Women's Perspective of Factors that Influence Induction of Labor

University Of Michigan At Ann Arbor, Ann Arbor MI

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Abstract

According to the 2010 National Vital Statistics final report utilizing the U.S. Standard Certificates for Live Births, the rate of induction of labor (IO) has increased by 140% between 1990 (9.5%) and 2007 (22.8%) for all births. It is believed that elective induction of labor, an intervention that is not medically justified, is responsible for th increase in use of this practice. Elective inductions have been associated with the increase in late pre- term babies and cesarean sections. However, scientific information identifying the factors that are influencing the increase have not been published. The proposed study is the first phase in a program of research designed to explore the factors as defined by women as the key informant that influence the use of induction of labor as an obstetric intervention. A convenience sample of postpartum women will be recruited from a University-based tertiary care medical center. Women that experienced either an elective IOL or an IOL with an equivocal indication, not currently supported by scientific evidence, will be eligible to participate in this qualitative investigation. A review of their medical birth record will also be completed to identif medical diagnosis, confirm rationale for induction, and identify birth outcomes. Grounded theory will guide the analysis plan to evaluate the gaps in translating evidence into practice and to meet the specific aims of 1) To explore childbearing women's knowledge and understanding of the benefits and risks of IOL (both elective and medically recommended with an equivocal indication) as an obstetrical intervention, 2) To identify the factors that influence a woman's decision regarding either category of IOL, and 3) Explore women's experience of having had either category of IOL. It is believed that accurately identifying these factors and integrating ths knowledge into evidence-based practices has the potential to influence health policy initiatives related to the use of evidence based practice and ultimately reduce elective and other non evidence-based IOL, thereby reducing maternity care costs and promoting optimal maternal/fetal birth outcomes.