour (IOL) has steadily increased, from 19% in 2006 to 26% in 2017. IOL has an impact on the woman’s experience of labour and birth, with women having to reconsider their birth plans and, in some cases, their planned place of birth. A need was identified for national guidance in this area, in order to provide education and recommendations around IOL.
Development
This guideline has been developed by members nominated by New Zealand College of Midwives, Royal Australian and New Zealand College of Obstetrics and Gynaecology (RANZCOG), and Royal Australasian College of Physicians, along with representatives of consumer groups and Midwifery and Obstetrics from around NZ. The multidisciplinary Clinical Guidelines Panel met regularly during 2018 and 2019.
Funding
The Nurture Foundation, and the Mercia Barnes Trust, RANZCOG, provided grants-in-aid to support the guideline development.
Implementation
A written request will be sent to the Ministry of Health for ratification.
Purpose
The purpose of this guideline is to provide a summary of the research evidence, to support clinical decision-making and consistency of practice for IOL at 37+0 weeks’ gestation or more, in the Aotearoa New Zealand context. This guideline has identified the most recent research evidence for some common potential clinical indications for IOL. An appropriate IOL is where evidence shows that benefit to mother and/or baby outweighs the risk.
Audience
This guideline has been developed to provide guidance for health professionals, to support shared decision-making within an evidence-based supportive framework. It should be used alongside best judgement, accounting for the individualised needs and preferences of the woman. This guideline is intended for the providers of maternity care. It also has implications for health service provider organisations and funders of maternity services.
Scope
The Panel acknowledges that there are many risk factors and conditions recognised during pregnancy that are associated with adverse maternal or perinatal outcome, including those reviewed in this guideline. However, the scope of this guideline is to only review research that evaluates IOL as an intervention to mitigate these risks.
Contact
Dr Michelle Wise, Senior Lecturer, Department of Obstetrics and Gynaecology, FMHS, University of Auckland, or email: InductionNZ@auckland.ac.nz