Methods of induction of labor and women's experience: a population-based cohort study with mediation analyses.
Cervical ripening
Induction of labor
Maternal experience, midwifery research, causal mediation analysis
Journal
BMC pregnancy and childbirth
ISSN: 1471-2393
Titre abrégé: BMC Pregnancy Childbirth
Pays: England
ID NLM: 100967799
Informations de publication
Date de publication:
14 Sep 2021
14 Sep 2021
Historique:
received:
15
12
2020
accepted:
26
07
2021
entrez:
15
9
2021
pubmed:
16
9
2021
medline:
7
1
2022
Statut:
epublish
Résumé
Negative childbirth experience may affect mother wellbeing and health. However, it is rarely evaluated in studies comparing methods of induction of labor (IoL). To compare women's experience of IoL according to the method, considering the mediating role of interventions and complications of delivery. We used data from the MEDIP prospective population-based cohort, including all women with IoL during one month in seven French perinatal networks. The experience of IoL, assessed at 2 months postpartum, was first compared between cervical ripening and oxytocin, and secondarily between different cervical ripening methods. Mediation analyses were used to measure the direct and indirect effects of cervical ripening on maternal experience, through delivery with interventions or complications. The response rate was 47.8% (n = 1453/3042). Compared with oxytocin (n = 541), cervical ripening (n = 910) was associated less often with feelings that labor went 'as expected' (adjusted risk ratio for the direct effect 0.78, 95%CI [0.70-0.88]), length of labor was 'acceptable' (0.76[0.71-0.82]), 'vaginal discomfort' was absent (0.77[0.69-0.85]) and with lower global satisfaction (0.90[0.84-0.96]). Interventions and complications mediated between 6 and 35% of the total effect of cervical ripening on maternal experience. Compared to the dinoprostone insert, maternal experience was not significantly different with the other prostaglandins. The balloon catheter was associated with less pain. Cervical ripening was associated with a less positive experience of childbirth, whatever the method, only partly explained by interventions and complications of delivery. Counselling and support of women requiring cervical ripening might be enhanced to improve the experience of IoL.
Sections du résumé
BACKGROUND
BACKGROUND
Negative childbirth experience may affect mother wellbeing and health. However, it is rarely evaluated in studies comparing methods of induction of labor (IoL).
AIM
OBJECTIVE
To compare women's experience of IoL according to the method, considering the mediating role of interventions and complications of delivery.
METHODS
METHODS
We used data from the MEDIP prospective population-based cohort, including all women with IoL during one month in seven French perinatal networks. The experience of IoL, assessed at 2 months postpartum, was first compared between cervical ripening and oxytocin, and secondarily between different cervical ripening methods. Mediation analyses were used to measure the direct and indirect effects of cervical ripening on maternal experience, through delivery with interventions or complications.
FINDINGS
RESULTS
The response rate was 47.8% (n = 1453/3042). Compared with oxytocin (n = 541), cervical ripening (n = 910) was associated less often with feelings that labor went 'as expected' (adjusted risk ratio for the direct effect 0.78, 95%CI [0.70-0.88]), length of labor was 'acceptable' (0.76[0.71-0.82]), 'vaginal discomfort' was absent (0.77[0.69-0.85]) and with lower global satisfaction (0.90[0.84-0.96]). Interventions and complications mediated between 6 and 35% of the total effect of cervical ripening on maternal experience. Compared to the dinoprostone insert, maternal experience was not significantly different with the other prostaglandins. The balloon catheter was associated with less pain.
DISCUSSION
CONCLUSIONS
Cervical ripening was associated with a less positive experience of childbirth, whatever the method, only partly explained by interventions and complications of delivery.
CONCLUSION
CONCLUSIONS
Counselling and support of women requiring cervical ripening might be enhanced to improve the experience of IoL.
Identifiants
pubmed: 34521377
doi: 10.1186/s12884-021-04076-x
pii: 10.1186/s12884-021-04076-x
pmc: PMC8442398
doi:
Substances chimiques
Oxytocics
0
Oxytocin
50-56-6
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
621Investigateurs
Catherine Crenn-Hebert
(C)
Adrien Gaudineau
(A)
Frédérique Perrotte
(F)
Pierre Raynal
(P)
Elodie Clouqueur
(E)
Gaël Beucher
(G)
Catherine Deneux-Tharaux
(C)
Pierre-Yves Ancel
(PY)
Informations de copyright
© 2021. The Author(s).
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