Induction of labour: what do women think?

A study has 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).

Harkness et al (2023) carried out a questionnaire-based postnatal survey as part of the CHOICE Study, which is being carried out in NHS maternity units in the UK.

Participants were 309 women who had induction of labour.

The researchers found that:

“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.” Harkness et al (2023).

This isn’t a new finding. Over the years, I have written about several other studies which show that women are dissatisfied with the information they receive around induction, and with aspects of the induction process itself.

One thing that is relatively new is the idea of having an ‘outpatient induction,’ which includes going to hospital for a cervical ripening agent to be inserted, and then going home again. However, the women’s experiences show that this is not the solution that some proponents are saying it is.

“Although it can provide a more comfortable environment, home cervical ripening is not always an acceptable solution.”

The downsides of induction

The researchers also found that, Women described maternity care negatively impacted by staffing shortages; delays to care sometimes led to unsafe situations.” (Harkness et al 2023).

In fact, staff can make all the difference, as, “Women who had a positive experience of IOL described supportive interaction with staff as a significant contribution to that.” (Harkness et al 2023).

Harkness et al (2023) concluded that,

“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.” (Harkness et al 2023).

You can read the study in full here.

Other research…

This isn’t the first study which has shown that women aren’t happy with the information they are given about induction. You can find several more linked from my induction resources page.

Neither are these findings limited to the UK. For example, a German study showed that women want more information and support with decision-making about induction of labour, especially when there is no good medical reason to do this (for instance in the case of routine induction for so-called ‘post-term’ pregnancy). The study also found that most women who experienced induction of labour would try to avoid it in a future pregnancy, and many would like to have information on alternative and complementary methods of induction of labour. 

How to find out more

I’ve written loads about induction of labour, and it is one of the most searched-for topics on my website. You can find a page detailing the resources that I have available on post-term pregnancy and induction of labour here, and I’ve written recent blog posts detailing the ten things that I wish women knew about induction of labour (and that’s because I speak to so many women who feel like the ones in the study above) and how to cancel a labour induction, because it saddens me that, these days, some women don’t even realise that they have a choice.

In Your Own Time was written to help parents and professionals better understand the issues and the evidence relating to the current induction epidemic. Looks at the evidence relating to due dates, ‘post-term’, older and larger women, suspected big babies, maternal race and more.

What’s right for you?

I want to live in a world where women and families are well-informed about the issues and about the pros and cons of interventions before they have to make decisions about whether these interventions are right for them.

I know that lots of other people want that too, and they want to gain the knowledge and build the confidence to talk to others about these important issues.

I also know that one or two women will reply to this to say that they were really happy with their induction experience.

That’s great. I am genuinely delighted that some women have a good experience.

But too many don’t, as this latest research shows, and we need to do something about this.

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