New research finds women are being steered towards a ‘routine acceptance of induction’ in labour

18 January 2018

New research, conducted by academics at the University of Hertfordshire, has found that women are not always getting enough information from their midwives and antenatal classes about what to expect during induction, or the possible risks.

The study, published in the January issue of British Journal of Midwifery, found that two thirds of the women interviewed received more meaningful information about induction from their family members and friends than from their midwives.

Induction of labour is one of the most frequently performed interventions in pregnancy, accounting for around 25% of all births in England, according to figures from the NHS. Although induction carries the risk of further interventions and is associated with increased pain in labour and an increased likelihood of instrumental delivery, induction for post-dates pregnancy was generally presented to the study’s participants as routine, with little or no discussion of other options.

As part of a qualitative study, researchers interviewed 21 women about their experiences of being induced. The interviews took place 3-6 weeks after giving birth following induction. No distinction was made in respect of the reasons for induction, but all women had been classed as low risk at the start of the pregnancy and none had requested induction as part of their care plan.

Information sources

Although most of the study’s participants had attended antenatal classes, several of them were not sure whether their classes had covered induction and those who recalled information described it as not very meaningful or memorable. Additionally, women found that information from their midwives in the antenatal clinic was often perfunctory or limited to a leaflet, as midwives gave the appearance of being too busy to offer much explanation.

Dr Annabel Jay, Principal Lecturer in Midwifery at the University of Hertfordshire and lead author on the study, said: “Providing information and preparing women for what to expect during induction is key to informed choice, particularly where the risks and benefits are not easily quantifiable.

“These findings suggest a new approach is needed for the management of uncomplicated, post-dates pregnancy. Rather than steering people towards routine acceptance of induction, women should be given individualised information, taking account of their clinical status, social and cultural background and their desire for choice and information. Additionally, providers of maternity care need to allow more contact time for women and midwives to discuss options in an unhurried and balanced manner.

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