Just about one million women—a quarter of all pregnant women who deliver in the US each year—end up needing to have labor induced. So you might be surprised to learn there's no best practice for the procedure. After comparing four different induction techniques, researchers have determined a combination of two methods is not only the best available option, but the most efficient.
In the largest-ever clinical trial of labor induction methods (involving 500 women), researchers from the Perelman School of Medicine at the University of Pennsylvania found that a combination of a Foley catheter and the drug misoprostol can reduce labor by hours. Misoprostol mimics the hormone prostaglandin, which is used to induce labor. A Foley catheter is a type of balloon catheter that works by gently coaxing the cervix open.
"Previous studies comparing labor-induction methods have looked at a small patient population, few induction methods, and have produced conflicting results," says lead study author Lisa D. Levine, MD, MSCE. "Our results clearly show that the misoprostol-Foley combination method could significantly reduce the total time mothers spend in the delivery room—potentially leading to a reduction in labor-associated healthcare costs and risks to mothers and their babies."
To conduct the study, researchers split the 500 women into four groups with four different induction methods and calculated the average length of labor:
Misoprostol alone: 17.6 hours
Foley catheter alone: 17.7 hours
Foley catheter + misoprostol: 13.1 hours
Foley catheter + oxytoicin: 14.5 hours
"Using combination methods in every case of labor induction in America would spare pregnant women more than 100,000 days of labor annually," Levine says. "That in turn would reduce hospital costs, reduce the health risks to mother and child that come with prolonged labor and reduce the stress that mothers experience while awaiting delivery."
Still, a previous study says duration isn't exactly what women are worried about: Women would rather have a long labor if it means less pain.