Women’s experiences of cervical ripening

This blog post looks at two studies which have looked specifically at women’s experiences of cervical ripening. One was published about a decade before the other, which allows us to consider whether things have improved in that time.

What is cervical ripening?

The term ‘cervical ripening’ refers to the process whereby the cervix – or opening of the womb – becomes softer, thinner, and starts to open, ready for labour.

It is something that happens naturally in late pregnancy and early labour, if we let things happen in their own time.

You can learn more about cervical ripening and the stages of induction in this book.

Cervical ripening on antenatal wards

A key study on this topic was published in 2015, when researchers explored women’s experiences of inpatient cervical ripening on antenatal wards.

The researchers did not set up any kind of intervention; they simply interviewed some of the women who had experienced usual care during induction for so-called ‘prolonged pregnancy’.

Overall, as the authors’ summary shows, the women, “reported negative experiences of inpatient cervical ripening“, and these negative experiences “appeared to relate to their senses of being undermined” (Brown & Furber 2015).

The woman who were interviewed in depth had four key areas of concern.

1. Having support and comfort from significant others undermined

“Discontent with being separated from partners and significant others resonated with almost all of the participants. Isolation from significant others appeared to be exacerbated at night, even though ward staff, and other women, were present on the ward:

… and I could hear all the other women around me all moaning … crying … doing the same thing … everyone’s all in pain at the same time, but you’re on your own … and them literally having their heads [the staff] popped around the corner, every, like once an hour … wasn’t nice really. But at the same time you just think, well, this is all you can have … you can’t have any more. [Participant 1 (P1)]”  (Brown & Furber 2015).

2. Understanding of the procedure undermined

“The main issue appeared to be a lack of awareness that partners would not be allowed to remain with women on the ward during for the duration of the procedure:

…it wasn’t quite what I, what we were expecting. I mean we didn’t realise until we got there that he wasn’t allowed to stay with me the whole time. [P1]

The potential for the procedure of cervical ripening to extend over a few days was also not made clear to women:

I wasn’t really told that, you know, it could take three days for you to actually go into labour. [P4]”  (Brown & Furber 2015).

3. The women’s perception of their own physiological sensations was undermined

“The approach to assessing whether there had been progression beyond cervical ripening seemed to be guided by rigid criteria. Midwives appeared to disregard women’s own perceptions and descriptions of their physiological sensations. In other words it appeared, from participant accounts, that no matter what symptoms and sensations individual women described, external assessments by caregivers prevailed:

To be honest I felt like everything was a paper exercise, because I wasn’t fitting into the right boxes, you know the boxes couldn’t be ticked properly. Then I was just kind of left to it basically, until everything was, sort of, lined up on the chart properly for me to go through to the next stage. [P1]”  (Brown & Furber 2015).

4. The women’s sense of freedom was undermined

“All participants reported that they were encouraged by caregivers to mobilise during the time they spent on the antenatal ward. Participants’ feelings of freedom to mobilise appeared to be compromised within the ward environment; their sense of freedom to mobilise appeared to be facilitated by leaving the ward environment:

I think I spent more time out of the ward that I did in the ward, “cause I just wanted to be walking and walking.” [P7]

Leaving the ward during the night appeared to be problematic:

…I tried walking around at night time, “cause I was so bored once, and then like no one’s around. So then you’re a bit like, “Ohhhh, I’ll just go back” … “cause if no one was around and if you fell or anything, you know. [P5]”  (Brown & Furber 2015).

Long waits for labour

It is also worth noting that some of these women spent a considerable amount of time on the antenatal ward before they moved to the labour ward.

The woman who was on the antenatal ward for the shortest length of time, 12 hours, was having her fourth baby.

The two women having their second babies spent 13 and 52 hours on the antenatal ward, and the four women having their first babies spent 19, 19, 25 and 72 hours there.

Although the number of women in this study is too small to be the basis of any generalisable numerical results, I can say from experience that these time spans are not unusual. 

When women write or speak to me about their experiences of induction of labour, this is one of the things that they particularly mention not having been told about.

What can we learn from this?

The authors of the 2015 study offered a useful discussion about the implications of their findings, which are complex. 

Some of the women felt safer on the ward even though they felt restricted by the policies there. 

The possibilities of offering outpatient (sic) cervical ripening and providing areas where partners can stay was suggested, although the former is often seen as less than ideal from a safety perspective.  As I mentioned above, this has now changed, and some women have the option of going home during the cervical ripening process. So let’s look at a more recent study, and see if that helped.

Women and birth partners’ experiences of cervical ripening at home and in hospital

This latest study looked at the experiences of women AND their birth partners. “Sixty interviews were conducted with 43 women and 17 birth partners, of which 10 women and three birth partners experienced home cervical ripening.” (Yuill et al 2025).

These figures themselves are interesting, as they reflect the authors’ finding that, in reality, only a few women were offered or considered eligible for home cervical ripening. This echoes the experience of a number of women I have talked to who found that, while they were told ahead of time that they would be able to go home, were then told once they arrived for the procedure that this wasn’t possible or advisable.

The addition of partners in this study gives us additional insight into how poor practice can affect the woman and others. For example:

“One woman reported not being allowed by the consultant to phone her partner to join the discussion about induction, and her partner described how this affected them:

I’m angry about it because she wasn’t given an opportunity to make a decision with me or go away and think about it, it had to be done in a ten-minute chat with a doctor. We can blame COVID all we want, but we’re playing with people’s lives here and big, big decisions (Birth partner 4, non-case study site, hospital).” (Yuill et al 2025).

The physical environment

“In addition to wanting genuine choice about setting, having their own space was an important mediator to people’s experience during cervical ripening. Women and birth partners reported the lack of privacy in shared induction ‘bays’ contributed to negative experiences, including heightened anxiety and lack of sleep:

‘It was awful. Just hearing how long their labours were, how sore it was, and things that had gone wrong with their baby or their babies are in like the neonatal unit. If they felt like they had lack of choice as well. …It just filled me with fear and dread. And you couldn’t get away from it because you are in a four-bedded room. (Service user 074, case study Site 4, hospital)

[My partner] was trying to sleep, and it’s difficult to sleep when people are constantly coming in and out of the room. You know, we’ve only got a curtain between you and next door, and people are in pain, screams. You can hear family on the phone. (Birth partner of 097, case study Site 5, hospital)” (Yuill et al 2025).

Women who were able to go home or secure a single room felt very differently about this. This is, again, however, not something that can be guaranteed ahead of time.

Pain, uncertainty, separation and delays

Women described cervical ripening as painful, and there was an interesting contrast here. Some of those who stayed in hospital were able to access pain relief which wasn’t available to those who went home, but some of those who went home feel more comfortable because they were able to move around freely, access whatever they need, and have privacy that isn’t available in hospitals.

Other aspects which women discussed included uncertainty, the difficulty of being separate from their partner, and delays in the induction process.

“Having personal space with attentive care and their needs met appeared to make women’s experiences better, but these factors did not completely remove uncertainty or lessen this state of limbo, which made one woman feel “trapped”:

It was just the two of us sitting about sort of just waiting on news, and the days were long … there were times where we were in the room for hours on end, and I just didn’t know when we would be expecting the next visit and that made me feel a little bit more trapped in that room. (Service user 030, case study Site 4, hospital)” (Yuill et al 2025).

So have things changed?

The final two categories related to people’s experiences of care and the lasting effects of this. Sadly, while some participants had positive experiences, many did not. This is reflected in the authors’ summarising of their findings.

“Although some, in either setting, described a straightforward experience, many were either mixed or negative when it came to the process of cervical ripening, regardless of where it took place. Most women and partners were positive about home cervical ripening as an option and highlighted its potential benefits, yet limited choice about going home and anxiety about returning to the hospital was also reported. Some viewed going home as risky, valuing the constant presence of healthcare professionals, which they expected would be available in a hospital setting. However, our findings suggest that those having home cervical ripening may have over-estimated the level of monitoring or care they would have received in the hospital setting. As described above, this might depend on their location within the hospital, staff workloads and whether the person was deemed to be in established labour or not yet in labour [6, 10, 11].” (Yuill et al 2025).

It is also very poignant that, “a key source of uncertainty were delays in commencing or continuing the IOL process, with consequent anxiety for those at home about admission to the hospital, and for those in hospital about admission to the labour ward.” (Yuill et al 2025).

As in the previous study, many women waited for days before labour commenced, and this had a profound effect on their wellbeing.

“This finding was supported by the wider numbers in our postnatal survey, which self-reported a time period from commencement of CR to admission to labour ward of 3–168 h for those who went home and a maximum of 260 h (11 days) for those who stayed at the hospital [5]. The tension between being categorised as high-risk enough to end pregnancy early but low-risk enough for the process to be delayed, sometimes for days, presented a conflict that profoundly affected some women.” (Yuill et al 2025).

In conclusion

Yuill et al (2025) concluded that:

“Participants reported limitations in choice, in relation to IOL and to staying in hospital or returning home for cervical ripening.

While most viewed home cervical ripening as a positive option and described benefits such as greater privacy, comfort and partner support, it was clear that being able to choose was key.

Some respondents experienced anxiety in relation to home cervical ripening, preferring to be in a setting where they expected they would receive ongoing monitoring and professional care.

Busy services, midwifery staff shortages and inability of services to progress the induction process as intended, led to stress and anxiety in relation to delays in admission, with women feeling they needed to perform a ‘good patient’ role to receive care.

While staff support was highly valued and helped to support a more positive experience, this was not consistently available, leading in some cases to distressing or traumatic experiences.

Our study suggests that a policy of offering home cervical ripening is acceptable to parents, but with the caveat that there should be genuine, informed choice and sufficient staff and resources to care for the numbers of women who undergo IOL.”

How to get informed

As these studies show, women’s experiences of cervical ripening are varied. It is important that everyone is able to weigh up the pros and cons of any intervention, in order to make the decisions that are right for them.

Here are a few more resources if you would like to find out more about the induction process.

We have an information hub with links to all of the induction-related blog posts on this website:

Post-term pregnancy and induction of labour resources

My Inducing Labour book explains the process of induction in detail, ad walks you through what to expect, as well as looking at the evidence for various situations in which you might be offered induction/

Inducing Labour

And In Your Own Time looks more broadly at the current situation we are in with induction, exploring the reasons that it is offered so frequently and looking at the evidence which does (or doesn’t) support the recommendations that are made in this area.

In Your Own Time

Brown SJ and Furber CM (2015). Women’s experiences of cervical ripening as inpatients on an antenatal ward.  Sexual & Reproductive Healthcare, doi:10.1016/j.srhc.2015.06.003

Yuill C, Harkness M, Cheyne H et al (2025). Women and birth partners’ experiences of cervical ripening at home and in hospital. BMC Pregnancy Childbirth 25, 84 (2025). https://doi.org/10.1186/s12884-024-06936-8

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Books to help you become informed and make the decisions that are right for you…

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