Nulliparous Women's Experience in the Immediate Postpartum Period After Cervical Ripening According to the Method: A...

Area of Science:

• Obstetrics and Gynecology
• Maternal-Fetal Medicine
• Patient-Centered Care

Background:

• Patient experience is crucial in evaluating labor induction methods.
• Cervical ripening for labor induction can be associated with less positive childbirth experiences.
• Understanding the impact of specific cervical ripening methods on patient experience is needed for improved counseling.

Purpose of the Study:

• To assess if the method of cervical ripening influences nulliparous women's experience of ripening and childbirth.
• To compare patient experiences across different cervical ripening methods: cervical ripening balloon (CRB), dinoprostone vaginal insert (PG), oral misoprostol (M), and repeated methods (R).

Main Methods:

• Prospective observational study of 340 nulliparous women undergoing cervical ripening at term.
• Methods included CRB, PG, oral misoprostol, or repeated methods, chosen at the obstetrician's discretion.
• Postpartum questionnaires assessed women's experiences of ripening and childbirth using Likert scales; multivariate logistic regression analyzed associations.

Main Results:

• Overall vaginal birth rates were similar across methods (73-87%).
• Ripening experience was significantly better with CRB, PG, or M compared to repeated methods (p < 0.001).
• Repeated methods were significantly associated with worse experiences of ripening (aOR = -1.4) and childbirth (aOR = -0.75) after multivariate adjustment.

Conclusions:

• Nulliparous women requiring repeated cervical ripening methods report significantly worse experiences.
• Single methods (PG, CRB, M) resulted in similar, more positive experiences compared to repeated methods.
• Method choice for cervical ripening impacts patient experience, independent of delivery mode or morbidity.