Women's experiences of induction of labour during the COVID-19 pandemic: a cross-sectional survey
Induction of labour is an increasingly common intervention. This study's aim was to explore women's experiences of induction, in particular of decision making and choice.
A cross-sectional study was carried out with women who were induced with live, term infant(s) in two urban trusts. Their experiences were assessed using a postal survey that included the birth satisfaction scale and open questions on women's experiences. Chi-squared and Fisher's exact tests were used to test for associations between aspects of the induction process and women's characteristics (age, parity, ethnic group). Qualitative data were analysed thematically.
Half (52.9%) of the respondents reported waiting to start induction. The majority felt sufficiently involved in decision making (62.1%) and choice (59.6%). Most reported having enough information about the reason for (82%) and process of (83%) induction. The qualitative themes were emotional response, communication, feeling unheard, quality of care and the negative impact of COVID-19 policies.
Women's overall experiences were positive. Improvements should focus on reducing delays to induction.
Induction of labour is a common global intervention (Vogel et al, 2015; World Health Organization, 2018; Seijmonsbergen-Schermers et al, 2020), with many countries reporting increasing rates of induction (Hedegaard et al, 2014; Marconi, 2019; Centers for Disease Control and Prevention, 2020; Ministry of Health, 2021). Data for England suggest that 33% of women underwent induction of labour in 2021/2022 compared to 22% in 2011/2012 (NHS Digital, 2022).
Induction is undertaken for various reasons, the most common being post-maturity and pre-labour membrane rupture (National Institute for Health and Care Excellence, 2021). Compared with awaiting spontaneous labour, induction at or beyond term, especially post-41 weeks is associated with fewer perinatal deaths, a probable reduction in caesarean sections and fewer neonatal intensive care admissions (Mishanina et al, 2014; Middleton et al, 2020). For some women, induction of labour is planned from the beginning of pregnancy, while for others, it is in rapid response to an acute situation.
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