Trends in stimulation and induction of labor 1989-1995.

Between 1989 and 1995 the rates for stimulation and induction of labor rose every year, representing a 48 and 77 percent, respectively, total rise over the time period. In 1995 the rate of stimulation was 161 per 1,000 live births and of induction 160. Two percent, or 74,167, of the 3,899,589 births in 1995 had both procedures performed. While rates of stimulation decline with advancing maternal age, the induction rates tend to be higher for older women. Rates for both procedures increased between 1989 and 1995 for both black and white women in all age categories. Women whose pregnancies have extended beyond the expected gestation of 37 weeks consistently had much higher rates of both stimulation and induction. Rates for both procedures rose for doctors of medicine (MD's), doctors of osteopathy (DO's) and certified nurse-midwives (CNM's). DO's had the greatest increases in both stimulation and induction rates. Declines in the cesarean section rate were greater for births that were stimulated or induced than for those without either of these procedures. The rates for stimulated or induced vaginal birth after cesarean (VBAC) were double those of VBACs without such procedures.