Women's experiences of augmentation of labour

A study looking at women’s experiences of augmentation of labour has highlighted problems with informed decision making and shown that having a synthetic oxytocin infusion in labour can cause an atypically painful labour and lead to negative birth experiences.

Alòs-Pereñíguez et al (2022) set out to “…explore and synthesise women’s views and experiences of augmentation of labour with synthetic oxytocin infusion.”

They looked for studies involving, “…women of any age, parity, and cultural background who underwent augmentation of labour with synthetic oxytocin infusion” and found 25 studies across 14 countries which met their inclusion criteria.

We already know this!

I’m aware that many of the people who read this won’t be surprised by the results.

Some will say, “but we already know this.”

They’re right.

The study results reflect the experiences of the midwives, birth workers and others who want women and families to experienced good, respectful, evidence-based care. But the fact that we ‘know’ something from experience doesn’t mean that we shouldn’t research it. Apart from the fact that research helps test unproven theories and can offer correction, modification and nuance, we live in a world in which evidence is needed – at least in some quarters – to increase awareness and underpin change.

What did the researchers find?

Alòs-Pereñíguez et al’s (2022) first key finding was that, “The principles of informed consent regarding the decision to augment women’s labour were not routinely respected.” While many women wanted to make their own decisions regarding augmentation, this “did not automatically translate into being involved in decision making.” The studies, “highlighted the lack of information they received” and some of the women who agreed to augmentation said they regretted it afterwards.

This study also highlights another difficult issue that is increasingly discussed by midwives and birth workers. In some settings, when women are deemed to be ‘too knowledgeable’ and demanding in wanting to make decisions about their own and their baby’s care, they feel they are ‘punished’ for this.

Alòs-Pereñíguez et al (2022) also found that, “Women consistently associated AOL with increased pain … and loss of control … Women struggled to cope because of the intensity of the contractions and/or the short time they had to rest in between contractions.”

What can be done?

The researchers suggest that, “incorporating women’s views and experiences of augmentation of labour in evidence-based practice and clinical guidelines is essential.”

I couldn’t agree more. I have written the very same thing about induction of labour, both on this website and in my book, “In Your Own Time,” and induction often involves the giving of intravenous oxytocin. Unsurprisingly then, many of Alòs-Pereñíguez et al’s (2022) findings echo those in the literature on women’s experiences of induction.

Sadly, that literature isn’t taken into account in most of the guidelines or national recommendations.

As with many qualitative studies, my summary is only scratching the surface and I would encourage anyone reading this to go and read the entire study, which you can find here.

Alòs-Pereñíguez S, O’Malley D & Daly D (2022). Women’s views and experiences of augmentation of labour with synthetic oxytocin infusion: a qualitative evidence synthesis. Midwifery 2022: 103512. https://doi.org/10.1016/j.midw.2022.103512.

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