Playing the Stats & Semantics Game with Elective Inductions.

I just read an article talking about a new study that was published in BMJ talking about how elective inductions produced less stillbirths. You can read it here. It talked about the enormous compilation of pregnancies that were examined: 938, 643 births were not subjected to elective induction and 176, 136 births were planned inductions. Then, it said that there was a .18% chance of stillbirths in the group that did not have a planned induction and a .08% chance of stillbirths in the pregnancies with planned inductions.

They deducted, “Inducing women at 40 weeks is safe!” Also the author said, “In fact, it could be very slightly safer.”

There was no link to the study, so I searched the BMJ myself.  The studies specifics on the BMJ article also weren’t included, but more details were mentioned that the annoying article left out. Factors to consider:

  • The actual article said that the percentages (.18% and .08%) weren’t actually of the entire million women monitored. The actual article gave those percentages simply as examples from two smaller groups. The actual stats involved with the presented percentages were 37 still births of 44,764 elective inductions and 627 stillbirths of the 350,643 pregnancies involved with the “expectant management group.”
  • This study didn’t compare natural births allowed to run their natural courses with elective inductions. It compared elective inductions with an “expected management group.” That group, according to the actual BMJ article, was the group of women who were allowed the continuation of pregnant which would result in either spontaneous labor, unplanned induction or unplanned c-section. Well…. that’s a bit different, isn’t it?
  • The groups that the percentages which were bragged about was based on was a group whose labor happened at 40 weeks. We already learned that 40 weeks isn’t actually the average time when spontaneous labor happens. It’s merely when the due date happens. So, the women who were laboring at 40 weeks might not have even been about to deliver. Maybe they were just having contractions and their labor “stalled” resulting in “unplanned induction” or “emergency c-section.”
  • This study took a large sampling of women from 1981 and 2007. I would certainly be interested to learn what years had more of which groups. You know, a more detailed look.
  • The study looked at gestations between 37 and 41 weeks. Almost every woman I know who has delivered in a birth center by a midwife or in a home birth naturally makes it to at least 41 weeks. So, those others, the ones who lasted longer were not even factored in to this comparison.

So, with all of those things being taken into consideration, coupled with the fact that 350,643 is 7.8 times as many as 44,764 and the actual percentages we are comparing (.18% and .08%) are so tiny anyway, and compounded by the fact that elective inductions resulted in more need for NICU care, this entire study provides absolutely no evidence that elective inductions are safe at all.

The only evidence being presented, frankly, is that when you word things just right and leave important details out of the picture, you can lie and get away with it.

 

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