Maternal satisfaction with active management of labor: a randomized controlled trial

Area of Science:

• Obstetrics and Gynecology
• Maternal Health Research
• Clinical Trial Methodology

Background:

• Active labor management is known to shorten labor duration and reduce prolonged labor rates.
• The impact of active labor management on patient satisfaction has not been previously studied in randomized controlled trials.
• Understanding factors influencing maternal satisfaction is crucial for improving labor care.

Purpose of the Study:

• To evaluate if active management of labor influences maternal satisfaction with care.
• To identify independent predictors of satisfaction with labor care in low-risk nulliparous women.

Main Methods:

• A randomized controlled trial involving nulliparous women in spontaneous labor was conducted.
• Women were assigned to either active management (n=320) or routine care (n=331).
• Maternal satisfaction was assessed via postal questionnaire at 6 weeks postpartum; logistic regression identified predictors.

Main Results:

• High maternal satisfaction (77%) was observed, with no significant difference between the active management and routine care groups.
• Adequate pain relief, one-to-one midwifery care, clear information, accurate labor length expectations, absence of postpartum hemorrhage, and fewer than three vaginal examinations were associated with higher satisfaction.
• Fewer than three vaginal examinations and one-to-one midwifery care emerged as significant independent predictors of satisfaction.

Conclusions:

• Active management of labor does not adversely affect women's satisfaction with labor and delivery care.
• Future research should focus on measuring potential satisfaction predictors both before and during labor.