In 1985, in order to stem the tide of increasing medical intervention during childbirth, the World Health Organisation (WHO) determined (amongst other things) that no geographical region should have an induction of labour rate of more than 10 percent. To exceed this rate would reflect the inappropriate use of technology. New Zealand’s current rate of 24.4 percent (Ministry of Health, 2015) is more than twice the WHO goal.
The Referral Guidelines in New Zealand obliges a Lead Maternity Carer to recommend to the woman that a consultation with a medical specialist is warranted “in a timely manner for planned induction by 42 weeks”.
While this may be for assessment, discussion and planning of care, it frequently results in the woman being booked for induction of labour, irrespective of her or her unborn baby’s wellness, simply because of the length of pregnancy. This practice is purported to prevent unexpected stillbirth—an opinion that is contentious when considering the evidence. As the average incidence of pregnancy reaching forty-two weeks—that is, the outer range of a term pregnancy—is reported as 10%, there will be many women who are exposed to unnecessary induction of labour for simple post-dates who would otherwise labour spontaneously.
This workshop is currently being converted to a freely available (open source) movie. It covers evidence-informed positioning on post-dates issues.
Dr Maggie Banks (PhD, RM, RGON) has worked in a variety of practice settings, first as a nurse (from 1972) primarily in women’s health and neonatal intensive care, then as midwife (from 1987). A self-employed midwife in home birth practice since 1989, Maggie combined the role of midwifery educator with practice from 1998—2014. She has regularly taught throughout Australasia, as well as having been a guest speaker at conferences held in the Australia, US and Canada. Maggie is the author of Breech Birth Woman-Wise and Home Birth Bound: Mending the Broken Weave.
What did participants say about this workshop
- Loved it. The readings were great – very interesting. Really enjoyed the lecture and especially the live classroom.
- Interesting reading material and the lecture was compelling listening to reinforce what we all know but sometimes forget.
- The forum and feedback [was the most valuable] as it made me realize that the issues of post-dates and IOL are global. Being able to work through this at home and have access to all the readings, slides and lectures plus the forum and discussions.
- Good mix of talking, reading, watching, learning from others and discussing. Loved it.
- I have really enjoyed this workshop being on line makes it easily accessible and what I have gained from it is going to help me support my Midwifery colleagues and clients to keep birth Normal.
- Maggie has a way of making you reflect deeply about the way you practice. An enjoyable and worthwhile workshop..