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Problem
Despite equivocal evidence, induction of labour (IOL) for post-dates pregnancy is
an increasingly common birth intervention that impacts well women and their babies.
Birth interventions can cause iatrogenic harm to mothers and babies. Recent evidence
shows that routine post-dates IOL does not reduce the chance of stillbirth.
Background
Previous studies have shown how assumptions and beliefs within biomedical discourse
filter into medical research. Discourse influences clinical practice guidelines, policies
and how information is communicated to women.
Methods
We used Foucauldian discourse analysis to critically analyse the biomedical literature
on IOL, adding to current knowledge about both the intervention itself and how it
is shaped by medical discourse. We purposively sampled biomedical, quantitative research
on IOL, published in the last five years, using key search terms. Twelve studies met
the criteria.
Findings / Results
In this presentation, we show how current biomedical literature concerns itself with
“the dangerousness of [prolonged] pregnancy”, which prioritises the safety of the
fetus, while maintaining a narrative that post-dates IOL is “safe and necessary”,
despite this not necessarily being the case, at least not for every woman. This exposes
the “invisibility of women” in the research and practice of IOL for post-dates.
Discussion
We juxtapose these discourses and extend our findings, drawing on current qualitative
literature to demonstrate how women’s experiences reflect these medical assumptions,
feeling that IOL is inevitable, or that they do not have a choice. This is concerning,
because although constructed as a “safe” intervention, it is not without risk, and
raises questions about informed consent.
Conclusion
There is increasing concern about overmedicalisation of birth. Critiquing the dominance
of obstetric knowledge claims is important to give space for women’s voices, to recognise
other forms of knowledge and to humanise birth.
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Copyright
© 2022 Published by Elsevier Inc.
