WOMENS EVALUATIONS OF INDUCTION OF LABOR VERSUS EXPECTANT MANAGEMENT FOR PRELABOR RUPTURE OF THE MEMBRANES AT TERM

Background: Induction of labor has become common practice in many West er countries, but few studies have assessed women's views. Methods: A randomized, controlled trial was conducted at 72 hospitals in six coun tries. Five thousand forty-one women meeting eligibility criteria, wit h no contraindications for induction of labor or expectant management, were randomly assigned to four groups: Induction with intravenous oxy tocin, induction with vaginal prostaglandin E-2 gel, or expectant mana gement followed by induction with either oxytocin or with prostaglandi n E-2 gel if complications developed. The three main outcome measures were evaluations of the treatment received, perceived control during c hildbirth, and evaluations of the experience of trial participation. R esults: Questionnaires were completed by 81.9 percent of the sample. N o significant differences occurred between the two induction groups. C ompared with the expectant management groups, induced women were less likely to report there was nothing they liked about their treatment an d less likely to report that the treatment caused additional worry. No between-group differences occurred in experienced control during chil dbirth. Women in the induction groups were more likely to be willing t o participate in the study again and to feel reassured. Conclusions: W omen's preferences should be considered when making decisions about th eir method of management when membranes rupture before labor. Obtainin g participants' views is both feasible and worthwhile when evaluating forms of medical care.