American Journal of Obstetrics & Gynecology
Volume 200, Issue 6 , Pages 674.e1-674.e7, June 2009

Reduction of elective inductions in a large community hospital

Presented at the 75th Annual Meeting of the Pacific Coast Obstetrical and Gynecological Society, Victoria, BC, Canada, Oct. 15-19, 2008.

  • Dale P. Reisner, MD

      Affiliations

    • Division of Perinatal Medicine, Department of Obstetrics and Gynecology, Swedish Medical Center, Seattle, WA
    • Obstetrix Medical Group of Washington, Seattle, WA
    • ,
  • Terri K. Wallin, RN, MHA

      Affiliations

    • Home Care Services, Swedish Medical Center, Seattle, WA
    • ,
  • Rosalee W. Zingheim, RN, MN

      Affiliations

    • Department of Clinical Effectiveness, Swedish Medical Center, Seattle, WA
    • ,
  • David A. Luthy, MD

      Affiliations

    • Division of Perinatal Medicine, Department of Obstetrics and Gynecology, Swedish Medical Center, Seattle, WA
    • Obstetrix Medical Group of Washington, Seattle, WA

Received 15 September 2008; received in revised form 10 December 2008; accepted 26 February 2009. published online 20 April 2009.

Objective

Our goal was to lower unplanned primary cesarean deliveries by reducing elective inductions.

Study Design

To implement and sustain an induction management program, a committee of care providers reviewed induction rates. “Elective” and other categories were defined. An induction consent form was drafted. Consent compliance, induction rates, hours in labor and delivery and mode of delivery were evaluated. Outcomes were compared with historical data from 2 years earlier.

Results

A total of 10,166 nulliparas and 9869 multiparas attempted vaginal deliveries. Elective inductions decreased significantly, from 4.3% to 0.8% in nulliparas and from 13% to 9.5% in multiparas. A longer time to delivery was seen for both nulliparas (5.2 hours) and multiparas (4 hours) with elective inductions. Unplanned primary cesarean delivery rates are significantly lower in spontaneously laboring women, compared with those induced.

Conclusion

A program aimed at reducing elective inductions was successfully implemented and sustained.

Key words: elective induction, induction rates, induction reduction

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 Cite this article as: Reisner DP, Wallin TK, Zingheim RW, et al. Reduction of elective inductions in a large community hospital. Am J Obstet Gynecol 2009;200:674.e1-674.e7.

 Reprints not available from the authors.

PII: S0002-9378(09)00210-5

doi:10.1016/j.ajog.2009.02.021

American Journal of Obstetrics & Gynecology
Volume 200, Issue 6 , Pages 674.e1-674.e7, June 2009

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