Labour induction practices in France: A population-based declarative survey in 94 maternity units

Area of Science:

• Obstetrics and Gynecology
• Perinatal Medicine
• Clinical Practice Research

Background:

• In 2016, 22.0% of deliveries in France were induced, with significant heterogeneity in methods and indications.
• Lack of high-level evidence has led to non-recommended practices in labor induction.
• Understanding current practices is crucial as they may influence perinatal outcomes.

Purpose of the Study:

• To report current practices of labor induction in France.
• To investigate the methods and attitudes towards labor induction in French maternity units.

Main Methods:

• A survey was conducted across 94 maternity units in seven perinatal networks.
• A questionnaire was emailed to department heads or delivery room supervisors regarding induction methods and attitudes in specific obstetric situations.

Main Results:

• Labor induction rates varied widely (7.7%–33%) across maternity units.
• Most units used multiple agents for cervical ripening, with dinoprostone and balloon catheters being common.
• A significant proportion of units (75.5%) reported inductions without medical indication, and 23.4% even with unfavorable cervices. Practices for specific obstetric scenarios also varied widely.

Conclusions:

• The wide variability and persistence of disapproved practices in labor induction necessitate an evaluation of the effectiveness and safety of different strategies.
• Standardization of labor induction protocols based on evidence is recommended to improve perinatal outcomes.