Induction of Labor Policy

[nurse mojoe]

I recently took my update Induction of Labor policy & procedure to our medical staff meeting for approval. In reviewing the policy one of our physician's questioned why it read, when labor induction is elective, the gestational age of the fetus must be 39 weeks or more and the method of determination of gestational age will be documented by the attending physician in the medical record. I explained to him that was one of the revised guidelines from ACOG. The physician felt like this would limit he/she in doing what they wanted to whether it be medically necessary or not. He/she wanted me to add, when delivery is in the best interest of mother and/or fetus. My thougths are 'IT IS WHAT IT IS". Would appreciate any feedback you might have?

[hkrntobe]

ACOG guidelines are what they are, Period. No amount of amendments, additions, or revisions by you can change those guidelines. Guess the Physician will just have to use his best judgment.

[Elvish, BSN, DNP, RN, NP]

I'm no risk management person, but IMO if the policy is clear that 'elective induction' should only be done at 39+ weeks, he is still covered should the earlier induction be a medically necessary one. Unless he likes to push social inductions....

[melmarie23, MSN, RN]

I'm no risk management person, but IMO if the policy is clear that 'elective induction' should only be done at 39+ weeks, he is still covered should the earlier induction be a medically necessary one. Unless he likes to push social inductions....

exactly. Elective inductions v. medically necessary ones are a horse of another color

[klone, MSN, RN]

Many physicians can be quite creative on "medically necessary". What? One highish pressure in the office?? IOL for PIH! No labs, no proteinuria, just one high pressure.

[bagladyrn, RN]

In other words he wants to continue doing those early inductions for "maternal discomfort". (Meaning she won't quit calling me/coming in).

[Elvish, BSN, DNP, RN, NP]

Many physicians can be quite creative on "medically necessary". What? One highish pressure in the office?? IOL for PIH! No labs, no proteinuria, just one high pressure.

I've seen this happen too. I was grateful to have an OB with this last pregnancy that did NOT do that. My pressures were high-ish most of the pregnancy (130s/80s most of the time) and being that my urine was always clear, he chose to leave me alone. I'm grateful for it, and went into labor on my own at 39+5, resulting in an 8lb 3oz baby. Clearly she was getting some juice! :)