Elective Induction of Labor and Pregnancy Outcomes
In 2008, 23% of births in the United States (nearly 1 million) were initiated by induction. Many inductions are elective, that is, performed without a medical or obstetric indication, typically for the woman’s comfort or convenience. In prior studies, this proportion has ranged from 13 to 49% of inductions. This suggests that 130,000 to 490,000 births in the U.S. each year are initiated by elective induction. As a pilot study, we examined the prevalence of induction from 2001-8 using linked electronic health data and birth certificate data at two integrated health care delivery systems, Kaiser Permanente Southern California (KPSC) and Group Health (GH). The prevalence of induction rose from 24% to 30%. Among all births, the prevalence of induction with no documented indication rose from 4.7% to 8.4%. At KPSC, we examined trends by race and ethnicity. Induction with no documented indication was more common in whites than any other group, but similar increases were seen in all groups.