Hello everyone, I'm a little late on this thread but...
here in NZ inductions run at about 30%, in the tertiary centres. We still
have a few rural maternity units. All women have a "lead maternity carer"
(LMC) which is most often a midwife. Many women choose to have a private
obstetrician (all maternity care is free  here unless you choose an O&G
privately) and a few women have a general practitioner as their LMC. The LMC
holds the purse strings and must pay for things like scans and lab tests.
Hospital care is free, as is necessary secondary/tertiary care (eg abnormal)

Even with m/w care there is a high level of intervention. We do have some
social inductions, but mostly i think (hope) that there are real indications
for most.
I think though that there is so much fear of litigation, although we don't
traditionally have a history of suing hcp's. It is more the "what if
something goes wrong and I didn't induce this woman... i couldn't live with
the consequences." Only the most resiliant woman will resist the fear of a
stillborn or disabled child, and there are risks with post-term babies, ie
meconium aspiration etc.

We are moving towards C/S on demand... can't believe this ! Rates vary from
about 5-10% in a hospital with a high Maori population, to 30-45% in other
centres.
Home birth rates are only 2-5%

Interestingly, while the Irish idea of active management of labour has had
good outcomes, the impetus behind the inception was because the labour room
is the bottleneck in the hospital - Dublin's Rotunda could not cope with
women staying there too long! Not due to any good medical reason at all -
although good things have come out of it. I think things have changed there
of late however, and the AML is not pushed quite so much.

Fiona Hermann
RN, RM, mother to 3 sponatneously born boys, 1 at home

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