Maternal attitudes to amniotomy and labor duration: a survey in early pregnancy

Although maternal choice increasingly influences intrapartum care, little is known about maternal attitudes about many outcomes and interventions, particularly the length of labor. Early amniotomy decreases the length of labor and particularly the frequency of prolonged (> 12 hr) labor but is often avoided by health professionals. The objective of this survey was to assess the attitudes of women in a major Dublin teaching hospital about the length of labor, amniotomy, and epidural analgesia.

An anonymous, structured, self-completed questionnaire was given to 438 women at their booking visit to the hospital antenatal clinic in February 1998. Participants could ring "agree," "disagree," "don't know," or "don't care" to seven different statements.

The questionnaire was returned by 398 (92%) women; demographic details were similar to those for the overall hospital population. Of these, 73.5 percent of women wanted a quick labor; 82 percent wanted it to last less than 12 hours. Nearly one-half specifically wanted epidural analgesia. Only 13 percent wished to avoid amniotomy; significantly more multiparas disagreed with "avoiding amniotomy."

Many women want a quick and painless labor, and do not object to the interventions that help achieve this.