Experience of induction of labour: a cross-sectional postnatal survey of women at UK maternity units

Abstract

AbstractBackgroundInduction of Labour (IOL) is an increasingly common obstetric intervention, offered to 30-50% of pregnant women in the UK. IOL affects experience of childbirth: it is more painful than spontaneous labour and more likely to lead to additional interventions including operative birth. Experience of childbirth is important to women, and negative experience of childbirth has been linked to serious psychological harm. The high and rising rate of IOL has implications for provision of safe, effective, person-centred maternity services, yet there is little information about women’s experiences of induction.AimTo explore women’s views and experiences of key elements of the IOL process, including at home or in hospital cervical ripening (CR)MethodsA questionnaire-based postnatal survey of 309 women who had IOL at UK maternity units in 2021/22, undertaken as part of the CHOICE Study process evaluation The questionnaire was administered online and included fixed response and free text options. Findings are reported as descriptive statistics with content analysis of women’s comments providing context.FindingsInformation to support choice and understand what to expect about IOL is often inadequate or unavailable. Having IOL can create anxiety and remove options for birth that women had hoped would enhance their experience. Although it can provide a more comfortable environment, home CR is not always an acceptable solution. Women described maternity care negatively impacted by staffing shortages; delays to care sometimes led to unsafe situations.Women who had a positive experience of IOL described supportive interaction with staff as a significant contribution to that.ConclusionsWomen do not experience IOL as a benign and consequence free intervention. There is urgent need for research to better target IOL and optimise safety and experience for women and their babies. Relatively few women were offered CR at home and further research is needed on this experience.