Women´s expectations and experiences of labour induction—a questionnaire-based analysis of a randomised controlled trial

Background: Although the induction of labour is a commonly used procedure in obstetrical care, there are limited data on its psycho-emotional effects on the woman. This study analysed the expectations and experiences of women included in a randomised controlled trial comparing different routes of labour induction. The primary aim of this questionnaire-based study was to evaluate women’s general satisfaction with induced labours and identify factors associated with a negative experience. The secondary aim was to compare the orally administrated misoprostol (OMS) to a misoprostol vaginal insert (MVI), while focusing on general maternal satisfaction. Methods Primiparous women (n = 196) with a singleton foetus in cephalic presentation, ≥ 37 weeks of gestation, with a Bishop´s score ≤ 4 planning labour induction were randomly allocated to receive either OMS (Cytotec®) or MVI (Misodel®). Data were collected by validated questionnaires, the Wijma Delivery Expectation/Experience Questionnaire (A+B). The pre-labour part of the questionnaire (W-DEQ version A) was given to participants to complete within one hour before the start of induction, and the post-labour part of the questionnaire (W-DEQ version B) was administered after birth and collected before the women were discharged from hospital. Background characteristics and delivery outcomes were extracted from maternity files and correlated to the results from the questionnaires. Results The mean score of the post-labour questionnaire (W-DEQ B) was 61.2 (22.9) and OMS and MVI generated comparable experiences among the participating women with a W-DEQ B score of 59.4 (21.0) and 62.7 (24.7), respectively (p = 0.48). It was found that 11.8% (17/143) reported a severe fear of childbirth (W-DEQ A score ≥ 85). Women that stated a severe fear before the start of induction had a 3.7 times increased risk of experiencing labour induction negatively (OR 3.7 [95% CI; 1.04–13.41]). Conclusion Severe fear of childbirth was a risk factor for a negative experience of labour induction. OMS compared to MVI generated comparable results among participating women in this randomised controlled trial.