References

Barbour R. Introducing qualitative research.London: SAGE Publications Ltd; 2008

Bradbury-Jones C, Sambrook S, Irvine F. Power and empowerment in nursing: a fourth theoretical approach. J Adv Nurs. 2008; 62:(2)258-66 https://doi.org/https://doi.org/10.1111/j.1365-2648.2008.04598.x

Cartwright A. Mothers experiences of induction. BMJ. 1977; 2:(6089)745-9 https://doi.org/https://doi.org/10.1136/bmj.2.6089.745

Cheyne H, Abhyankar P, Williams B. Elective induction of labour: the problem of interpretation and communication of risks. Midwifery. 2012; 28:(4)412-15 https://doi.org/https://doi.org/10.1016/j.midw.2012.06.009

Cooper M, Warland J. Improving women's knowledge of prostaglandin induction of labour through the use of information brochures: A quasi-experimental study. Women Birth. 2011; 24:(4)156-64 https://doi.org/https://doi.org/10.1016/j.wombi.2010.10.003

Maternity matters: choice, access and continuity of care in a safe service.London: DH; 2007

DeVries R, Salvesen HB, Wiegers TA, Williams S. What (and why) do women want?.(eds). New York: Routledge; 2001

Edwards N. Safety in birth: the contextual conundrums faced by women in a ‘risk society’ driven by neoliberal policies. MIDIRS. 2008; 18:(4)463-70

Fahy K. Reflecting on practice to theorise empowerment for women: using Foucaults concepts. Aust J Midwifery. 2002; 15:(1)5-13 https://doi.org/https://doi.org/10.1016/S1445-4386(02)80017-9

Furedi F. Culture of Fear Revisited, 4th edn. London: Continuum; 2006

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

Gatward H, Simpson M, Woodhart L, Stainton MC. Women's experiences of being induced for post-dates pregnancy. Women Birth. 2007; 23:(1)3-9 https://doi.org/https://doi.org/10.1016/j.wombi.2009.06.002

Gibson WJ, Brown A. Working with qualitative data.Los Angeles and London: Sage; 2009

Gigerenzer G, Muir-Gray J. Better doctors, better patients, better decisions: envisioning health care 2020.Cambridge, Massachusetts: The MIT Press; 2011

Green JM, Coupland VA, Kitzinger JV. Great expectations: a prospective study of women's expectations and experiences of childbirth.Hale: Books for Midwives Press; 1998

Hallgren A, Kihlgren M, Norberg A, Forslin L. Women's perceptions of childbirth and childbirth education before and after education and birth. Midwifery. 1995; 11:(3)130-7 https://doi.org/https://doi.org/10.1016/0266-6138(95)90027-6

Heimstad R, Romundstad PR, Hyett J, Mattsson LA, Salvesen KA. Women's experiences and attitudes towards expectant management and induction of labor for post-term pregnancy. Acta Obstet Gynecol Scand. 2007; 86:(8)950-6 https://doi.org/https://doi.org/10.1080/00016340701416929

Henderson J, Redshaw M. Womens experience of induction of labor: a mixed methods study. Acta Obstet Gynecol Scand. 2013; 92:(10)1159-67

Jay A, Thomas H, Brooks F. In labor or in limbo? the experiences of women undergoing induction of labour in hospital: findings of a qualitative study. Birth. 2017; https://doi.org/https://doi.org/10.1111/birt.12310

Johanson R, Burr R, Leighton N, Jones P. Informed choice? Evidence of the persuasive power of professionals. J Public Health (Bangkok). 2000; 22:(3)439-40 https://doi.org/https://doi.org/10.1093/pubmed/22.3.439

Jomeen J. Choice in childbirth: a realistic expectation?. British Journal of Midwifery. 2007; 15:(8)485-90 https://doi.org/https://doi.org/10.12968/bjom.2007.15.8.24388

Kirkham M. Informed Choice in Maternity Care.Hampshire and New York: Palgrave Macmillan; 2004

Kirkham M, Stapleton H. The culture of maternity service as a barrier to informed choice. In: Kirkham M (ed). Hampshire and New York: Palgrave Macmillan; 2004

Kitzinger S. Some mothers' experiences of induced labour (report from the National Childbirth Trust).London: Department of Health and Social Security; 1975

Levine C. Research involving economically disadvantaged people. In: Emanuel EJ, Grady CC, Crouch RA, Lie RK, Miller FG, Wendler D (eds). Oxford: Oxford University Press; 2008

Levy V. Maintaining equilibrium: a grounded theory study of the processes involved when women make informed choices during pregnancy. Midwifery. 1999; 15:(2)109-19 https://doi.org/https://doi.org/10.1016/S0266-6138(99)90007-4

Levy V. How midwives used protective steering to facilitate informed choice in pregnancy. In: Kirkham M. (ed). Hampshire and New York: Palgrave Macmillan; 2004

Lewis BV, Rana S, Crook E. Letter: patient response to induction of labour. Lancet. 1975; 305:(7917) https://doi.org/https://doi.org/10.1016/S0140-6736(75)93188-8

Maher J. Progressing through labour and delivery: Birth time and women's experiences. Women's Studies International Forum. 2008; 31:129-37

Moore JE, Low LK, Titler MG, Dalton VK, Sampselle CM. Moving toward patient-centered care: womens decisions, perceptions, and experiences of the induction of labor process. Birth. 2014; 41:(2)138-46 https://doi.org/https://doi.org/10.1111/birt.12080

Murtagh M, Folan M. Womens experiences of induction of labour for post-dates pregnancy. British Journal of Midwifery. 2014; 22:(2)105-10 https://doi.org/https://doi.org/10.12968/bjom.2014.22.2.105

Induction of labour.London: RCOG Press; 2008

Induction of labour [CG70].London: NICE; 2008

Induction of labour: NICE Quality Standard 60.London: NICE; 2014

Newburn M. Culture, control and the birth environment. Pract Midwife. 2003; 6:(8)20-5

Hospital Maternity Activity.London: Health and Social Care Information Centre; 2016

Nuutila M, Halmesmäki E, Hiilesmaa V, Ylikorkala O. Womens anticipations of and experiences with induction of labor. Acta Obstet Gynecol Scand. 1999; 78:(8)704-9 https://doi.org/https://doi.org/10.1080/j.1600-0412.1999.780808.x

Rees JT. A consideration of ethical issues fundamental to researching sensitive topics: substance use during pregnancy. Evidence Based Midwifery. 2011; 9:(1)16-22

Roberts LJ, Young KR. The management of prolonged pregnancy-an analysis of womens attitudes before and after term. BJOG. 1991; 98:(11)1102-6 https://doi.org/https://doi.org/10.1111/j.1471-0528.1991.tb15361.x

Rogers K. Ethics and qualitative research: issues for midwifery researchers. British Journal of Midwifery. 2008; 16:(3)179-82 https://doi.org/https://doi.org/10.12968/bjom.2008.16.3.28694

Sakala C. Roundtable discussion Part 2: Why do women go along with this stuff?. Birth. 2006; 33:(3)246-7

Shetty A, Burt R, Rice P, Templeton A. Womens perceptions, expectations and satisfaction with induced labour—A questionnaire-based study. Eur J Obstet Gynecol Reprod Biol. 2005; 123:(1)56-61 https://doi.org/https://doi.org/10.1016/j.ejogrb.2005.03.004

Skyrme L. Induction of labour for post-term pregnancy. British Journal of Midwifery. 2014; 22:(6)400-7 https://doi.org/https://doi.org/10.12968/bjom.2014.22.6.400

Stapleton H, Kirkham M, Curtis P, Thomas G. Framing information in antenatal care. British Journal of Midwifery. 2002; 10:(4)197-201 https://doi.org/https://doi.org/10.12968/bjom.2002.10.4.10330

Stewart P. Patients attitudes to induction and labour. BMJ. 1977; 2:(6089)749-52 https://doi.org/https://doi.org/10.1136/bmj.2.6089.749

Weaver J. Choice, control and decision-making in labour. In: Clement S (ed). London: Churchill Livingstone; 1998

Induction of labour: How do women get information and make decisions? Findings of a qualitative study

02 January 2018
15 min read
Volume 26 · Issue 1

Abstract

Background

Induction of labour is one of the most frequent interventions in pregnancy. While it is not always unwelcome, it is associated with increased labour pain and further interventions. Evidence from earlier studies suggests that induction is often commenced without full discussion and information, which questions the validity of women's consent. This study aimed to add depth and context to existing knowledge by exploring how first-time mothers acquire information about induction and give consent to the procedure.

Method

A qualitative study into women's experiences of induction was undertaken, comprising 21 women, who were interviewed 3-6 weeks after giving birth following induction.

Findings

Information from midwives and antenatal classes was minimal, with family and friends cited as key informants. Midwives presented induction as the preferred option, and alternative care plans, or the relative risks of induction versus continued pregnancy, were rarely discussed. Women reported that midwives often appeared rushed, with little time for discussion.

Conclusions

Providers of maternity care need to devise more flexible ways of working to create time and opportunities for midwives to discuss induction in detail with women and to promote fully informed decision-making.

Induction of labour is one of the most frequently performed interventions in pregnancy, accounting for around 25% of all births in England (NHS Digital, 2017). Induction carries the risk of further interventions and is associated with increased pain in labour and an increased likelihood of instrumental delivery (Shetty et al, 2005; National Institute for Health and Clinical Excellence (NICE), 2008; Cheyne et al, 2012).

Epidemiological evidence from numerous studies in Europe, Israel and the USA (National Collaborating Centre for Women's and Children's Health (NCC-WCH), 2008) has shown a gradually increasing risk of perinatal mortality in pregnancies exceeding 40 weeks, although the absolute risk remains very low. These studies suggest that the potential health benefits to women and babies of inducing labour after 41 weeks outweigh the additional costs to the maternity care provider (NCC-WCH, 2008). Where medical conditions such as pre-eclampsia or Type 1 diabetes exist, the dangers of continuing the pregnancy may not be controversial (Cheyne et al, 2012); however, approximately half of all inductions in the UK are performed for uncomplicated, post-date pregnancies, where the risk of perinatal death is low (2-3 per 1000 births). In these situations, the risk of maternal morbidity resulting from induction is relatively high, compared to spontaneous labour (NCC-WCH, 2008; Cheyne et al, 2012). In keeping with the principles of woman-centred care (Department of Health, 2007), the decision to induce labour or continue with the pregnancy rests with the woman. NICE guidelines state that:

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