Baker K. How to make critiquing easy. Midwives. 2014; 17:(2)34-35

Biem SRD, Turnell RW, Olatunbosun O, Tauh M, Biem HJ. A randomized controlled trial of outpatient versus inpatient labour induction with vaginal controlled-release prostaglandin-E2: effectiveness and satisfaction. J Obstet Gynaecol Can. 2003; 25:(1)23-31

Bollapragada SS, MacKenzie F, Norrie JD Randomised placebo-controlled trial of outpatient (at home) cervical ripening with isosorbide mononitrate (IMN) prior to induction of labour - clinical trial with analyses of efficacy and acceptability. The IMOP Study. BJOG. 2009; 116:(9)1185-1195

Britton F, Evans J, Stephenson E, Vinayakaroo L. ‘Category I: E – Poster Presentations: Maternal Medicine'. BJOG. 2018;

Clarke P, Round N, Blythe S. Development of a home induction of labour framework. Br J Midwifery. 2017; 25:(1)34-40

Critical Appraisal Skills Programme. CASP Checklists. 2017. (accessed 9 May 2019)

Diederen M, Gommers JSM, Wilkinson C, Turnbull D, Mol BWJ. Safety of the balloon catheter for cervical ripening in outpatient care: complications during the period from insertion to expulsion of a balloon catheter in the process of labour induction: a systematic review. BJOG. 2018; 125:(9)1086-1095

Focussing on physiological processes in labour and birth. 2017. (accessed 9 May 2019)

Eddama O, Petrou S, Schroeder L The cost-effectiveness of outpatient (at home) cervical ripening with isosorbide mononitrate prior to induction of labour. BJOG. 2009; 116:(9)1196-1203

Fink A. Conducting research literature reviews. From the internet to paper, 3rd edn. London: Sage Publications Ltd; 2010

Gammie N, Key S. Time's up! Women's experience of induction of labour. Pract Midwife. 2014; 17:(4)15-18

Henderson J, Redshaw M. Women's experience of induction of labor: a mixed methods study. Acta Obstet Gynecol Scand. 2013; 92:(10)1159-1167

Henry A, Madan A, Reid R Outpatient Foley catheter versus inpatient prostaglandin E2 gel for induction of labour: a randomised trial. BMC Pregnancy Childbirth. 2013; 13:(1)

Jay A, Thomas H, Brooks F. Induction of labour: how do women get information and make decisions? Findings of a qualitative study. Br J Midwifery. 2018; 26:(1)22-29

Kelly AJ, Alfirevic Z, Ghosh A. Outpatient versus inpatient induction of labour for improving birth outcomes. Cochrane Database Syst Rev. 2013; (11)

NHS Digital. NHS maternity statistics, England 2017-2018. 2018. (accessed 9 May 2019)

Better Births: Improving Outcomes of Maternity Services in England.London: NHS England; 2016

Inducing labour [CG70].London: NICE; 2008

Inducing labour [QS60].London: NICE; 2014

O'Brien E, Rauf Z, Alfirevic Z, Lavender T. Women's experiences of outpatient induction of labour with remote continuous monitoring. Midwifery. 2013; 29:(4)325-331

O'Connor D. Saving Babies' Lives: A care bundle for reducing stillbirth.London: NHS England; 2018

O'Dwyer S, Raniolo C, Roper J, Gupta M. Improving induction of labour - a quality improvement project addressing Caesarean section rates and length of process in women undergoing induction of labour. BMJ Qual Improv Rep. 2015; 4:(1)

Oliver P. Succeeding with your literature review: a handbook for students.Maidenhead: Open University Press; 2012

Oster C, Adelson PL, Wilkinson C, Turnbull D. Inpatient versus outpatient cervical priming for induction of labour: therapeutic landscapes and women's preferences. Health Place. 2011; 17:(1)379-385

Reid M, Lorimer K, Norman JE, Bollapragada SS, Norrie J. The home as an appropriate setting for women undertaking cervical ripening before the induction of labour. Midwifery. 2011; 27:(1)30-35

Sharp AN, Stock SJ, Alfirevic Z. Outpatient induction of labour in the UK: a survey of practice. Eur J Obstet Gynecol Reprod Biol. 2016; 204:21-23

Siu C, Comerasamy H. Doing a research project in nursing and midwifery-a basic guide to research using the literature review methodology.London: SAGE Publications; 2013

Smith LK. Outpatient induction of labour with prostaglandins: Safety, effectiveness and women's views. Br J Midwifery. 2017; 25:(12)774-782

Turnbull D, Adelson P, Oster C, Bryce R, Fereday J, Wilkinson C. Psychosocial outcomes of a randomized controlled trial of outpatient cervical priming for induction of labor. Birth. 2013; 40:(2)75-80

Vogel JP, Osoti AO, Kelly AJ, Livio S, Norman JE, Alfirevic Z. Pharmacological and mechanical interventions for labour induction in outpatient settings. Cochrane Database Syst Rev. 2017; 9

Wilkinson C, Adelson P, Turnbull D. A comparison of inpatient with outpatient balloon catheter cervical ripening: a pilot randomized controlled trial. BMC Pregnancy Childbirth. 2015; 15:(1)

Women's experiences of outpatient induction of labour

02 June 2019
16 min read
Volume 27 · Issue 6



Outpatient induction of labour is offered to relieve the pressure on inpatient stay and to improve women's experiences.


To contribute to the knowledge of outpatient induction of labour with the focus on women's experiences to inform practice. The question was: ‘What are women's experiences of outpatient induction of labour?’


A comprehensive literature review using a pluralistic approach and thematic analysis.


The review found three themes: the home as a positive setting for outpatient induction of labour, the value of outpatient induction of labour in promoting normality and the importance of receiving reassurance during outpatient induction of labour.


Although the results were mostly positive and in favour of outpatient induction of labour, there were variations in service provision. There was a lack of understanding as to how best to offer reassurance to women once discharged home, which was found to have a direct effect on their experiences.

Approximately 32.6% of labours in the UK are induced, either before or after the estimated due date (NHS Digital, 2018). This number has increased by 12.2% in the past 10 years (NHS Digital, 2018) and is likely to increase further due to a rise in more complex pregnancies with risk factors that indicate the need for delivery of the fetus. A further significant influence on induction of labour rates is the publication of the Saving Babies' Lives Care Bundle (O'Connor, 2016), which states an objective to decrease the stillbirth rate by 20% by 2020. By implementing the recommendations set out in the care bundle, there is a likelihood that induction of labour rates will increase and affect service demands (O'Connor, 2016).

However, it is widely recognised that most women want as much as possible to have a physiological and normal birth (Gammie and Key, 2014; Downe, 2017; Jay et al, 2018). Induction of labour has been shown to have a negative impact on women's experiences, often leading to dissatisfaction, increased pain, increased likelihood of instrumental births and obstetric interventions (O'Dwyer et al, 2015). Women have also reported neglect due to staff shortages, a lack of choice in care when undergoing induction of labour and a lack of privacy in the ward environment, which is typically where induction of labour takes place (Henderson and Redshaw, 2013). As a result, outpatient induction of labour services have become an attractive option to improve women's experience of induction of labour (Henderson and Redshaw, 2013). This supports the recommendations set out in Better Births (National Maternity Review, 2016), which called for high-quality, personalised and family friendly services to be provided to women and their families. Seven key recommendations were developed, one of which, ‘personalised care’, identified that women should be encouraged to make informed choices about their care, with clinical commissioning groups (CCGs) providing maternity services in a range of settings, including the home (National Maternity Review, 2016).

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