EBB 393 - Evidence on Inducing at 41 Weeks or Later

At the 41-week mark in pregnancy, conversations and decisions about induction can start to feel more urgent and complex. In this episode, Dr. Rebecca Dekker and Dr. Sara Ailshire share why the 41st week has become such a focus in maternity care and what the evidence actually says about induction at this milestone.   They discuss elective induction versus expectant management and key findings from major studies like the INDEX and SWEPIS trials. They also talk through potential benefits and risks, including changes in stillbirth risk, newborn outcomes, and maternal experiences.   Content Warning: This episode contains discussion of stillbirth. Please take care while listening.   (00:05:58) How common is labor induction? U.S. rates and challenges with data accuracy (00:09:25) Medically indicated vs. elective induction (00:15:24) The limits of research on induction vs. expectant management (00:20:18) The INDEX trial (00:28:36) Follow-up observational study to INDEX: preferences, Cesarean rates, and outcomes (00:32:51) The SWEPIS trial (00:41:59) Impact of SWEPIS on guidelines and outcomes in Sweden (00:44:40) Benefits of elective induction at 41 weeks (00:46:34) Risks and potential downsides of induction (00:49:18) FAQ: Induction and VBAC considerations   For a full list of resources and references, visit ebbirth.com/inducingduedates.   For more information about Evidence Based Birth® and a crash course on evidence based care, visit www.ebbirth.com. Follow us on Instagram and YouTube! Ready to learn more? Grab an EBB Podcast Listening Guide or read Dr. Dekker's book, "Babies Are Not Pizzas: They're Born, Not Delivered!" If you want to get involved at EBB, join our Professional membership (scholarship options available) and get on the wait list for our EBB Instructor program. Find an EBB Instructor here, and click here to learn more about the EBB Childbirth Class.