INDEX (Induction Experience) assessment of how women feel about induced labour: A prospective observational study

Women's experience of induction of labour and how to identify risk factors for poor experience had not been evaluated in the literature.

The experience of induction can be a source of distress for women. The validated EXIT self-questionnaire assesses maternal satisfaction with labour induction.

To assess the satisfaction and experience of women who have undergone induction of labour with cervical ripening and so identify risk factors for a poor experience of induction.

This was a prospective observational study including pregnant women with cervical ripening before induction. Longitudinal information on meals, sleep, ambulation, vomiting, and pain were collected prospectively using a time-stamped self-questionnaire, and women were asked to fill in the validated EXIT self-questionnaire in the week after birth.

Women induced with a balloon catheter had a worse experience of time taken to give birth (Estimate: -1.44, p = 0.001) but a better experience of contractions (Estimate: 1.44, p = 0.009) and improved comfort (Estimate: 0.94, p = 0.006). Induction for post-term was a factor of negative experience related to the time to give birth (Estimate: -0.72, p = 0.013). High pain duration (Estimate: -2.73, p = 0.018) and insufficient sleep (Estimate: 0.31, p = 0.059) were risk factors for a negative experience of contractions. A long walking time contributed to comfort during cervical ripening (Estimate: 0.91, p = 0.103).

Multivariate models based on our time-stamped self-questionnaire showed that some of these variables were essential to assessing experience during cervical ripening and in particular pain (Estimate: -2.73, p = 0.018), sleep (Estimate: 0.31, p = 0.059), and walking time (Estimate: 0.91, p = 0.102).

Recording of these variables by women during induction could help us identify those likely to require support during cervical ripening, thereby improving our practices, and enabling individualized care.