Abstract
BackgroundAlthough labor induction is a commonly used procedure in obstetrical care, there are limited data on its psycho-emotional effects on the woman. This study analysed the expectations and experiences of women in different routes of labor induction. The study’s primary aim was to compare women’s delivery experience if induced by orally administrated misoprostol (OMS) compared with misoprostol vaginal insert (MVI). Secondly, an evaluation of women’s general satisfaction with induced labor was made, and factors associated with a negative experience.MethodsPrimiparous women (n = 196) with a singleton fetus in cephalic presentation, ≥ 37 weeks of gestation, with a Bishop’s score ≤ 4 planning labor induction were randomly allocated to receive either OMS (Cytotec®) or MVI (Misodel®). Data were collected by validated questionnaires, the Wijma Delivery Expectation/Experience Questionnaire (A + B). The pre-labor part of the survey (W-DEQ version A) was given to participants to complete within 1 hour before the start of induction, and the post-labor part of the questionnaire (W-DEQ version B) was administered after birth and collected before the women were discharged from hospital.ResultsIt was found that 11.8% (17/143) reported a severe fear of childbirth (W-DEQ A score ≥ 85). Before the induction, women with extreme fear had 3.7 times increased risk of experiencing labor induction negatively (OR 3.7 [95% CI, 1.04–13.41]).ConclusionNo difference was identified between OMS and MVI when delivery experience among women induced to labor was analysed. Severe fear of childbirth before labor was a risk factor for a negative experience of labor induction.Trial registrationClinical trial register number NCT02918110. Date of registration on May 31, 2016.
Highlights
Labor induction is a commonly used procedure in obstetrical care, there are limited data on its psycho-emotional effects on the woman
One hundred ninety-six primiparous women were included in the study; 93 were allocated to misoprostol vaginal insert (MVI) and 103 to orally administrated misoprostol (OMS) as the method of induction (Fig. 1)
The results of this questionary-based study were presented in three groups according to the result of the W-DEQ B
Summary
Labor induction is a commonly used procedure in obstetrical care, there are limited data on its psycho-emotional effects on the woman. This study analysed the expectations and experiences of women in different routes of labor induction. Methods: Primiparous women (n = 196) with a singleton fetus in cephalic presentation, ≥ 37 weeks of gestation, with a Bishop’s score ≤ 4 planning labor induction were randomly allocated to receive either OMS (Cytotec®) or MVI (Misodel®). The induction of labor is a commonly used obstetrical intervention in low-income as well as developed countries. This procedure is usually performed late in pregnancy to prevent maternal or fetal complications. Compared with the spontaneous onset of labor, induction may increase the woman’s risk of a less positive birth experience [6, 7]. Dissatisfaction increases the risk of post-traumatic stress disorder (PTSD) and possible preference for CS with her pregnancy [8, 9]
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