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Danilack VA, Siegel-Reamer L, Lum L, Kesselring C, Brousseau EC, Guthrie KM. From "disappointing" to "fantastic": Women's experiences with labor induction in a U.S. tertiary hospital. Birth 2023; 50:959-967. [PMID: 37475194 DOI: 10.1111/birt.12750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/08/2022] [Accepted: 06/29/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The series of interventions that comprise labor induction shape patient experiences; however, patient perceptions are not always considered when structuring the process of care. Through qualitative interviews, we elucidated women's expectations and experiences regarding labor induction. METHODS Labor induction patients were recruited from a United States tertiary care hospital's postpartum mother-baby unit and invited to participate in semi-structured qualitative interviews. Interview questions included expectations and experiences of the labor induction process, side effects and health outcomes of concern, reflections on personal tolerance of different interventions, and thoughts about an ideal process. RESULTS Between April and September 2018, 36 women were interviewed. The labor induction process involved a wide range of experiences; when asked to characterize labor induction in one word, responses ranged from horrible, frustrating, and terrifying to simple, fast, and smooth. Inductions were often described as longer than what was expected. The most polarizing induction method was the Foley balloon catheter. Women's concerns regarding side effects largely centered on the health of their baby, and an ideal induction involved fewer interventions. CONCLUSIONS Experiences with labor induction vary greatly and are related to expectations. The way interventions are introduced influences women's perceptions of control and their ultimate level of contentment with the birthing process. Attention to experiences and preferences has the potential to improve quality of care through communication, shared decision-making, and education.
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Affiliation(s)
- Valery A Danilack
- Department of Obstetrics and Gynecology (Research), Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | | | - Liana Lum
- The College, Brown University, Providence, Rhode Island, USA
| | - Cailey Kesselring
- Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Erin Christine Brousseau
- Department of Obstetrics and Gynecology (Research), Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Kate M Guthrie
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
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Ramlee N, Azhary JMK, Hamdan M, Saaid R, Gan F, Tan PC. Predictors of maternal satisfaction with labor induction: A prospective observational cohort study. Int J Gynaecol Obstet 2023; 163:547-554. [PMID: 37177795 DOI: 10.1002/ijgo.14848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/16/2023] [Accepted: 04/20/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To identify independent predictors of maternal satisfaction with labor induction. METHOD In this prospective observational cohort study, 769 women prior to their labor induction had sleep and psychological well-being assessed using Pittsburgh Sleep Quality Index and Depression, Anxiety and Stress Scales. Women were asked about the adequacy of labor induction information provided and their involvement and time pressure felt in the decision-making for their labor induction. Maternal characteristics, induction and intrapartum care measures, and labor and neonatal outcomes were also assessed. Prior to discharge, women rated their satisfaction with their birth experience. RESULTS A total of 34 variables were considered for bivariate analysis, with 15 found to have P < 0.05. Following adjusted analysis, 10 independent predictors of maternal satisfaction were identified: maternal education, previous cesarean delivery, maternal involvement, information provided, and decision-making time pressure regarding labor induction, amniotomy, induction to delivery interval, mode of delivery, postpartum hemorrhage, and neonatal admission. Maternal satisfaction was not associated with sleep, depression, anxiety, or stress. CONCLUSION The identification of independent predictors of maternal satisfaction allows for patient selection, targeting of specific preinduction and intrapartum care, and focus on induction methods that can reduce induction to delivery interval, cesarean birth, and delivery blood loss to maximize women's satisfaction with labor induction.
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Affiliation(s)
- Nurbayani Ramlee
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | | | - Mukhri Hamdan
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Rahmah Saaid
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Farah Gan
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Peng Chiong Tan
- Department of Obstetrics and Gynecology, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
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Peralta A, Drainoni ML, Declercq ER, Belanoff CM, Radoff K, Bearse E, Iverson RE. Development and testing of a decision aid to achieve shared decision-making for routine labor induction. Birth 2023; 50:636-645. [PMID: 36825853 DOI: 10.1111/birt.12716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 09/20/2022] [Accepted: 01/27/2023] [Indexed: 02/25/2023]
Abstract
BACKGROUND This quality improvement project aimed to create a decision aid for labor induction in healthy pregnancies at or beyond 39 weeks that met the needs of pregnant people least likely to experience shared decision-making and to identify and test implementation strategies to support its use in prenatal care. METHODS We used quality improvement and qualitative methods to develop, test, and refine a patient decision aid. The decision aid was tested in three languages by providers across obstetrics, family medicine, and midwifery practices at a tertiary care hospital and two community health centers. Outcomes included patients' understanding of their choices, pros and cons of choices, and the decision being theirs or a shared one with their provider. RESULTS Patient interview data indicated that shared decision-making on labor induction was achieved. Across three Plan-Do-Study-Act cycles, we interviewed a diverse group of 24 pregnant people: 20 were people of color, 16 were publicly insured, and 15 were born outside the United States. All but one (23/24) reported feeling the decision was theirs or a shared one with their provider. The majority could name induction choices they had along with pros and cons. Interviewees described the decision-making experience as empowering and positive. Nine medical providers tested the decision aid and gave feedback. Providers stated the tool helped improve the quality of their counseling and reduce bias. CONCLUSION This project suggests that using an evidence-based and well-tested decision aid can help achieve shared decision-making on labor induction for a diverse group of pregnant people.
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Affiliation(s)
| | - Mari-Lynn Drainoni
- School of Public Health, Boston University, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Eugene R Declercq
- School of Public Health, Boston University, Boston, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | | | - Kari Radoff
- School of Medicine, Boston University, Boston, MA, USA
- Boston Medical Center, Boston, MA, USA
| | - Emily Bearse
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
- Dartmouth, Geisel School of Medicine, Hanover, New Hampshire, USA
| | - Ronald E Iverson
- School of Medicine, Boston University, Boston, MA, USA
- Boston Medical Center, Boston, MA, USA
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Davies-Tuck ML, Davey MA, Hodges RL, Wallace EM. Fetal surveillance from 39 weeks' gestation to reduce stillbirth in South Asian-born women. Am J Obstet Gynecol 2023; 229:286.e1-286.e9. [PMID: 36907532 DOI: 10.1016/j.ajog.2023.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 02/23/2023] [Accepted: 02/28/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND In July 2017, the State of Victoria's largest maternity service implemented a new clinical guideline to reduce the rates of stillbirth at term for South Asian women. OBJECTIVE This study aimed to evaluate the impact of offering fetal surveillance from 39 weeks to South Asian-born women on rates of stillbirth and neonatal and obstetrical interventions. STUDY DESIGN This was a cohort study of all women receiving antenatal care at 3 large metropolitan university-affiliated teaching hospitals in Victoria, who gave birth in the term period between January 2016 and December 2020. Differences in rates of stillbirth, neonatal deaths, perinatal morbidities, and interventions after July 2017 were determined. Multigroup interrupted time-series analysis was used to assess changes in rates of stillbirth and induction of labor. RESULTS A total of 3506 South Asian-born women gave birth before, and 8532 after the change in practice. There was a 64% reduction in term stillbirth (95% confidence interval, 87% to 2%; P=.047) after the change in practice from 2.3 per 1000 births to 0.8 per 1000 births. The rates of early neonatal death (3.1/1000 vs 1.3/1000; P=.03) and special care nursery admission (16.5% vs 11.1%; P<.001) also decreased. There were no significant differences in admission to the neonatal intensive care unit, 5-minute Apgar score <7, or birthweight, or differences in the trends of induction of labor per month. CONCLUSION Fetal monitoring from 39 weeks may offer an alternative to routine earlier induction of labor to reduce the rates of stillbirth without causing an increase in neonatal morbidity and attenuating trends in obstetrical interventions.
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Affiliation(s)
| | - Mary-Ann Davey
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia
| | - Ryan L Hodges
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia; Monash Health, Clayton, Australia
| | - Euan M Wallace
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Australia; Department of Health and Human Services, Melbourne, Australia
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Tadokoro Y, Takahata K, Shuo T, Shinohara K, Horiuchi S. Changes in Salivary Oxytocin Level of Term Pregnant Women after Aromatherapy Footbath for Spontaneous Labor Onset: A Non-Randomized Experimental Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6262. [PMID: 37444109 PMCID: PMC10341564 DOI: 10.3390/ijerph20136262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 06/09/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Abstract
BACKGROUND Aromatherapy is usually used to stimulate labor. However, its specific physiological effects have been scarcely examined. We evaluated whether an aromatherapy footbath increases oxytocin levels in term pregnant women. METHODS In this quasi-experimental study, low-risk term pregnant women in Japan underwent aromatherapy using a footbath (1) infused with clary sage and lavender essential oils, (2) infused with jasmine oil, or (3) with no infused oils (control group). The primary outcome was the salivary oxytocin level. The secondary outcomes were uterine contractions and cortisol levels. RESULTS In the clary sage and lavender group (n = 28), the oxytocin level increased significantly after the footbath (p = 0.035). The jasmine group (n = 27) and control group (n = 27) exhibited trends toward a respective increase and decrease in the oxytocin level; however, the changes in the oxytocin levels between the clary sage and lavender group and the control group showed no significance difference. There were no significant differences in the changes in the uterine contractions and cortisol levels between the experiment and control groups. CONCLUSIONS The changes in the oxytocin levels in the clary sage and lavender group did not differ significantly with those in the control group, possibly because of the small sample size. Further studies are required to examine the effects of repeated aromatherapy footbaths to stimulate labor.
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Affiliation(s)
- Yuriko Tadokoro
- Chiba Faculty of Nursing, Tokyo Healthcare University, Funabashi 273-8710, Japan
| | - Kaori Takahata
- School of Nursing, Shonan Kamakura University of Medical Sciences, Kamakura 247-0066, Japan;
| | - Takuya Shuo
- Faculty of Health and Medical Sciences, Hokuriku University, Kanazawa 920-1180, Japan;
| | - Kazuyuki Shinohara
- Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki 852-8523, Japan;
| | - Shigeko Horiuchi
- Women’s Health and Midwifery, School of Nursing Science, St. Luke’s International University, Tokyo 104-0044, Japan;
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Migliorelli F, Ferrero L, McCarey C, Marcenaro S, Othenin-Girard V, Chilin A, Martinez de Tejada B. Prediction of spontaneous onset of labor at term (PREDICT study): Research protocol. PLoS One 2022; 17:e0271065. [PMID: 35830435 PMCID: PMC9278770 DOI: 10.1371/journal.pone.0271065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/19/2022] [Indexed: 11/18/2022] Open
Abstract
Background Recent studies have shown that elective induction of labor versus expectant management after 39 weeks of pregnancy result in lower incidence of perinatal complications, while the proportion of cesarean deliveries remains stable, or even decreases. Still, evidence regarding collateral consequences of the potential increase of induction of labor procedures is still lacking. Also, the results of these studies must be carefully interpreted and thoroughly counter-balanced with women’s thoughts and opinions regarding the active management of the last weeks of pregnancy. Therefore, it may be useful to develop a tool that aids in the decision-making process by differentiating women who will spontaneously go into labor from those who will require induction. Objective To develop a predictive model to calculate the probability of spontaneous onset of labor at term. Methods We designed a prospective national multicentric observational study including women enrolled at 39 weeks of gestation, carrying singleton pregnancies. After signing an informed consent form, several clinical, ultrasonographic, biophysical and biochemical variables will be collected by trained staff. If delivery has not occurred at 40 weeks of pregnancy, a second visit and evaluation will be performed. Prenatal care will be continued according to current hospital guidelines. Once recruitment is completed, the information gathered will be used to develop a logistic regression-based predictive model of spontaneous onset of labor between 39 and 41 weeks of gestation. A secondary exploration of the data collected at 40 weeks, as well as a survival analysis regarding time-to-delivery outcomes will also be performed. A total sample of 429 participants is needed for the expected number of events. Conclusion This study aims to develop a model which may help in the decision-making process during follow-up of the last weeks of pregnancy. Trial registration NCT05109247 (clinicaltrials.gov).
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Affiliation(s)
- Federico Migliorelli
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
- Department of Gynecology and Obstetrics, Paule de Viguier Hospital, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
- * E-mail:
| | - Ludovica Ferrero
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Catherine McCarey
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Sara Marcenaro
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Véronique Othenin-Girard
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Antonina Chilin
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
| | - Begoña Martinez de Tejada
- Division of Obstetrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland
- Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Waldron S, Contziu H, Aleshin O, Phipps H. A snapshot of women’s and clinicians’ perceptions of the double balloon catheter for induction of labor. Eur J Midwifery 2022; 6:33. [PMID: 35702061 PMCID: PMC9150372 DOI: 10.18332/ejm/146689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/02/2022] [Accepted: 02/14/2022] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Induction of labor (IOL) is rising globally and is growing steadily in the state of New South Wales, Australia. There are numerous methods of induction of labor, including the double balloon catheter (DBC). There is minimal evidence on women’s attitudes and experiences and clinician’s opinions on the use of the DBC. This study aims to explore the views regarding DBC insertion and effectiveness from women induced with a DBC and clinicians involved in the catheter insertion and care. METHODS This study is a descriptive survey of two prospective, de-identified, self-reported questionnaires which were completed in 2016. One questionnaire was administered to term pregnant women that were admitted to the antenatal ward post IOL, and the other was completed by midwives and obstetric doctors working in the ward at the time. RESULTS The DBC appeared to be a well-accepted method of cervical ripening among women (61%) and clinicians (>82%). Success of DBC to achieve an artificial rupture of membrane post removal, directly correlates to women’s acceptance (61%). While most clinicians (59–67%) perceived insertion of DBC in an outpatient setting and then women discharged home was appropriate, only 13% of women were in favor. On the logistics of the procedure in respect to insertion and removal of the DBC, there were differences of opinion, with only 43% of women, 77% of midwives and 33% of doctors stating that the timing of insertion and removal needed to be improved. CONCLUSIONS This study highlights the need to undertake qualitative research to further explore women’s views and perceptions on IOL in order to ensure that clinical practice is woman-centered and evidenced-based, and to guide policy and protocol.
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Affiliation(s)
- Sarah Waldron
- RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, Australia
| | - Hannah Contziu
- RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, Australia
| | - Olga Aleshin
- RPA Women and Babies, Royal Prince Alfred Hospital, Sydney, Australia
| | - Hala Phipps
- Sydney Institute for Women, Children and their Families, Sydney Local Health District, Sydney, Australia
- School of Nursing and Midwifery, Faculty of Health, University of Technology Sydney, Sydney, Australia
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
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Bossung V, Rath W, Rody A, Schwarz C. Heterogenous use of misoprostol for induction of labour: results of an online survey among midwives in German-speaking countries. Arch Gynecol Obstet 2021; 304:1501-1511. [PMID: 33938998 PMCID: PMC8553731 DOI: 10.1007/s00404-021-06079-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 04/23/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE This online survey looked at the experiences and general perceptions of midwives concerning induction of labour and the specific use of misoprostol. METHODS We published an online questionnaire with 24 questions in German on midwives' experiences and perceptions of different methods of induction of labour. RESULTS The online survey was answered by 412 midwives between February 2016 and February 2017. At least 20% of the 24 questions were answered in 333 questionnaires, which were included in this analysis. Oral misoprostol was the most common induction method for primipara and for women with a previous vaginal birth and an unfavourable cervix. Apart from alternative methods for induction of labour like castor oil and complementary/alternative methods, oral misoprostol was the preferred method of induction of labour by midwives. Midwives described a wide range of dosage schedules concerning application intervals, starting doses, and the maximum daily dose of misoprostol. Approximately 50% of the participants of this study described prescriptions of more than 200 µg misoprostol daily for induction of labour. CONCLUSION Misoprostol is widely used in Germany and was one of the three preferred methods of induction of labour among midwives in our study next to castor oil and complementary/alternative methods. The preparation and dosage of misoprostol vary significantly among hospitals and do not adhere to international guidelines. Midwives voiced their concerns about inconsistent indications and heterogenous use of different methods and dosages of induction. They wished for more patience with late-term pregnancies and individualized shared decision-making between pregnant women and obstetricians.
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Affiliation(s)
- Verena Bossung
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany.
| | - Werner Rath
- Department of Obstetrics and Gynecology, University Hospital RWTH Aachen, Pauwelsstraße 30, 52074, Aachen, Germany
| | - Achim Rody
- Department of Obstetrics and Gynecology, University Hospital of Schleswig-Holstein, Campus Luebeck, Ratzeburger Allee 160, 23538, Luebeck, Germany
| | - Christiane Schwarz
- Department of Midwifery Science, C/O BMO, University of Luebeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
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Coates R. Attitudes of pregnant women and healthcare professionals to labour induction and obtaining consent for labour induction. Best Pract Res Clin Obstet Gynaecol 2021; 77:64-75. [PMID: 34625350 DOI: 10.1016/j.bpobgyn.2021.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
Induction of labour is experienced by up to one third of women and can be a negative experience, in relation to both the decision about whether to have an induction of labour (IoL) and the experience of the process of IoL. This paper reviews the limited evidence of women's views on and experiences of: information provision; shared decision-making; preferences for method and location of IoL; indications for IoL; pain management; and effective communication and support. Healthcare professionals' views are reviewed, but are underrepresented, and further research is needed to understand experiences of gaining consent for IoL. Systematic review evidence is drawn on where possible, but reviews often found small numbers of papers for inclusion, and provide insights rather than conclusive evidence. Future research would benefit from using validated measures to assess the experience of IoL.
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Affiliation(s)
- Rose Coates
- Centre for Maternal and Child Health Research, School of Health Sciences, City University of London, Northampton Square, London, EC1V 0HB, UK.
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Farnworth A, Graham RH, Haighton CA, Robson SC. How is high quality research evidence used in everyday decisions about induction of labour between pregnant women and maternity care professionals? An exploratory study. Midwifery 2021; 100:103030. [PMID: 34048941 DOI: 10.1016/j.midw.2021.103030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/29/2021] [Accepted: 05/03/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To explore the use of high quality research evidence in women's and maternity care professionals' decisions about induction of labour (IOL). METHODS A qualitative study underpinned by a social constructionist framework, using semi-structured interviews and generative thematic analysis. SETTING A large tertiary referral maternity unit in northern England in 2013/14. PARTICIPANTS 22 randomly selected health care professionals involved in maternity care (midwives, obstetricians, maternity service managers), and 16 postnatal women, 3-8 weeks post-delivery, who were offered IOL in their most recent pregnancy. FINDINGS Three themes were identified in the data; (1) the value of different forms of knowledge, (2) accessing and sharing knowledge, and (3) constrained pathways and default choices. Findings echo other evidence in suggesting that women do not feel informed about IOL or that they have choices about the procedure. This study illuminates potential explanatory factors by considering the complex context within which IOL is discussed and offered (e.g. presentation of IOL as routine rather than a choice, care pathways that make declining IOL appear undesirable, blanket use of clinical guidelines without consideration of individual circumstances and preferences). KEY CONCLUSIONS This study suggests that organisational, social, and professional factors conspire towards a culture where (a) IOL has become understood as a routine part of maternity care rather than an intervention to make an informed choice about, (b) several factors contribute to demotivate women and health care practitioners from seeking to understand the evidence base regarding induction, and (c) health care professionals can find themselves ill-equipped to discuss the relative risks and benefits of IOL and its alternatives. IMPLICATIONS FOR PRACTICE It is important that IOL is recognised as an optional intervention and is not presented to women as a routine part of maternity care. When IOL is offered it should be accompanied by an evidence informed discussion about the options available to support informed decision making. Health care professionals should be supported to understand the evidence base and our findings suggest that any attempt to facilitate this needs to acknowledge and tackle complex organisational, social and professional influences that contribute to current care practices.
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Affiliation(s)
- Allison Farnworth
- Newcastle University, Level 6, Leazes Wing, Royal Victoria Infirmary. Richardson Road, Newcastle upon Tyne. NE1 7RU, United Kingdom.
| | - Ruth H Graham
- Newcastle University, Level 6, Leazes Wing, Royal Victoria Infirmary. Richardson Road, Newcastle upon Tyne. NE1 7RU, United Kingdom
| | - Catherine A Haighton
- Newcastle University, Level 6, Leazes Wing, Royal Victoria Infirmary. Richardson Road, Newcastle upon Tyne. NE1 7RU, United Kingdom
| | - Stephen C Robson
- Newcastle University, Level 6, Leazes Wing, Royal Victoria Infirmary. Richardson Road, Newcastle upon Tyne. NE1 7RU, United Kingdom
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11
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Coates D, Thirukumar P, Henry A. The experiences of shared decision-making of women who had an induction of labour. PATIENT EDUCATION AND COUNSELING 2021; 104:489-495. [PMID: 32843263 DOI: 10.1016/j.pec.2020.08.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/02/2020] [Accepted: 08/16/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES The importance of shared decision-making (SDM) in relation to induction of labour (IOL) is recognised, little is known about women's experiences of and satisfaction with decision-making and how this can be improved. The aim of this study was to 1) gain insight into women's experiences of SDM in relation to IOL, 2) understand the factors associated with satisfaction versus dissatisfaction during SDM, and 3) identify recommendations for service improvement. METHODS Qualitative semi-structured telephone interviews were conducted with 32 women who had a recent IOL at one of eight public hospitals in Sydney, Australia. An inductive approach to coding and categorisation of themes was used. RESULTS While women reported varied experiences with SDM, many reported not feeling that they had a choice about IOL, not being presented with the risks and benefits of different birth options, and receiving insufficient information about the IOL process and methods. Satisfaction versus dissatisfaction with SDM appeared more closely related to a woman's willingness to have an IOL and their willingness to defer decision-making, rather than the process of SDM. Recommendations for improvement included improved SDM practices, access to guidelines and continuity of care. CONCLUSION There is a need to improve SDM processes around IOL. PRACTICE IMPLICATIONS Particular areas for improvement include more comprehensive discussions surrounding the pros and cons of different birth methods and the IOL process. Decision aids and clinician training may assist with SDM.
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Affiliation(s)
- Dominiek Coates
- University of Technology Sydney, Faculty of Health, Centre for Midwifery and Child and Family Health, Sydney, Australia.
| | | | - Amanda Henry
- School of Women's and Children's Health, UNSW Medicine, UNSW, Australia; Department of Women's and Children's Health, St George Hospital, Sydney, Australia; The George Institute for Global Health, UNSW Medicine, Australia
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Nespoli A, Colciago E, Fumagalli S, Locatelli A, Hollins Martin CJ, Martin CR. Validation and factor structure of the Italian version of the Birth Satisfaction Scale-Revised (BSS-R). J Reprod Infant Psychol 2020; 39:516-531. [PMID: 33084372 DOI: 10.1080/02646838.2020.1836333] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To validate the Italian-language version of the Birth Satisfaction Scale-Revised (BSS-R) and report key measurement properties of the tool. To evaluate the impact of antenatal class attendance on BSS-R assessed birth satisfaction. BACKGROUND Maternal satisfaction is one of the standards of care defined by the World Health Organisation (WHO) to improve the quality of services. The BSS-R is a multi-dimensional self-report measure of the experience of labour and birth. METHODS Cross-sectional instrument evaluation design examining factor structure and key aspects of validity and reliability. Embedded between-subjects design to examine known-group discriminant validity and the impact of antenatal class attendance on BSS-R sub-scale and total scores as dependent variables. After giving birth, 297 women provided data for analysis. RESULTS The Italian version of the BSS-R (I-BSS-R) was the key study measure. The established three-factor and bi-factor models of the BSS-R were found to offer an excellent fit to the data. Comparison of the tri-dimensional measurement model and the bi-factor model of the BSS-R found no significant differences between models. Women who attended antenatal classes had significantly lower stress experienced during childbearing sub-scale scores (I-BSS-R SE), compared to those who did not. Good convergent, divergent validity and known-groups discriminant validity were established for the I-BSS-R. Internal consistency observations were found to be sub-optimal in this population. CONCLUSIONS On all key psychometric indices, with the exception of internal consistency that requires further investigation, the I-BSS-R was found to be a valid translation of the original BSS-R. The impact of antenatal classes on birth satisfaction warrants further research.
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Affiliation(s)
- Antonella Nespoli
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Elisabetta Colciago
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Simona Fumagalli
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy
| | - Anna Locatelli
- School of Medicine and Surgery, University of Milano - Bicocca, Monza, Italy.,Unit of Mother and Child, ASST Vimercate
| | | | - Colin R Martin
- Institute of Clinical and Applied Health Research (ICAHR), Faculty of Health Sciences, University of Hull, UK
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Declercq E, Belanoff C, Iverson R. Maternal perceptions of the experience of attempted labor induction and medically elective inductions: analysis of survey results from listening to mothers in California. BMC Pregnancy Childbirth 2020; 20:458. [PMID: 32787802 PMCID: PMC7425604 DOI: 10.1186/s12884-020-03137-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 07/28/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The rate of induction of labor in the U.S. has risen from 9.6% in 1990 to 25.7% in 2018, including 31.7% of first-time births. Recent studies that have examined inductions have been small qualitative studies or relied on either medical records or administrative data. This study examines induction from the perspective of those women who experienced it, with a particular focus on the prevalence and predictors of inductions for nonmedical indications, women's experience of pressure to induce labor and the relationship between the attempt to medically initiate labor and cesarean section. METHODS Study data are drawn from the 2119 respondents to the Listening to Mothers in California survey who were planning to have a vaginal birth in 2016. Mothers were asked if there had been an attempt to medically initiate labor, if it actually started labor, if they felt pressured to have the induction, if they had a cesarean and the reason for the induction. Reasons for induction were classified as either medically indicated or elective. RESULTS Almost half (47%) of our respondents indicated an attempt was made to medically induce their labor, and 71% of those attempts initiated labor. More than a third of the attempts (37%) were elective. Attempted induction overall was most strongly associated with giving birth at 41+ weeks (aOR 3.28; 95% C.I. 2.21-4.87). Elective inductions were more likely among multiparous mothers and in pregnancies at 39 or 40 weeks. The perception of being pressured to have labor induced was related to higher levels of education, maternal preference for less medical intervention in birth, having an obstetrician compared to a midwife and gestational ages of 41+ weeks. Cesarean birth was more likely in the case of overall induction (aOR 1.51; 95% C.I. 1.11-2.07) and especially following a failed attempt at labor induction (aOR 4.50; 95% C.I. 2.93-6.90). CONCLUSION Clinicians counselling mothers concerning the need for labor induction should be aware of mothers' perceptions about birth and engage in true shared decision making in order to avoid the maternal perception of being pressured into labor induction.
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Affiliation(s)
- Eugene Declercq
- Community Health Sciences Department Boston University School of Public Health, 801 Massachusetts Ave., Boston, MA 02118 USA
| | - Candice Belanoff
- Community Health Sciences Department Boston University School of Public Health, 801 Massachusetts Ave., Boston, MA 02118 USA
| | - Ronald Iverson
- Department of Obstetrics and Gynecology, Boston University School of Medicine, 72 E Concord St, Boston, MA 02118 USA
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14
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Kagwisage J, Balandya BS, Pembe AB, Mujinja PGM. Health Related Quality of Life Post Labour Induction with Misoprostol Versus Dinoprostone At Muhimbili National Hospital in Dar Es Salaam, Tanzania: A cross Sectional Study. East Afr Health Res J 2020; 4:58-64. [PMID: 34308221 PMCID: PMC8279179 DOI: 10.24248/eahrj.v4i1.622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 05/26/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Labour induction using Misoprostol or Dinoprostone results to similar maternal and foetal clinical outcomes. However, the clinical outcome measures have rarely been combined with effects of interventions on patients' health related quality of life. This study aimed to assess postpartum health related quality of life of parturient after labour induction with vaginal administration of misoprostol versus dinoprostone. METHODS This was a comparative cross sectional study in which pregnant women who underwent labour induction with misoprostol and dinoprostone during the study period were included. Data were collected within 24 hours post-delivery using the 36 item short form health survey questionnaire which consists of 24 attributes distributed in five domains including bodily pains and physical performance three attributes each, mental health seven attributes, general health two attributes, social functioning six attributes and three attributes for labour induction satisfaction. We first estimated scores of all attributes in each domain using Likert scales and then the domain scores were converted into a 0 to 100 scales to express in percentage of total scores. Quality of life was compared in the two study groups using the independent samples T Test. Multivariate regression analysis was performed to control for marital status, gravidity, parity, baseline cervical status, time interval from induction to delivery and mode of delivery. RESULTS Women who received misoprostol reported better health related quality of life compared to those who received dinoprostone (mean score 92.89 vs. 87.25;P<.00). Misoprostol group had significantly higher scores in all domains of health related quality of life; reduced bodily pain (93.76 vs. 84.19;P<.00), physical performance (83.64 vs. 73.58;P<.00), mental health (96.40 vs. 93.55; P<.00), general health (93.78 vs. 90.23;P=.01), social functioning (94.81 vs. 91.25;P<.00) and satisfaction perceptions (94.96 vs. 90.71;P<.00). CONCLUSION Health related quality of life information is of particular value in routine care of natal and postnatal mothers. Current and updated guidelines should address the impacts of labour induction interventions on maternal health related quality of life, and encourage the use of quality of life information in provision of holistic natal and postnatal care services. Clinical trials are recommended to determine the effectiveness of labour induction with either of the two methods and address the historical adverse outcomes associated to the use of misoprostol.
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Affiliation(s)
- Jonas Kagwisage
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Belinda S Balandya
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Andrea B Pembe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Phares GM Mujinja
- Department of Behavioral Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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15
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Keulen JKJ, Nieuwkerk PT, Kortekaas JC, van Dillen J, Mol BW, van der Post JAM, de Miranda E. What women want and why. Women's preferences for induction of labour or expectant management in late-term pregnancy. Women Birth 2020; 34:250-256. [PMID: 32444268 DOI: 10.1016/j.wombi.2020.03.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 03/03/2020] [Accepted: 03/23/2020] [Indexed: 01/25/2023]
Abstract
BACKGROUND Both 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. METHODS Obstetrical 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. RESULTS Of 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%). CONCLUSION Women'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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Affiliation(s)
- J K J Keulen
- Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, The Netherlands; Amsterdam Reproduction & Development Research Institute, Amsterdam UMC, University of Amsterdam, The Netherlands.
| | - P T Nieuwkerk
- Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - J C Kortekaas
- Department of Obstetrics and Gynaecology, Radboud UMC, Nijmegen, The Netherlands
| | - J van Dillen
- Department of Obstetrics and Gynaecology, Radboud UMC, Nijmegen, The Netherlands
| | - B W Mol
- Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - J A M van der Post
- Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, The Netherlands
| | - E de Miranda
- Department of Obstetrics and Gynaecology, Amsterdam UMC, University of Amsterdam, The Netherlands
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16
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Coates D, Donnolley N, Foureur M, Henry A. Women's experiences of decision-making and attitudes in relation to induction of labour: A survey study. Women Birth 2020; 34:e170-e177. [PMID: 32146087 DOI: 10.1016/j.wombi.2020.02.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/20/2020] [Accepted: 02/24/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND Rates of induction of labour have been increasing globally to up to one in three pregnancies in many high-income countries. Although guidelines around induction, and strength of the underlying evidence, vary considerably by indication, shared decision-making is increasingly recognised as key. The aim of this study was to identify women's mode of birth preferences and experiences of shared decision-making for induction of labour. METHOD An antenatal survey of women booked for an induction at eight Sydney hospitals was conducted. A bespoke questionnaire was created assessing women's demographics, indication for induction, pregnancy model of care, initial birth preferences, and their experience of the decision-making process. RESULTS Of 189 survey respondents (58% nulliparous), major reported reasons for induction included prolonged pregnancy (38%), diabetes (25%), and suspected fetal growth restriction (8%). Most respondents (72%) had hoped to labour spontaneously. Major findings included 19% of women not feeling like they had a choice about induction of labour, 26% not feeling adequately informed (or uncertain if informed), 17% not being given alternatives, and 30% not receiving any written information on induction of labour. Qualitative responses highlight a desire of women to be more actively involved in decision-making. CONCLUSION A substantial minority of women did not feel adequately informed or prepared, and indicated they were not given alternatives to induction. Suggested improvements include for face-to-face discussions to be supplemented with written information, and for shared decision-making interventions, such as the introduction of decision aids and training, to be implemented and evaluated.
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Affiliation(s)
- Dominiek Coates
- University of Technology Sydney, Faculty of Health, Centre for Midwifery and Child and Family Health, Australia; Maridulu Budyari Gumal, the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE) Australia; School of Women's and Children's Health, UNSW Medicine, UNSW, Sydney, Australia.
| | - Natasha Donnolley
- National Perinatal Epidemiology and Statistics Unit, Centre for Big Data Research in Health, UNSW, Sydney, Australia.
| | - Maralyn Foureur
- University of Newcastle, Faculty of Health and Medicine, Australia; Hunter New England Nursing and Midwifery Research Centre, Australia.
| | - Amanda Henry
- School of Women's and Children's Health, UNSW Medicine, UNSW, Sydney, Australia; Department of Women's and Children's Health, St George Hospital, Sydney, Australia; The George Institute for Global Health, UNSW Medicine, Australia
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17
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Wise MR, Marriott J, Battin M, Thompson JMD, Stitely M, Sadler L. Outpatient balloon catheter vs inpatient prostaglandin for induction of labour (OBLIGE): a randomised controlled trial. Trials 2020; 21:190. [PMID: 32066505 PMCID: PMC7027046 DOI: 10.1186/s13063-020-4061-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 01/09/2020] [Indexed: 12/02/2022] Open
Abstract
Background Approximately one in four pregnant women undergo an induction of labour. The purpose of this study is to investigate the clinical effectiveness, safety, and cost-effectiveness for mothers and babies of two methods of cervical ripening – inpatient care for women starting induction with vaginal prostaglandin E2 hormones, or allowing women to go home for 18 to 24 h after starting induction with a single-balloon catheter. Methods/design This is a multi-centre randomised controlled trial in New Zealand. Eligible pregnant women, with a live singleton baby in a cephalic presentation who undergo a planned induction of labour at term, will be randomised to outpatient balloon-catheter induction or in-hospital prostaglandin induction. The primary outcome is caesarean section rate. To detect a 24% relative risk reduction in caesarean rate from a baseline of 24.8%, with 80% power and 5% type 1 error, will require 1552 participants in a one to one ratio. Discussion If outpatient balloon-catheter induction reduces caesarean section rates, has additional clinical benefits, and is safe, cost-effective, and acceptable to women and clinicians, we anticipate change in induction of labour practice around the world. We think that home-based balloon-catheter induction will be welcomed as part of a patient-centred labour-induction care package for pregnant women. Trial registration Australia New Zealand Clinical Trials Registry (ANZCTR), ACTRN: 12616000739415. Registered on 6 June 2016.
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Affiliation(s)
- Michelle R Wise
- Department of Obstetrics and Gynaecology, University of Auckland, PO Box 92019, Auckland, 1142, New Zealand.
| | - Joy Marriott
- Department of Obstetrics and Gynaecology, University of Auckland, PO Box 92019, Auckland, 1142, New Zealand
| | - Malcolm Battin
- Newborn Services, Auckland District Health Board and Department of Paediatrics, University of Auckland, Auckland, New Zealand
| | - John M D Thompson
- Department of Obstetrics and Gynaecology, University of Auckland, PO Box 92019, Auckland, 1142, New Zealand
| | - Michael Stitely
- Department of Women's and Children's Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Lynn Sadler
- Women's Health, Auckland District Health Board, 2 Park Road, Grafton, Auckland, 1023, New Zealand
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18
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Coates D, Makris A, Catling C, Henry A, Scarf V, Watts N, Fox D, Thirukumar P, Wong V, Russell H, Homer C. A systematic scoping review of clinical indications for induction of labour. PLoS One 2020; 15:e0228196. [PMID: 31995603 PMCID: PMC6988952 DOI: 10.1371/journal.pone.0228196] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 01/10/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The proportion of women undergoing induction of labour (IOL) has risen in recent decades, with significant variation within countries and between hospitals. The aim of this study was to review research supporting indications for IOL and determine which indications are supported by evidence and where knowledge gaps exist. METHODS A systematic scoping review of quantitative studies of common indications for IOL. For each indication, we included systematic reviews/meta-analyses, randomised controlled trials (RCTs), cohort studies and case control studies that compared maternal and neonatal outcomes for different modes or timing of birth. Studies were identified via the databases PubMed, Maternity and Infant Care, CINAHL, EMBASE, and ClinicalTrials.gov from between April 2008 and November 2019, and also from reference lists of included studies. We identified 2554 abstracts and reviewed 300 full text articles. The quality of included studies was assessed using the RoB 2.0, the ROBINS-I and the ROBIN tool. RESULTS 68 studies were included which related to post-term pregnancy (15), hypertension/pre-eclampsia (15), diabetes (9), prelabour rupture of membranes (5), twin pregnancy (5), suspected fetal compromise (4), maternal elevated body mass index (BMI) (4), intrahepatic cholestasis of pregnancy (3), suspected macrosomia (3), fetal gastroschisis (2), maternal age (2), and maternal cardiac disease (1). Available evidence supports IOL for women with post-term pregnancy, although the evidence is weak regarding the timing (41 versus 42 weeks), and for women with hypertension/preeclampsia in terms of improved maternal outcomes. For women with preterm premature rupture of membranes (24-37 weeks), high-quality evidence supports expectant management rather than IOL/early birth. Evidence is weakly supportive for IOL in women with term rupture of membranes. For all other indications, there were conflicting findings and/or insufficient power to provide definitive evidence. CONCLUSIONS While for some indications, IOL is clearly recommended, a number of common indications for IOL do not have strong supporting evidence. Overall, few RCTs have evaluated the various indications for IOL. For conditions where clinical equipoise regarding timing of birth may still exist, such as suspected macrosomia and elevated BMI, researchers and funding agencies should prioritise studies of sufficient power that can provide quality evidence to guide care in these situations.
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Affiliation(s)
- Dominiek Coates
- Centre for Midwifery and Child and Family Health, Faculty of Health, University of Technology Sydney, Australia
| | - Angela Makris
- Department of Medicine, Western Sydney University, Sydney, Australia
- Women’s Health Initiative Translational Unit (WHITU), Liverpool Hospital, Liverpool, Australia
| | - Christine Catling
- Centre for Midwifery and Child and Family Health, Faculty of Health, University of Technology Sydney, Australia
| | - Amanda Henry
- School of Women’s and Children’s Health, UNSW Medicine, University of New South Wales, Sydney, Australia
- Department of Women’s and Children’s Health, St George Hospital, Sydney, Australia
- The George Institute for Global Health, UNSW Medicine, Sydney, Australia
| | - Vanessa Scarf
- Centre for Midwifery and Child and Family Health, Faculty of Health, University of Technology Sydney, Australia
| | - Nicole Watts
- Centre for Midwifery and Child and Family Health, Faculty of Health, University of Technology Sydney, Australia
| | - Deborah Fox
- Centre for Midwifery and Child and Family Health, Faculty of Health, University of Technology Sydney, Australia
| | - Purshaiyna Thirukumar
- School of Women’s and Children’s Health, UNSW Medicine, University of New South Wales, Sydney, Australia
| | - Vincent Wong
- Liverpool Diabetes Collaborative Research Unit, Ingham Institute of Applied Research Science, University of New South Wales, Liverpool, Australia
| | - Hamish Russell
- South Western Sydney Local Health District, Sydney, Australia
| | - Caroline Homer
- Centre for Midwifery and Child and Family Health, Faculty of Health, University of Technology Sydney, Australia
- Maternal and Child Health Program, Burnet Institute, Victoria, Australia
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Roberts J, Evans K, Spiby H, Evans C, Pallotti P, Eldridge J. Women's information needs, decision-making and experiences of membrane sweeping to promote spontaneous labour. Midwifery 2020; 83:102626. [PMID: 31954296 DOI: 10.1016/j.midw.2019.102626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 12/11/2019] [Accepted: 12/31/2019] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To explore and synthesise evidence of women's information needs, decision-making and experiences of membrane sweeping to promote spontaneous labour. DESIGN A systematic review following the Joanna Briggs Institute (JBI) meta-aggregative approach to qualitative evidence synthesis. Relevant databases were searched for literature published in English between 2000-19. Study quality was assessed using the JBI quality assessment tool for qualitative studies. SETTING Qualitative research conducted in OECD countries describing women's information needs, decision-making and/or experiences of membrane sweeping to promote spontaneous labour. FINDINGS One article met the criteria for inclusion. This article describes the experience of a membrane sweep given without consent. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE There is a lack of evidence around women's information needs, decision-making and experiences of membrane sweeping. This is concerning, especially in the context of rising rates of formal induction of labour. Further research is needed to investigate how women are being offered membrane sweeping and what information women need to make informed choices about membrane sweeping to promote spontaneous labour.
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Affiliation(s)
- Julie Roberts
- Division of Midwifery, School of Health Sciences, University of Nottingham, Floor 12, Tower Building, University Park, Nottingham NG7 2RD UK.
| | - Kerry Evans
- Division of Midwifery, School of Health Sciences, University of Nottingham, Floor 12, Tower Building, University Park, Nottingham NG7 2RD UK.
| | - Helen Spiby
- Division of Midwifery, School of Health Sciences, University of Nottingham, Floor 12, Tower Building, University Park, Nottingham NG7 2RD UK.
| | - Catrin Evans
- School of Health Sciences, University of Nottingham, B Floor, Queens Medical Centre, Nottingham NG7 2UH UK.
| | - Phoebe Pallotti
- Division of Midwifery, School of Health Sciences, University of Nottingham, Floor 12, Tower Building, University Park, Nottingham NG7 2RD UK.
| | - Jeanette Eldridge
- School of Health Sciences, University of Nottingham, B Floor, Queens Medical Centre, Nottingham NG7 2UH UK.
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20
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Lou S, Hvidman L, Uldbjerg N, Neumann L, Jensen TF, Haben JG, Carstensen K. Women's experiences of postterm induction of labor: A systematic review of qualitative studies. Birth 2019; 46:400-410. [PMID: 30561053 DOI: 10.1111/birt.12412] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 11/19/2018] [Accepted: 11/19/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Over the last decade, induction of labor (IOL) in postterm pregnancies has increased. Studies have shown the medical advantages of postterm IOL, but less is known about the perspectives of the pregnant women. This review aimed to summarize the current qualitative evidence on women's experience of postterm IOL. METHODS A systematic literature search was performed in three databases. A total of 3193 publications were identified, but only eight studies met the inclusion criteria. Thematic analysis guided the data extraction and synthesis. The Confidence in the Evidence for Reviews of Qualitative research (CERQual) approach was used to assess confidence in the findings. RESULTS Three major findings were identified. First, for some women, IOL required a shift in expectations because the hope of spontaneous labor had to be given up. Second, the IOL decision was considered a recommendation from health care professionals and was experienced as a nondecision. Finally, the induction process was experienced as a sequential set of steps where the women were expected to fit into the existing hospital organization. The CERQual assessment suggested moderate confidence in all findings. DISCUSSION The negative experiences identified in this review can be greatly reduced by a communicative and patient-centered approach. To support informed choice and shared decision making, women need high-quality, unbiased information about IOL, alternative options, and potential outcomes, in addition to time for reflection on their personal values and preferences. Women may need a professionally initiated and supported opportunity to re-evaluate their hopes and expectations before IOL.
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Affiliation(s)
- Stina Lou
- DEFACTUM -Public Health and Health Services Research, Central Denmark Region, Aarhus, Denmark.,Center for Fetal Diagnostics, Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark
| | - Lone Hvidman
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Niels Uldbjerg
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Lone Neumann
- Department of Obstetrics and Gynaecology, Randers Regional Hospital, Randers, Denmark
| | - Trine Fritzner Jensen
- Department of Obstetrics and Gynaecology, Randers Regional Hospital, Randers, Denmark
| | - Joke-Gesine Haben
- Department of Obstetrics and Gynaecology, Aarhus University Hospital, Aarhus, Denmark
| | - Kathrine Carstensen
- DEFACTUM -Public Health and Health Services Research, Central Denmark Region, Aarhus, Denmark
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21
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Induction of labour: Experiences of care and decision-making of women and clinicians. Women Birth 2019; 33:e1-e14. [PMID: 31208865 DOI: 10.1016/j.wombi.2019.06.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 05/31/2019] [Accepted: 06/03/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND There has been a rise in induction of labour over recent decades. There is some tension in the literature in relation to when induction is warranted and when not, with variability between guidelines and practice. Given these tensions, the importance of shared decision-making between clinicians and women is increasingly highlighted as paramount, but it remains unclear to what extent this occurs in routine care. METHOD Using a scoping review methodology, quantitative and qualitative evidence were considered to answer the research question "What are the views, preferences and experiences of women and clinicians in relation to induction of labour more broadly, and practices of decision-making specifically?" To identify studies, the databases PubMed, Maternity and Infant Care, CINAHL and EMBASE were searched from 2008 to 2018, and reference lists of included studies were examined. FINDINGS 20 papers met inclusion criteria, in relation to (a) women's preferences, experiences and satisfaction with IOL; (b) women's experience of shared-decision making in relation to induction; (c) interventions that improve shared decision-making and (d) factors that influence decision-making from the perspective of clinicians. Synthesis of the included studies indicates that decision-making in relation to induction of labour is largely informed by medical considerations. Women are not routinely engaged in the decision making process with expectations and preferences largely unmet. CONCLUSION There is a need to develop strategies such as decision aids, the redesign of antenatal classes, and clinician communication training to improve the quality of information available to women and their capacity for informed decision-making.
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Woman-centered care: Women's experiences and perceptions of induction of labor for uncomplicated post-term pregnancy: A systematic review of qualitative evidence. Midwifery 2018; 67:46-56. [DOI: 10.1016/j.midw.2018.08.018] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/30/2018] [Accepted: 08/15/2018] [Indexed: 11/16/2022]
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Women's experiences of induction of labour: Qualitative systematic review and thematic synthesis. Midwifery 2018; 69:17-28. [PMID: 30390463 DOI: 10.1016/j.midw.2018.10.013] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/16/2018] [Accepted: 10/24/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To explore and synthesise evidence of women's experiences of induction of labour (IoL). DESIGN Systematic review and thematic synthesis of peer-reviewed qualitative evidence. Relevant databases were searched from inception to the present day. Study quality was appraised using the Critical Appraisal Skills Programme (CASP) qualitative research appraisal tool. SETTING AND PARTICIPANTS Low and high risk women who had experienced IoL in an inpatient or outpatient setting. FINDINGS Eleven papers (representing 10 original studies) published between 2010 and 2018 were included for thematic synthesis. Four key analytical themes were identified: ways in which decisions regarding induction were made; women's ownership of the process; women's social needs when undergoing IoL; and the importance of place in the induction process. The review indicates that IoL is a challenging experience for women, which can be understood in terms of the gap between women's needs and the reality of their experience concerning information and decision-making, support, and environment. KEY CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Providing good quality appropriately timed information and supporting women's self-efficacy to be involved in decision-making around IoL may benefit women by facilitating a sense of ownership or control of labour. Compassionate support from significant others and healthcare professionals in a comfortable, private and safe environment should be available to all women.
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Roberts J, Walsh D. “Babies come when they are ready”: Women’s experiences of resisting the medicalisation of prolonged pregnancy. FEMINISM & PSYCHOLOGY 2018. [DOI: 10.1177/0959353518799386] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Being pregnant beyond one’s estimated due date is a relatively common experience and requires complex decisions about whether to induce labour or wait for spontaneous onset. We report a qualitative study undertaken in the UK in 2016. We interviewed fifteen women and eleven more took part in an online focus group. Using thematic analysis, resistance to the medicalisation of prolonged pregnancy was identified as a strong theme. Drawing on the work of Armstrong and Murphy, we identify both conceptual and behavioural resistance in the accounts of women who accepted, delayed or declined induction of labour. Experiential knowledge played a key role in resistance, but women found this was devalued. Some healthcare staff used risk discourse to pressure women to comply with induction protocols but were unwilling to engage in discussion. The social context provided further pressure to produce a baby ‘on time’, with induction normalised as the way to manage prolonged pregnancy. Online spaces provided additional information and support for women to question the medicalisation of prolonged pregnancy. We end by considering the implications for policies of choice and agency in maternity care as well as the need for additional social support for women who are ‘overdue’.
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Viteri OA, Sibai BM. Challenges and Limitations of Clinical Trials on Labor Induction: A Review of the Literature. AJP Rep 2018; 8:e365-e378. [PMID: 30591843 PMCID: PMC6306280 DOI: 10.1055/s-0038-1676577] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/12/2018] [Indexed: 11/03/2022] Open
Abstract
Induction of labor is a common obstetric procedure performed in nearly a quarter of all deliveries in the United States. Pharmacological (prostaglandins, oxytocin) and/or mechanical methods (balloon catheters) are commonly used for labor induction; however, there is ongoing debate as to which method is the safest and most effective. This narrative review discusses key limitations of published trials on labor induction, including the lack of well-designed randomized controlled trials directly comparing specific methods of induction, heterogeneous trial populations, and wide variation in the protocols used and outcomes reported. Furthermore, the majority of published trials were underpowered to detect significant differences in the most clinically relevant efficacy and safety outcomes (e.g., cesarean delivery, neonatal mortality). By identifying the limitations of labor induction trials, we hope to highlight the importance of quality published data to better inform guidelines and drive evidence-based treatment decisions.
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Affiliation(s)
- Oscar A Viteri
- Avera Medical Group Maternal Fetal Medicine, Avera McKennan Hospital and University Health Center, Sioux Falls, South Dakota
| | - Baha M Sibai
- Department of Obstetrics, Gynecology and Reproductive Sciences, UTHealth McGovern Medical School, Houston, Texas
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Wier J, Hinchey-Beer S, Walker L. Improving induction of labour for women through the development of a new pathway. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/bjom.2018.26.9.585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jacqueline Wier
- Senior midwifery lecturer, Canterbury Christ Church University
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Grobman WA, Rice MM, Reddy UM, Tita ATN, Silver RM, Mallett G, Hill K, Thom EA, El-Sayed YY, Perez-Delboy A, Rouse DJ, Saade GR, Boggess KA, Chauhan SP, Iams JD, Chien EK, Casey BM, Gibbs RS, Srinivas SK, Swamy GK, Simhan HN, Macones GA. Labor Induction versus Expectant Management in Low-Risk Nulliparous Women. N Engl J Med 2018; 379:513-523. [PMID: 30089070 PMCID: PMC6186292 DOI: 10.1056/nejmoa1800566] [Citation(s) in RCA: 693] [Impact Index Per Article: 115.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The perinatal and maternal consequences of induction of labor at 39 weeks among low-risk nulliparous women are uncertain. METHODS In this multicenter trial, we randomly assigned low-risk nulliparous women who were at 38 weeks 0 days to 38 weeks 6 days of gestation to labor induction at 39 weeks 0 days to 39 weeks 4 days or to expectant management. The primary outcome was a composite of perinatal death or severe neonatal complications; the principal secondary outcome was cesarean delivery. RESULTS A total of 3062 women were assigned to labor induction, and 3044 were assigned to expectant management. The primary outcome occurred in 4.3% of neonates in the induction group and in 5.4% in the expectant-management group (relative risk, 0.80; 95% confidence interval [CI], 0.64 to 1.00). The frequency of cesarean delivery was significantly lower in the induction group than in the expectant-management group (18.6% vs. 22.2%; relative risk, 0.84; 95% CI, 0.76 to 0.93). CONCLUSIONS Induction of labor at 39 weeks in low-risk nulliparous women did not result in a significantly lower frequency of a composite adverse perinatal outcome, but it did result in a significantly lower frequency of cesarean delivery. (Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development; ARRIVE ClinicalTrials.gov number, NCT01990612 .).
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Affiliation(s)
- William A Grobman
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Madeline M Rice
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Uma M Reddy
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Alan T N Tita
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Robert M Silver
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Gail Mallett
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Kim Hill
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Elizabeth A Thom
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Yasser Y El-Sayed
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Annette Perez-Delboy
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Dwight J Rouse
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - George R Saade
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Kim A Boggess
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Suneet P Chauhan
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Jay D Iams
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Edward K Chien
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Brian M Casey
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Ronald S Gibbs
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Sindhu K Srinivas
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Geeta K Swamy
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - Hyagriv N Simhan
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
| | - George A Macones
- From the Department of Obstetrics and Gynecology, Northwestern University, Chicago (W.A.G., G.M.); University of Alabama at Birmingham, Birmingham (A.T.N.T.); University of Utah Health Sciences Center, Salt Lake City (R.M.S., K.H.); Stanford University, Stanford, CA (Y.Y.E.-S.); Columbia University, New York (A.P.-D.); Brown University, Providence, RI (D.J.R.); University of Texas Medical Branch, Galveston (G.R.S.), University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston (S.P.C.), and University of Texas Southwestern Medical Center, Dallas (B.M.C.) - all in Texas; University of North Carolina at Chapel Hill, Chapel Hill (K.A.B.), and Duke University, Durham (G.K.S.) - both in North Carolina; Ohio State University, Columbus (J.D.I.), and MetroHealth Medical Center, Case Western Reserve University, Cleveland (E.K.C.) - both in Ohio; University of Colorado School of Medicine, Anschutz Medical Campus, Aurora (R.S.G.); University of Pennsylvania, Philadelphia (S.K.S.); University of Pittsburgh, Pittsburgh (H.N.S.) - both in Pennsylvania; Washington University, St. Louis (G.A.M.); the George Washington University Biostatistics Center, Washington, DC (M.M.R., E.A.T.); and the Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (U.M.R.)
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Hernández-Martínez A, Arias-Arias A, Morandeira-Rivas A, Pascual-Pedreño AI, Ortiz-Molina EJ, Rodriguez-Almagro J. Oxytocin discontinuation after the active phase of induced labor: A systematic review. Women Birth 2018; 32:112-118. [PMID: 30087073 DOI: 10.1016/j.wombi.2018.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/25/2018] [Accepted: 07/11/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND Oxytocin is the most widely used drug in the induction of labor, but it could have potential adverse effects that derive from uterine hyperstimulation. AIM To determine the benefits and drawbacks of oxytocin continuation versus oxytocin discontinuation after the active phase of induced labor. METHODS We systematically searched Pubmed, EMBASE, Scopus, ClinicalTrials.gov and Cochrane Library Plus until October 2017, for randomized controlled trials comparing oxytocin continuation with oxytocin discontinuation when the active phase of labor is reached were included. Data was collected by three reviewers and quality of the included studies assessed using the methodology recommended in the Cochrane Handbook. StatsDirect software was used to calculate risk ratios for binary variables and weighted mean differences for continuous variables. A fixed-effects or random-effects model was used as appropriate. RESULTS Nine studies were selected including 1538 women, 774 in the oxytocin continuation group and 764 in the oxytocin discontinuation group. The incidence of cesarean sections (14.3% vs. 8.6%; relative risk, 1.67; 95% confidence interval: 1.25-2.23), uterine hyperstimulation (12.4% vs. 4.7%; relative risk, 2.59; 95% confidence interval: 1.70-3.93) and nonreassuring fetal heart rate (19.2% vs.12.5%; relative risk, 1.55; 95% confidence interval: 1.18-2.02) were significantly higher in the oxytocin continuation group. An increase in the duration of the second stage of labor in the oxytocin discontinuation group was observed (pooled mean difference, -7.03; 95% confidence interval: -9.80 to -4.26). CONCLUSIONS After the active phase of induced labor, oxytocin continuation increases the risk of cesarean section, uterine hyperstimulation and alterations to the fetal heart rate.
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Affiliation(s)
- Antonio Hernández-Martínez
- Department of Obstetrics & Gynecology, "Mancha-Centro" Hospital, Alcázar de San Juan, Ciudad Real, Spain; University of Castilla-La Mancha, Spain.
| | - Angel Arias-Arias
- Research Support Unit, "Mancha-Centro" Hospital, Alcazar de San Juan, Ciudad Real, Spain
| | - Antonio Morandeira-Rivas
- Department of General and Digestive Surgery, "Mancha-Centro" Hospital, Alcázar de San Juan, Ciudad Real, Spain
| | - Ana I Pascual-Pedreño
- Department of Obstetrics & Gynecology, "Mancha-Centro" Hospital, Alcázar de San Juan, Ciudad Real, Spain
| | - Elias J Ortiz-Molina
- Department of Obstetrics & Gynecology, "Mancha-Centro" Hospital, Alcázar de San Juan, Ciudad Real, Spain
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29
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Crosby DA, O’Reilly C, McHale H, McAuliffe FM, Mahony R. A prospective pilot study of Dilapan-S compared with Propess for induction of labour at 41+ weeks in nulliparous pregnancy. Ir J Med Sci 2017; 187:693-699. [DOI: 10.1007/s11845-017-1731-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 12/11/2017] [Indexed: 11/29/2022]
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30
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Mattern E, Lohmann S, Ayerle GM. Experiences and wishes of women regarding systemic aspects of midwifery care in Germany: a qualitative study with focus groups. BMC Pregnancy Childbirth 2017; 17:389. [PMID: 29162039 PMCID: PMC5698932 DOI: 10.1186/s12884-017-1552-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 10/31/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Knowledge of pregnant women's and mothers' viewpoints on midwifery care is crucial for its appropriate delivery and research. In Germany, comprehensive research to more fully understand women's needs in pregnancy, labour, birth and the postpartum period until weaning is lacking. International studies provide some knowledge of women's expectations, their choices, and subjective criteria indicating good midwifery care. METHODS This study explores pregnant women's and mothers' experiences, needs and wishes regarding systemic aspects of midwifery care (access, availability, choices, model of midwifery care; maternity care in the healthcare system). 50 women participated in 10 focus groups in 5 states of Germany. The groups were heterogeneous with regard to age, parity, model of maternity care used, and rating of satisfaction. Women with limited educational years (n = 9) were personally contacted by midwives and reached by social media. Also, mothers living in a mother-child home (n = 6) or attending a peer group for grieving parents (n = 5) were included. The digitally documented focus groups were systematically analysed in an itinerary hermeneutic manner. RESULTS Three themes were identified: (a) Knowledge or lack of awareness of midwifery care, (b) availability of and access to midwives, and (c) midwifery care in the healthcare system. Theme (a) entails the scope of midwifery care and the midwife's competence, but also a lack of information, inconsistent counselling, and difficulty identifying midwives. Theme (b) encompasses aspects such as the availability, accessibility and selection of a midwife, the effort involved in looking for a midwife, the challenge of transition points, and family midwives. Theme (c) relates interprofessional cooperation, gaps/inadequacies of care during latency phase, alternative models of care, and the importance of family and peer groups for women. CONCLUSIONS Midwifery care and research in Germany must address the issue of imparting relevant information about midwifery services. Interprofessional cooperation and management of transition points ought to be improved in the interests of the women concerned. Moreover, the quality of antenatal classes, support during latency phase, and intrapartum care in hospitals need to be addressed. Lastly, the special needs of vulnerable women in midwifery care must become a major focus in Germany.
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Affiliation(s)
- Elke Mattern
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
| | - Susanne Lohmann
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Gertrud M Ayerle
- Martin-Luther-Universität Halle-Wittenberg, Medizinische Fakultät, Institut für Gesundheits- und Pflegewissenschaft, Magdeburger Straße 8, 06112, Halle (Saale), Germany
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31
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König-Bachmann M, Schwarz C, Zenzmaier C. Women’s experiences and perceptions of induction of labour: Results from a German online-survey. Eur J Midwifery 2017. [DOI: 10.18332/ejm/76511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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32
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Women's self-reported experience of unplanned caesarean section: Results of a Swedish study. Midwifery 2017; 50:253-258. [PMID: 28505479 DOI: 10.1016/j.midw.2017.04.016] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 03/10/2017] [Accepted: 04/26/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND women´s experience of emergency caesarean section is often described as less positive compared to a vaginal birth or a planned caesarean section. Midwifery care for women where deviations from a normal birth process are present is a challenge. The aim of study was to compare self-reported birth outcomes for women undergoing birth through spontaneous onset of labour between those who actually had a vaginal birth and those who eventually had an emergency caesarean section. DESIGN AND SETTING the study was part of a prospective longitudinal cohort study of parents' experiences, attitudes, and beliefs related to childbirth. METHOD AND FINDINGS questionnaires were answered by 870 women in midpregnancy, two months postpartum and one year after birth. 766 women (88%) had a vaginal birth, and 104 (12%) had an emergency caesarean section. The most common indications of emergency caesarean section were dystocia, foetal distress, and malpresentation. Women in the emergency caesarean group were more likely to be primiparous (59.6%) and have a body mass index > 30 (10.7%). Childbirth fear was twice as common among these women, and they were more likely to have preferred a caesarean delivery when asked about birth preference in the middle of pregnancy (OR 3.7, Cl 1.8-7.5). Induction of labour (OR 2.5, Cl 1.6-4.0), the use of oxytocin for augmentation (OR 1.9, Cl 1.3-2.9), and the use of epidural as pain relief during labour (OR 5.6, Cl 3.6-8.7) were more common among women having an emergency caesarean section. Transport of the new-born to a neonatal intensive care unit was three times as common. More than a third (37%) of the women in the caesarean group preferred a caesarean section in case of another birth. Childbirth fear was more common one year after birth with 32% of these women describing their fear as moderate or strong (OR 3.6, CI 2.1-6.0). KEY CONCLUSIONS women undergoing emergency caesarean section are more likely to experience fear and to have a negative birth experience. It is essential for the midwife to promote a sense of control, involve the woman in the procedure, and create security in a threatening situation. This is made possible in relationship characterized by mutuality, trust, on-going dialogue, shared responsibility, and enduring presence.
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