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Improving induction of labour for women through the development of a new pathway

02 September 2018
Service Audit
02 September 2018
Volume 26 · Issue 9

Abstract

Background

Although induction of labour is a safe procedure for the pregnant woman at term, the process is not without risk. In recognition of these challenges associated with induction, an audit of local service provision was undertaken.

Aim

To identify problems with the existing induction service.

Methods

This was a retrospective analysis of women's notes from May to December 2016. All patient records of pregnant women who had received induction during this time (n=870) were examined, as well as complaints and feedback received by the service.

Findings

The audit identified several issues that would need to be addressed if the service was to be improved. These concerns were divided into two groups: the pregnant woman's perspective and service provision issues.

Conclusion

A new induction of labour pathway was created that aimed to address some of the concerns identified by the audit, and improve the care that women received. A further audit was conducted to assess the improvement in care as a result.

Induction of labour, whereby the onset of labour is stimulated using either pharmacological or mechanical methods, is one of the most common obstetric procedures carried out in the UK (McCarthy and Kenny, 2014). The incidence of women receiving induction of labour has increased over the past 10 years. In 2008, the Royal College of Obstetricians and Gynaecologists (RCOG) calculated that one in five women in the UK had labour induced, while latest figures suggest that the induction of labour rate is approximately 29.4%, and that this is on an upward trend (NHS Digital, 2017). This increasing number of women receiving induction creates its own challenges. Although induction of labour is a safe procedure for the pregnant woman at term, the process is not without risk (Schwarz et al, 2016), and problems include: increased pain and reduced efficiency when compared to spontaneous labour (National Institute for Health and Clinical Excellence (NICE), 2008); concerns related to the participation in the decision-making process (Henderson and Redshaw, 2013); and a disparity between women's expectations of labour and their lived experience (Shetty et al, 2005; Gatward et al, 2010).

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Induction of labour
Improving care
Women's experiences