Women's anticipations of and experiences with induction of labor

Although induction of labor is a common procedure, there are limited data on its psychoemotional effects. We studied women's expectations of and experiences with labor induction in a large university hospital.

A total of 296 parturients were recruited, with 270 (91%) taken into the final analysis. Of these, 135 underwent elective induction of labor (44 with amniotomy and 91 with cervical ripening by the use of vaginal prostaglandin gel, followed by amniotomy), whereas the remaining 135 women gave birth spontaneously and served as controls. Each woman was interviewed as to her knowledge, expectations, and feelings about labor before induction or at start of labor (controls) as well as after delivery with the help of questionnaires containing yes/no or multiple-choice questions and visual analog scales.

The induction and control groups, in regard to baseline clinical characteristics, did not differ. Labor ended in cesarean section for 24 women in the induction group (18%) and for 12 women in the control group (9%) (p=0.04); these women were included in the data analysis. In the induction group, 67%, and in the control group, 48% of women (p=0.002) reported having received sufficient information on labor induction from medical personnel at prenatal or obstetric clinics. Attitudes towards induction of labor were antenatally positive in 78% of women in the induction group and in 69% in the control group. The induction group reported fear of pain less often (45%) than the control group (57%) (p=0.03). In the induction group, 76 women (56%), and in the control group 94 women (70%) (p=0.02), wanted to participate in the decision on the method of induction, and 74% and 83%, respectively, wished to influence the timing of induction. When interviewed post partum, the labor experience corresponded with the patients' expectations better in the control than in the induction group (p=0.03). Labor induction was a positive experience in 90% of women who underwent immediate amniotomy and in 69% of those who received prostaglandin ripening first.

Labor induction was a positive experience only seldom eliciting negative feelings. A third of the parturients undergoing induction need more information on the procedure and most want to participate in decision-making concerning the method and timing of induction.