Abstract
Objectives This study explored women’s views and experiences of key elements of the induction of labour (IOL) process, including at home or in hospital cervical ripening (CR).
Design A questionnaire-based postnatal survey undertaken as part of the CHOICE Study process evaluation. The questionnaire was administered online and included fixed response and free-text options.
Setting National Health Service maternity units in the UK.
Participants 309 women who had an IOL.
Outcome measures The primary outcome measure was experience of IOL. Few women returned home during CR, meaning that statistical comparison between those who experienced home-based and hospital-based CR was not possible. Findings are reported as descriptive statistics with content analysis of women’s comments providing context.
Results Information 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.
Conclusions Women 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.
| Original language | English |
|---|---|
| Article number | e071703 |
| Number of pages | 10 |
| Journal | BMJ Open |
| Volume | 13 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 9 May 2023 |
Bibliographical note
Funding Information:The CHOICE Study was funded by the National Institute of Healthcare Research Health Technology and Assessment (NIHR HTA) NIHR127569.
Funding Information:
The authors declare the following competing interests Support for the present manuscript: The CHOICE Study was funded by National Institute of Healthcare Research Health Technology and Assessment (NIHR HTA). The grant was paid to institution and the authors have the following associations: Patient and public involvement (PPI) Group member (paid); Funded research fellows (2); Principal investigator and coinvestigators with funded time. CHOICE study budget has been used by some authors for travel and conference cost. Authors hold additional, paid to institution, grants from: NIHR; Wellcome Trust; Medical Research Council; Chief Scientist Office of Scotland; Tommy’s Charity; Scottish government; Aberlour Childcare Trust (small project grant); University of Stirling article processing fund. Authors declare the following: Consultancy fees: Natera, consultancy on preterm birth treatments (paid to institution); Honoria: Hologic, Honoria for educational talk (paid to institution); Expert testimony: Expert witness in (midwifery) in civil litigation claims (self employed) Authors declare the following participation on data safety monitoring or advisory boards: Membership of several NIHR Trial Steering committees; NIHR Health Technology and Assessment DMC and TSC Authors are unpaid members or trustees of the following Boards and Committees: National Institute of Health and Care Excellence Antenatal Guideline Group 2018-202; Cysters (CIO) Chair of trustees; Platform Housing Group, trainee Board role; UK Government Period Poverty Task Force, member; UK sepsis Trust, Trustee.
Data Availability Statement
Data are available on reasonable request.Keywords
- Decision Making
- OBSTETRICS
- Quality in health care