What women want and why. Women's preferences for induction of labour or expectant management in late-term pregnancy |
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| Affiliation: | 1. Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, The Netherlands;2. Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, The Netherlands;3. Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, The Netherlands;4. Department of Obstetrics and Gynaecology, Radboud UMC, Nijmegen, The Netherlands;5. Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia;1. School of Nursing and Midwifery, La Trobe University, Melbourne, Australia;2. Orygen, The National Centre of Excellence in Youth Mental Health, 35 Poplar Road, Parkville, Melbourne, Australia;3. Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia;1. University of Technology Sydney, Faculty of Health, Centre for Midwifery and Child and Family Health, Australia;2. Royal Hospital for Women, South Easters Sydney Local Health District, Australia;3. School of Women''s and Children''s Health, UNSW Medicine, UNSW, Sydney, Australia;4. National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, UNSW, Sydney, Australia;5. University of Newcastle, Faculty of Health and Medicine, Australia;6. Department of Women''s and Children''s Health, St George Hospital, Sydney, Australia;7. The George Institute for Global Health, UNSW Medicine, Australia;8. Hunter New England Nursing and Midwifery Research Centre, Australia;1. Women’s Clinical Service Unit, St James’ University Hospital, Delivery Suite, Level 5 Gledhow Wing, Beckett Street, Leeds LS9 7TF, United Kingdom;2. Adult, Child and Mental Health Nursing Academic Unit, School of Healthcare, University of Leeds, Room G17, Baines Wing, LS2 9UT, United Kingdom |
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| Abstract: | BackgroundBoth induction of labour at 41 weeks and expectant management until 42 weeks are common management strategies in low-risk pregnancy since there is no consensus on the optimal timing of induction in late-term pregnancy for the prevention of adverse outcomes. Our aim was to explore maternal preference for either strategy and the influence on quality of life and maternal anxiety on this preference.MethodsObstetrical low-risk women with an uncomplicated pregnancy were eligible when they reached a gestational age of 41 weeks. They were asked to fill in questionnaires on quality of life (EQ6D) and anxiety (STAI-state). Reasons of women's preferences for either induction or expectant management were explored in a semi-structured questionnaire containing open ended questions.ResultsOf 782 invited women 604 (77.2%) responded. Induction at 41 weeks was preferred by 44.7% (270/604) women, 42.1% (254/604) preferred expectant management until 42 weeks, while 12.2% (74/604) of women did not have a preference. Women preferring induction reported significantly more problems regarding quality of life and were more anxious than women preferring expectant management (p < 0.001). Main reasons for preferring induction of labour were: “safe feeling” (41.2%), “pregnancy taking too long” (35.4%) and “knowing what to expect” (18.6%). For women preferring expectant management, the main reason was “wish to give birth as natural as possible” (80.3%).ConclusionWomen's preference for induction of labour or a policy of expectant management in late-term pregnancy is influenced by anxiety, quality of life problems (induction), the presence of a wish for natural birth (expectant management), and a variety of additional reasons. This variation in preferences and motivations suggests that there is room for shared decision making in the management of late-term pregnancy. |
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| Keywords: | Late-term pregnancy Induction of labour Expectant management Preference Anxiety Quality of life |
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