Induction of Labour Consensus Statement Feedback

As a community of maternity services across Australia, WHA members now care for 60% of all women giving birth in the public health system, or more than 140,000 births each year.  This makes the WHA community a powerful group to discuss and agree on best practice care.  

Our annual clinical benchmarking program indicates that there continues to be considerable unexplained variation in practices across the WHA community.  In 2014/15, for example, WHA's Benchmarking Maternity Care program shows the mean rate of induction of labour for selected primipara was 30%, with the range for tertiary centres 21% to 51% and for Level 2-5 hospitals from 6.7% to 48.7%. 

For this reason, WHA has been convening annual meetings for the past 2 years to identify consensus on best practice care, and provide an opportunity for members to share & learn from one another about effective strategies to increase rates of normal birth for women and their babies.  

In November 2015, more than 80 individuals representing more than 50 WHA member hospitals met to discuss current practice and contemporary research findings in relation to Induction of Labour (IOL) and Caesarean Section (CS) for primiparous women.  Participants resolved to develop a WHA Consensus Statement on best practice care for the first time mother and spent 2 days on preparing the first draft document. 

The draft consensus statement was divided into 2 parts:

- Part 1 looks at evidence around induction of labour

- Part 2 looks at various aspects of labour and birth care

Following the workshop, WHA has incorporate all comments and feedback, as well as reviewing the literature to develop a consultation draft for Part 1 of the Consensus document.  

The consensus statement represents a first step towards identifying those elements of practice on which there is strong and clear indications of best practice care.  The aim is to assist member services to evaluate the extent to which their own services provide care consistent with contemporary evidence on best practice.  WHA is now seeking member comment and feedback on Part 1 of this draft consensus statement. 

For each section of the current draft we would welcome your feedback on the following:

   1. Is there any research/evidence that should be considered for inclusion that is not referenced within the current draft?

   2. Do you agree with the recommendations for practice?

   3. Do you agree with the implications for practice?

If you do not agree with the recommendations we would ask that you provide comment on your reasons, and include references for research and/or evidence to support your argument where possible.  While clinician judgement will always be critical in best practice care, we are seeking your support with creating a document that highlights those aspects of care on which there is widespread agreement about what constitutes best practice.  Areas where there is lack of clear evidence, or disagreement about interpretation of the evidence can be set aside for future discussion, and will not be included in this consensus statement.

Thank you for taking the time to provide your considered input to this important document.  We would welcome your feedback on or before Thursday 31 March.  

There will also be an opportunity to join us for a webconference discussion of  IOL and Part 1 on 29 March, email Heather if you would like dial in details.  

Yours sincerely,

Michael Nicholl

President

Women's Healthcare Australasia