A Systematic Review of Implementing an Elective Labor Induction Policy

Abstract

To evaluate the effect of implementing hospital policies aimed at reducing elective labor induction and increasing spontaneous labor rates. PubMed, CINAHL, Cochrane Database of Systematic Reviews, and Dissertation Abstracts International. Observational studies published from 2000 to 2010 were the only original studies from the past 20 years that met the review criteria. These focused on elective induction, labor induction policies, pre- and postimplementation of labor induction policy outcomes, and cesarean and maternal/neonatal morbidity rates. Six retrospective and three prospective observational studies regarding implementation of labor induction policies were reviewed for types of intervention guidelines implemented and outcomes on rates of induction, cesarean, and maternal/neonatal morbidity. Implementation of elective induction policies resulted in lower induction, cesarean, operative/instrumental vaginal delivery, and maternal/neonatal morbidity rates. Patients spontaneously gave birth before scheduled elective induction date after policies were implemented, thereby resulting in lower rates of elective induction. Elective labor induction policies should be developed and implemented in all labor and delivery units.