In 2019, attention was drawn to the study SWEPIS, which showed that fewer children die if women’s labor was already started at week 41 of pregnancy instead of at week 42, which was previously the practice.
A total of six children died in the study, all in the group to be started at week 42. Due to the deaths, the study was stopped early as it was deemed unethical to continue.
SWEPI’s results have led to a shift in maternity clinics around the country. The vast majority of clinics have changed their routines for starting and checking pregnant women. Today, it is common practice to start labor when the pregnancy has passed week 41.
Fewer dead children after routine change
Since the routine shift has a group of researchers compared the percentage of stillborn babies and babies who die within four weeks of birth, in the periods 2017 to 2019 and 2020 to September 2023.
The study shows that there has been a reduction in deaths by 47 percent since the routine change. The proportion of children who died in the womb or during their first month of life fell from 1.7 per 1,000 to 0.9 per 1,000.
– It has decreased since they changed their routines and became more active in starting these births than they were before, says Karin Källén.
Question marks remain
Although there has been a routine change, the routines still differ from region to region. It is therefore unclear whether the reduction is due to more women being initiated or whether it is due to increased checks in the final stages of pregnancy.
– This study cannot answer exactly which way is best, only that the changes made led to a strong improvement in the results, says Källén.
No clear connection to emergency caesarean sections
A concern has been that earlier initiations would increase the risk of emergency cesarean sections.
In the study, it was possible to see an increase in emergency caesarean sections by seven percent after the new routines were instituted. At the same time, an even higher increase in emergency caesarean sections was seen among deliveries in weeks 39 and 40.
– You can interpret the results in different ways, but in any case there is not a crystal-clear connection between induction frequency and increased rate of caesarean sections.