Abstract
Background: Negative childbirth experiences impact the well-being of women and their families. With rising induction of labor (IOL) rates and the inconsistent evidence regarding its impact on childbirth experiences, we conducted a systematic review and meta-analysis to estimate the overall effect of IOL versus expectant management on women’s childbirth experiences, defined as a woman’s self-assessment of her lasting memories of the childbirth event.
Methods: We searched databases (PubMed, Embase, Cochrane Library, Science Direct, ProQuest and EBSCO) for RCTs and observational studies from 1970 to September 2023. Inclusion criteria covered women aged 19 and older with live, singleton, cephalic pregnancies at 37 0/7 until 41 6/7 weeks gestation. Quality was assessed using the Jadad and Newcastle-Ottawa Scales. RevMan 5.4 software and random-effects meta-analysis were used, adhering to PRISMA guidelines.
Results: Of the 1.467 screened articles, we included nine studies from five European countries. Six studies (2.376 women) used the Childbirth Experience Questionnaire (CEQ). Overall CEQ scores showed no significant IOL vs. expectant management differences (MD = 0.01 [95% CI -0.06, 0.08]; p=0.78; I2 = 65%). Subgroup analyses favored IOL in RCTs (MD = 0.07 [95% CI 0.02, 0.13]; p=0.006; I2 = 0%) and studies with ≥500 participants (MD = 0.09 [95% CI 0.02, 0.15]; p=0.006; I2 = 0%). Conversely, four studies (48.324 women) using the Childbirth Experience Visual Analogue Scale (VAS) favored expectant management (OR = 0.73 [95% CI 0.63, 0.85]; p<0.001; I2 = 86%).
Conclusion: VAS assessments suggest a more positive childbirth experience with the expectant management group. Improvements in the IOL process, transfer to delivery, and pain relief administration may benefit the IOL group. In contrast, the overall CEQ scores did not significantly differ between groups. Clinical practice should consider individualized approaches that align with patient needs and medical contexts. Limitations, such as variability in study quality and data heterogeneity, should be acknowledged.
[1]
Oladapo, O.T.; Tunçalp, Ö.; Bonet, M. WHO model of intrapartum care for a positive childbirth experience: transforming care of women and babies for improved health and wellbeing. BJOG, 2018, 125(8), 918-922.
[http://dx.doi.org/10.1111/1471-0528.15237] [PMID: 29637727]
[http://dx.doi.org/10.1111/1471-0528.15237] [PMID: 29637727]
[2]
Hosseini Tabaghdehi, M.; Kolahdozan, S.; Keramat, A. Prevalence and factors affecting the negative childbirth experiences: A systematic review. J. Matern. Fetal Neonatal Med., 2020, 33(22), 3849-3856.
[3]
Taheri, M.; Takian, A.; Taghizadeh, Z.; Jafari, N.; Sarafraz, N. Creating a positive perception of childbirth experience: systematic review and meta-analysis of prenatal and intrapartum interventions. Reprod. Health, 2018, 15(1), 73.
[http://dx.doi.org/10.1186/s12978-018-0511-x] [PMID: 29720201]
[http://dx.doi.org/10.1186/s12978-018-0511-x] [PMID: 29720201]
[4]
Viirman, F.; Hess Engström, A.; Sjömark, J. Negative childbirth experience in relation to mode of birth and events during labour: A mixed methods study. Eur. J. Obstet. Gynecol. Reprod. Biol., 2023, 282, 146-154.
[http://dx.doi.org/10.1016/j.ejogrb.2023.01.031] [PMID: 36731207]
[http://dx.doi.org/10.1016/j.ejogrb.2023.01.031] [PMID: 36731207]
[5]
Dencker, A.; Nilsson, C.; Begley, C. Causes and outcomes in studies of fear of childbirth: A systematic review. Women Birth, 2019, 32(2), 99-111.
[http://dx.doi.org/10.1016/j.wombi.2018.07.004] [PMID: 30115515]
[http://dx.doi.org/10.1016/j.wombi.2018.07.004] [PMID: 30115515]
[6]
Shorey, S.; Yang, Y.Y.; Ang, E. The impact of negative childbirth experience on future reproductive decisions: A quantitative systematic review. J. Adv. Nurs., 2018, 74(6), 1236-1244.
[http://dx.doi.org/10.1111/jan.13534] [PMID: 29394456]
[http://dx.doi.org/10.1111/jan.13534] [PMID: 29394456]
[7]
Martin, J.A.; Hamilton, B.E.; Osterman, M.J.K.; Driscoll, A.K.; Drake, P. Births: Final data for 2017. Natl. Vital Stat. Rep., 2018, 67(8), 1-50.
[PMID: 30707672]
[PMID: 30707672]
[8]
WHO recommendations: Induction of labour at or beyond term. 2018. Available from: https://www.who.int/publications/i/item/9789240052796
[9]
Henriksen, L.; Grimsrud, E.; Schei, B.; Lukasse, M. Factors related to a negative birth experience – A mixed methods study. Midwifery, 2017, 51, 33-39.
[http://dx.doi.org/10.1016/j.midw.2017.05.004] [PMID: 28528179]
[http://dx.doi.org/10.1016/j.midw.2017.05.004] [PMID: 28528179]
[10]
Adler, K.; Rahkonen, L.; Kruit, H. Maternal childbirth experience in induced and spontaneous labour measured in a visual analog scale and the factors influencing it; a two-year cohort study. BMC Pregnancy Childbirth, 2020, 20(1), 415.
[http://dx.doi.org/10.1186/s12884-020-03106-4] [PMID: 32693773]
[http://dx.doi.org/10.1186/s12884-020-03106-4] [PMID: 32693773]
[11]
Lundh, C.; Øvrum, A.K.; Dahl, B. Women’s experiences with unexpected induction of labor: A qualitative study. European Journal of Midwifery, 2023, 7(March), 1-7.
[http://dx.doi.org/10.18332/ejm/161481] [PMID: 36970251]
[http://dx.doi.org/10.18332/ejm/161481] [PMID: 36970251]
[12]
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, 2021, 34(2), e170-e177.
[http://dx.doi.org/10.1016/j.wombi.2020.02.020] [PMID: 32146087]
[http://dx.doi.org/10.1016/j.wombi.2020.02.020] [PMID: 32146087]
[13]
Hong, J.; Atkinson, J.; Roddy Mitchell, A. Comparison of maternal labor-related complications and neonatal outcomes following elective induction of labor at 39 weeks of gestation vs expectant management. JAMA Netw. Open, 2023, 6(5), e2313162.
[http://dx.doi.org/10.1001/jamanetworkopen.2023.13162] [PMID: 37171818]
[http://dx.doi.org/10.1001/jamanetworkopen.2023.13162] [PMID: 37171818]
[14]
Alfirevic, Z.; Keeney, E.; Dowswell, T. Methods to induce labour: A systematic review, network meta‐analysis and cost‐effectiveness analysis. BJOG, 2016, 123(9), 1462-1470.
[http://dx.doi.org/10.1111/1471-0528.13981] [PMID: 27001034]
[http://dx.doi.org/10.1111/1471-0528.13981] [PMID: 27001034]
[15]
Research: The meaning of the childbirth experience; A review of the literature ProQuest Available from: https://www.proquest.com/openview/c109a632b983d04e4762bb188f401487/1?cbl=34121&pq-origsite=gscholar
[16]
Page, M.J.; McKenzie, J.E.; Bossuyt, P.M. The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 2021, 372, n71.
[http://dx.doi.org/10.1136/bmj.n71] [PMID: 33782057]
[http://dx.doi.org/10.1136/bmj.n71] [PMID: 33782057]
[17]
Drife, J.O. The history of labour induction: How did we get here? Best Pract. Res. Clin. Obstet. Gynaecol., 2021, 77, 3-14.
[http://dx.doi.org/10.1016/j.bpobgyn.2021.07.004] [PMID: 34330639]
[http://dx.doi.org/10.1016/j.bpobgyn.2021.07.004] [PMID: 34330639]
[18]
Dencker, A.; Taft, C.; Bergqvist, L.; Lilja, H.; Berg, M. Childbirth experience questionnaire (CEQ): development and evaluation of a multidimensional instrument. BMC Pregnancy Childbirth, 2010, 10(1), 81.
[http://dx.doi.org/10.1186/1471-2393-10-81] [PMID: 21143961]
[http://dx.doi.org/10.1186/1471-2393-10-81] [PMID: 21143961]
[19]
ACOG Practice bulletin No. 107: Induction of labor. Obstet. Gynecol., 2009, 114(2 Pt 1), 386-397.
[http://dx.doi.org/10.1097/AOG.0b013e3181b48ef5]
[http://dx.doi.org/10.1097/AOG.0b013e3181b48ef5]
[20]
Walker, K.F.; Bugg, G.J.; Macpherson, M. Randomized trial of labor induction in women 35 years of age or older. N. Engl. J. Med., 2016, 374(9), 813-822.
[http://dx.doi.org/10.1056/NEJMoa1509117] [PMID: 26962902]
[http://dx.doi.org/10.1056/NEJMoa1509117] [PMID: 26962902]
[21]
Larsson, C.; Saltvedt, S.; Edman, G.; Wiklund, I.; Andolf, E. Factors independently related to a negative birth experience in first-time mothers. Sex. Reprod. Healthc., 2011, 2(2), 83-89.
[http://dx.doi.org/10.1016/j.srhc.2010.11.003] [PMID: 21439526]
[http://dx.doi.org/10.1016/j.srhc.2010.11.003] [PMID: 21439526]
[22]
Falk, M.; Nelson, M.; Blomberg, M. The impact of obstetric interventions and complications on women’s satisfaction with childbirth a population based cohort study including 16,000 women. BMC Pregnancy Childbirth, 2019, 19(1), 494.
[http://dx.doi.org/10.1186/s12884-019-2633-8] [PMID: 31829151]
[http://dx.doi.org/10.1186/s12884-019-2633-8] [PMID: 31829151]
[23]
Nilvér, H.; Wessberg, A.; Dencker, A. Women’s childbirth experiences in the swedish post-term induction study (SWEPIS): A multicentre, randomised, controlled trial. BMJ Open, 2021, 11(4), e042340.
[http://dx.doi.org/10.1136/bmjopen-2020-042340] [PMID: 33827832]
[http://dx.doi.org/10.1136/bmjopen-2020-042340] [PMID: 33827832]
[24]
Turkmen, S.; Tjernström, M.; Dahmoun, M.; Bolin, M. Post‐partum duration of satisfaction with childbirth. J. Obstet. Gynaecol. Res., 2018, 44(12), 2166-2173.
[http://dx.doi.org/10.1111/jog.13775] [PMID: 30058272]
[http://dx.doi.org/10.1111/jog.13775] [PMID: 30058272]
[25]
Dencker, A.; Bergqvist, L.; Berg, M.; Greenbrook, J.T.V.; Nilsson, C.; Lundgren, I. Measuring women’s experiences of decision-making and aspects of midwifery support: A confirmatory factor analysis of the revised childbirth experience questionnaire. BMC Pregnancy Childbirth, 2020, 20(1), 199.
[http://dx.doi.org/10.1186/s12884-020-02869-0] [PMID: 32252679]
[http://dx.doi.org/10.1186/s12884-020-02869-0] [PMID: 32252679]
[26]
Lundh, A.; Gøtzsche, P.C. Recommendations by cochrane review groups for assessment of the risk of bias in studies. BMC Med. Res. Methodol., 2008, 8(1), 22.
[http://dx.doi.org/10.1186/1471-2288-8-22] [PMID: 18426565]
[http://dx.doi.org/10.1186/1471-2288-8-22] [PMID: 18426565]
[27]
Ribeiro, C.M.; Beserra, B.T.S.; Silva, N.G. Exposure to endocrine-disrupting chemicals and anthropometric measures of obesity: A systematic review and meta-analysis. BMJ Open, 2020, 10(6), e033509.
[http://dx.doi.org/10.1136/bmjopen-2019-033509] [PMID: 32565448]
[http://dx.doi.org/10.1136/bmjopen-2019-033509] [PMID: 32565448]
[28]
Higgins, J.P.T.; Thomas, J.; Chandler, J. Cochrane handbook for systematic reviews of interventions version 6.4. Cochrane, 2023. Available from: www.training.cochrane.org/handbook
[29]
Bergqvist, L.; Dencker, A.; Taft, C. Women’s experiences after early versus postponed oxytocin treatment of slow progress in first childbirth – A randomized controlled trial. Sex. Reprod. Healthc., 2012, 3(2), 61-65.
[http://dx.doi.org/10.1016/j.srhc.2012.03.003] [PMID: 22578752]
[http://dx.doi.org/10.1016/j.srhc.2012.03.003] [PMID: 22578752]
[30]
Hildingsson, I.; Karlström, A.; Larsson, B. Childbirth experience in women participating in a continuity of midwifery care project. Women Birth, 2021, 34(3), e255-e261.
[http://dx.doi.org/10.1016/j.wombi.2020.04.010] [PMID: 32595033]
[http://dx.doi.org/10.1016/j.wombi.2020.04.010] [PMID: 32595033]
[31]
Carlhäll, S.; Nelson, M.; Svenvik, M.; Axelsson, D.; Blomberg, M. Maternal childbirth experience and time in labor: A population-based cohort study. Sci. Rep., 2022, 12(1), 11930.
[http://dx.doi.org/10.1038/s41598-022-14711-y] [PMID: 35831421]
[http://dx.doi.org/10.1038/s41598-022-14711-y] [PMID: 35831421]
[32]
Mäkelä, K.; Palomäki, O.; Korpiharju, H.; Helminen, M.; Uotila, J. Satisfaction and dissatisfaction with pain relief and birth experience among induced and spontaneous-onset labours ending in vaginal birth: A prospective cohort study. Eur. J. Obstet. Gynecol. Reprod. Biol. X, 2023, 18, 100185.
[http://dx.doi.org/10.1016/j.eurox.2023.100185] [PMID: 37035413]
[http://dx.doi.org/10.1016/j.eurox.2023.100185] [PMID: 37035413]
[33]
Schaal, N.K.; Fehm, T.; Albert, J. Comparing birth experience and birth outcome of vaginal births between induced and spontaneous onset of labour: A prospective study. Arch. Gynecol. Obstet., 2019, 300(1), 41-47.
[http://dx.doi.org/10.1007/s00404-019-05150-8] [PMID: 30976970]
[http://dx.doi.org/10.1007/s00404-019-05150-8] [PMID: 30976970]
[34]
González-de la Torre, H.; Miñarro-Jiménez, S.; Palma-Arjona, I.; Jeppesen-Gutierrez, J.; Berenguer-Pérez, M.; Verdú-Soriano, J. Perceived satisfaction of women during labour at the hospital universitario materno-infantil of the canary islands through the childbirth experience questionnaire (CEQ-E). Enfermería Clínica, 2021, 31(1), 21-30.
[http://dx.doi.org/10.1016/j.enfcle.2020.05.002] [PMID: 32684375]
[http://dx.doi.org/10.1016/j.enfcle.2020.05.002] [PMID: 32684375]
[35]
Johansson, C.; Finnbogadóttir, H. First-time mothers’ satisfaction with their birth experience – A cross-sectional study. Midwifery, 2019, 79, 102540.
[http://dx.doi.org/10.1016/j.midw.2019.102540] [PMID: 31580998]
[http://dx.doi.org/10.1016/j.midw.2019.102540] [PMID: 31580998]
[36]
Bertucci, V.; Boffo, M.; Mannarini, S. Assessing the perception of the childbirth experience in Italian women: A contribution to the adaptation of the childbirth perception questionnaire. Midwifery, 2012, 28(2), 265-274.
[http://dx.doi.org/10.1016/j.midw.2011.02.009] [PMID: 21489665]
[http://dx.doi.org/10.1016/j.midw.2011.02.009] [PMID: 21489665]
[37]
Soriano-Vidal, F.J.; Oliver-Roig, A.; Cabrero-García, J.; Congost-Maestre, N.; Dencker, A.; Richart-Martínez, M. The Spanish version of the childbirth experience questionnaire (CEQ-E): Reliability and validity assessment. BMC Pregnancy Childbirth, 2016, 16(1), 372.
[http://dx.doi.org/10.1186/s12884-016-1100-z] [PMID: 27884123]
[http://dx.doi.org/10.1186/s12884-016-1100-z] [PMID: 27884123]
[38]
Henderson, J.; Redshaw, M. Women’s experience of induction of labor: A mixed methods study. Acta Obstet. Gynecol. Scand., 2013, 92(10), 1159-1167.
[http://dx.doi.org/10.1111/aogs.12211] [PMID: 23808325]
[http://dx.doi.org/10.1111/aogs.12211] [PMID: 23808325]
[39]
Hodnett, E.D.; Hannah, M.E.; Weston, J.A. Women’s evaluations of induction of labor versus expectant management for prelabor rupture of the membranes at term. TermPROM Study Group. Birth, 1997, 24(4), 214-220.
[http://dx.doi.org/10.1111/j.1523-536X.1997.00214.pp.x] [PMID: 9460311]
[http://dx.doi.org/10.1111/j.1523-536X.1997.00214.pp.x] [PMID: 9460311]
[40]
Alkmark, M.; Carlsson, Y.; Wendel, S.B. Efficacy and safety of oral misoprostol vs transvaginal balloon catheter for labor induction: An observational study within the swedish postterm induction study (SWEPIS). Acta Obstet. Gynecol. Scand., 2021, 100(8), 1463-1477.
[http://dx.doi.org/10.1111/aogs.14155] [PMID: 33768520]
[http://dx.doi.org/10.1111/aogs.14155] [PMID: 33768520]
[41]
Davey, M.A.; King, J. Caesarean section following induction of labour in uncomplicated first births- A population-based cross-sectional analysis of 42,950 births. BMC Pregnancy Childbirth, 2016, 16(1), 92.
[http://dx.doi.org/10.1186/s12884-016-0869-0] [PMID: 27121614]
[http://dx.doi.org/10.1186/s12884-016-0869-0] [PMID: 27121614]
[42]
Grobman, W.A.; Rice, M.M.; Reddy, U.M. Labor induction versus expectant management in low-risk nulliparous women. N. Engl. J. Med., 2018, 379(6), 513-523.
[http://dx.doi.org/10.1056/NEJMoa1800566] [PMID: 30089070]
[http://dx.doi.org/10.1056/NEJMoa1800566] [PMID: 30089070]
[43]
Osmundson, S.S.; Ou-Yang, R.J.; Grobman, W.A. Elective induction compared with expectant management in nulliparous women with a favorable cervix. Obstet. Gynecol., 2010, 116(3), 601-605.
[http://dx.doi.org/10.1097/AOG.0b013e3181eb6e9b] [PMID: 20733441]
[http://dx.doi.org/10.1097/AOG.0b013e3181eb6e9b] [PMID: 20733441]
[44]
Gibson, K.S.; Waters, T.P.; Bailit, J.L. Maternal and neonatal outcomes in electively induced low-risk term pregnancies. Am. J. Obstet. Gynecol., 2014, 211(3), 249.e1-249.e16.
[http://dx.doi.org/10.1016/j.ajog.2014.03.016] [PMID: 24631440]
[http://dx.doi.org/10.1016/j.ajog.2014.03.016] [PMID: 24631440]
[45]
Stock, SJ; Ferguson, E; Duffy, A; Ford, I; Chalmers, J; Norman, JE Outcomes of elective induction of labour compared with expectant management: Population based study. BMJ 2012; 344(may10 3):, , e2838.
[http://dx.doi.org/10.1136/bmj.e2838] [PMID: 22577197]
[http://dx.doi.org/10.1136/bmj.e2838] [PMID: 22577197]
[46]
Cheng, Y.W.; Kaimal, A.J.; Snowden, J.M.; Nicholson, J.M.; Caughey, A.B. Induction of labor compared to expectant management in low-risk women and associated perinatal outcomes. Am. J. Obstet. Gynecol., 2012, 207(6), 502.e1-502.e8.
[http://dx.doi.org/10.1016/j.ajog.2012.09.019] [PMID: 23063017]
[http://dx.doi.org/10.1016/j.ajog.2012.09.019] [PMID: 23063017]
[47]
Darney, B.G.; Snowden, J.M.; Cheng, Y.W. Elective induction of labor at term compared with expectant management: maternal and neonatal outcomes. Obstet. Gynecol., 2013, 122(4), 761-769.
[http://dx.doi.org/10.1097/AOG.0b013e3182a6a4d0] [PMID: 24084532]
[http://dx.doi.org/10.1097/AOG.0b013e3182a6a4d0] [PMID: 24084532]
[48]
Wessberg, A.; Lundgren, I.; Elden, H. Being in limbo: Women’s lived experiences of pregnancy at 41 weeks of gestation and beyond – A phenomenological study. BMC Pregnancy Childbirth, 2017, 17(1), 162.
[http://dx.doi.org/10.1186/s12884-017-1342-4] [PMID: 28578685]
[http://dx.doi.org/10.1186/s12884-017-1342-4] [PMID: 28578685]
[49]
Lou, S.; Hvidman, L.; Uldbjerg, N. Women’s experiences of postterm induction of labor: A systematic review of qualitative studies. Birth, 2019, 46(3), 400-410.
[http://dx.doi.org/10.1111/birt.12412] [PMID: 30561053]
[http://dx.doi.org/10.1111/birt.12412] [PMID: 30561053]
[50]
Blanch, G.; Lavender, T.; Walkinshaw, S.; Alfirevic, Z. Dysfunctional labour: A randomised trial. BJOG, 1998, 105(1), 117-120.
[http://dx.doi.org/10.1111/j.1471-0528.1998.tb09362.x] [PMID: 9442174]
[http://dx.doi.org/10.1111/j.1471-0528.1998.tb09362.x] [PMID: 9442174]
[51]
Waldenström, U.; Hildingsson, I.; Rubertsson, C.; Rådestad, I. A negative birth experience: Prevalence and risk factors in a national sample. Birth, 2004, 31(1), 17-27.
[http://dx.doi.org/10.1111/j.0730-7659.2004.0270.x] [PMID: 15015989]
[http://dx.doi.org/10.1111/j.0730-7659.2004.0270.x] [PMID: 15015989]
[52]
Leap, N.; Sandall, J.; Buckland, S.; Huber, U. Journey to confidence: Women’s experiences of pain in labour and relational continuity of care. J. Midwifery Womens Health, 2010, 55(3), 234-242.
[http://dx.doi.org/10.1016/j.jmwh.2010.02.001] [PMID: 20434083]
[http://dx.doi.org/10.1016/j.jmwh.2010.02.001] [PMID: 20434083]
