Rates of labor induction without medical indication are overestimated when derived from birth certificate data

Objective

The purpose of this study was to determine the rates of late preterm inductions without a medical indication from birth certificate data and to compare them with rates that were obtained from medical charts.

Study Design

The Ohio Perinatal Quality Collaborative, which comprises 20 hospitals in Ohio that came together in 2008 for the purpose of decreasing nonmedically indicated scheduled deliveries, abstracted data on all scheduled births between 36 weeks and 38 weeks 6 days of gestation. We compared labor inductions with “elective” documented or no indication documented in charts to birth certificate data for inductions with no maternal or fetal complications recorded.

Results

Birth certificates overestimate rates of induction without medical indication compared with chart abstraction (11% vs 1%; P < .0001). The monthly difference between chart abstraction and birth certificates averages 10.1%.

Conclusion

Birth certificates overestimate nonmedically indicated inductions by 11-fold. Until birth certificate data improve, nonmedically indicated induction rates that are calculated from birth certificates should be interpreted with caution.

Key words: birth certificate, induction of labor, medical indication