Methods of induction of labor and women’s experience: a population-based cohort study with mediation analyses
Abstract 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 To compare women’s experience of IoL according to the method, considering the mediating role of interventions and c...
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doaj-e62bf2523e184a959309ee476357e3aa2021-09-19T11:46:00ZengBMCBMC Pregnancy and Childbirth1471-23932021-09-012111910.1186/s12884-021-04076-xMethods of induction of labor and women’s experience: a population-based cohort study with mediation analysesPauline Blanc-Petitjean0Corinne Dupont1Bruno Carbonne2Marina Salomé3François Goffinet4Camille Le Ray5for the MEDIP study groupUniversité de Paris, CRESS, INSERM, INRARéseau périnatal Aurore - Hôpital de la Croix Rousse, Université Lyon 1, HESPER EA 7425 Health Services and Performance ResearchDepartment of Obstetrics and Gynecology, Princess Grace HospitalAP-HP, URC-CIC Paris Descartes Necker/CochinUniversité de Paris, CRESS, INSERM, INRAUniversité de Paris, CRESS, INSERM, INRAAbstract 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 To compare women’s experience of IoL according to the method, considering the mediating role of interventions and complications of delivery. 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 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 Cervical ripening was associated with a less positive experience of childbirth, whatever the method, only partly explained by interventions and complications of delivery. Conclusion Counselling and support of women requiring cervical ripening might be enhanced to improve the experience of IoL.https://doi.org/10.1186/s12884-021-04076-xInduction of laborCervical ripeningMaternal experience, midwifery research, causal mediation analysis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pauline Blanc-Petitjean Corinne Dupont Bruno Carbonne Marina Salomé François Goffinet Camille Le Ray for the MEDIP study group |
spellingShingle |
Pauline Blanc-Petitjean Corinne Dupont Bruno Carbonne Marina Salomé François Goffinet Camille Le Ray for the MEDIP study group Methods of induction of labor and women’s experience: a population-based cohort study with mediation analyses BMC Pregnancy and Childbirth Induction of labor Cervical ripening Maternal experience, midwifery research, causal mediation analysis |
author_facet |
Pauline Blanc-Petitjean Corinne Dupont Bruno Carbonne Marina Salomé François Goffinet Camille Le Ray for the MEDIP study group |
author_sort |
Pauline Blanc-Petitjean |
title |
Methods of induction of labor and women’s experience: a population-based cohort study with mediation analyses |
title_short |
Methods of induction of labor and women’s experience: a population-based cohort study with mediation analyses |
title_full |
Methods of induction of labor and women’s experience: a population-based cohort study with mediation analyses |
title_fullStr |
Methods of induction of labor and women’s experience: a population-based cohort study with mediation analyses |
title_full_unstemmed |
Methods of induction of labor and women’s experience: a population-based cohort study with mediation analyses |
title_sort |
methods of induction of labor and women’s experience: a population-based cohort study with mediation analyses |
publisher |
BMC |
series |
BMC Pregnancy and Childbirth |
issn |
1471-2393 |
publishDate |
2021-09-01 |
description |
Abstract 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 To compare women’s experience of IoL according to the method, considering the mediating role of interventions and complications of delivery. 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 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 Cervical ripening was associated with a less positive experience of childbirth, whatever the method, only partly explained by interventions and complications of delivery. Conclusion Counselling and support of women requiring cervical ripening might be enhanced to improve the experience of IoL. |
topic |
Induction of labor Cervical ripening Maternal experience, midwifery research, causal mediation analysis |
url |
https://doi.org/10.1186/s12884-021-04076-x |
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