Women's anticipations of and experiences with induction of labor

Background. Although induction of labor is a common procedure, there are li mited data on its psychoemotional effects. We studied women's expectations of and experiences with labor induction in a large university hospital. Patients and methods. A total of 296 parturients were recruited, with 270 ( 91%) taken into the final analysis. Of these, 135 underwent elective induct ion of labor (44 with amniotomy and 91 with cervical ripening by the use of vaginal prostaglandin gel, followed by amniotomy), whereas the remaining 1 35 women gave birth spontaneously and served as controls. Each woman was in terviewed as to her knowledge, expectations, and feelings about labor befor e induction or at start of labor (controls) as well as after delivery with the help of questionnaires containing yes/no or multiple-choice questions a nd visual analog scales. Results. The induction and control groups, in regard to baseline clinical c haracteristics, did not differ. Labor ended in cesarean section for 24 wome n in the induction group (18%) and for 12 women in the control group (9%) ( p=0.04); these women were included in the data analysis. In the induction g roup, 67%, and in the control group, 48% of women (p=0.002) reported having received sufficient information on labor induction from medical personnel at prenatal or obstetric clinics. Attitudes towards induction of labor were antenatally positive in 78% of women in the induction group and in 69% in the control group. The induction group reported fear of pain less often (45 %) than the control group (57%) (p=0.03). In the induction group, 76 women (56%), and in the control group 94 women (70%) (p=0.02), wanted to particip ate in the decision on the method of induction, and 74% and 83%, respective ly, wished to influence the timing of induction. When interviewed post part um, the labor experience corresponded with the patients' expectations bette r in the control than in the induction group (p=0.03). Labor induction was a positive experience in 90% of women who underwent immediate amniotomy and in 69% of those who received prostaglandin ripening first. Conclusion. Labor induction was a positive experience only seldom eliciting negative feelings. A third of the parturients undergoing induction need mo re information on the procedure and most want to participate in decision-ma king concerning the method and timing of induction.