Latest NICE Guideline on Induction of Labour

The recurrent theme of the new Guideline for Induction of Labour released by the National Institute for Health and Care Excellence (NICE) in the UK today is that in all circumstances, the woman’s decision about her care must be respected.

The Guideline covers whether and how to induce women with prelabour rupture of membranes, who have previously had a precipitate birth or a caesarean section, whose baby is in the breech position, or growth restricted, or suspected of being very large. The Guideline also discusses induction in the event of intrauterine death of the baby.

A useful Table shows the percentage of women who go into spontaneous labour at various stages of pregnancy; 99% of women start labour spontaneously by 41 weeks + 6 days. The risks of prolonged pregnancy are detailed with special mention made of the disproportionate number of women from some ethnic minority backgrounds and/or who live in deprived areas who suffer a stillbirth. It is recommended that these women receive extra care and monitoring.

The various methods of induction are discussed. The Guideline states that, ‘available evidence does not support’ the use of herbal supplements, acupuncture, homeopathy, castor oil, hot baths, enemas or sexual intercourse for Induction of Labour. The ‘available evidence’, however, is either extremely limited or non-existent which the Guideline does not make clear.

The Guideline also provides brief summaries of why the Committee made its recommendations in each set of circumstances in which induction might be offered. It also indicates where its recommendations have changed since the 2008 version of the Guideline.

The Guideline is 36 pages and clearly presented. It is essential reading for all practitioners and birth educators caring for women.

Read more:  NICE (2021) Inducing labour. Available at: <accessed 4 November, 2021>

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