Labour induced in the morning means fewer complications

Australian researchers say pregnant women who need for one reason or another to have their labour induced are better having the induction done in the morning than in the evening.

According to background information in the Australian study, previous research has consistently shown that spontaneous births peak in the evening and early hours of the morning.

It appears that when morning inductions take place fewer complications happen and the researchers suggest that could be because the timing more closely reflects the natural timing of labour onset resulting in a birth in the evening or early hours of the morning.

Dr. Jodie M. Dodd and her team of the University of Adelaide School of Pediatrics and Reproductive Health in South Australia, looked at 620 women who had been scheduled for an induced labour; 280 women were randomly assigned to labour induction in the morning and 340 to induction in the evening.

The researchers found that the women who began labour induction in the morning were significantly less likely to require an infusion of the hormone oxytocin to encourage contractions than women induced in the evening (45 percent versus 54 percent).

The women who had a morning induction also had a significantly shorter labour and were less likely to need instruments to help with vaginal birth.

Apart from these two factors no other statistically significant differences between the groups were seen in regard to maternal or infant complications, including the number of women who were in labour beyond 24 hours, uterine hyperstimulation, and fetal heart rate changes or Caesarean-section deliveries.

However the reality is that labour at night with birth during daytime hours is more convenient for staff members, most of whom work during the day rather than in the evening or night.

Although the researchers are unclear if these findings reflect physiological differences, or reflects differences in clinical practice that may occur by staff during the day and during the night, they believe women should be made aware of these factors and given the opportunity to decide themselves at what time they want to be admitted.

Dr. Dodd, a maternal fetal medicine subspecialist says based on their research, women who need an induction of labour should if possible be admitted to hospital in the morning.

The Women's and Children's Hospital in Adelaide is currently in the process of updating their induction of labour guidelines to include this information.

The research is published in the journal Obstetrics and Gynecology August 2006.