Maternal childbirth experience in induced and spontaneous labour measured in a visual analog scale and the factors influencing it; a two-year cohort study

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Abstract

Background

Poor maternal childbirth experience plays a role in family planning and subsequent pregnancies. The aim of this study was to compare childbirth experiences in induced and spontaneous labor and to investigate the factors influencing the childbirth experience.

Methods

This two-year cohort study included all women with term singleton pregnancies in cephalic presentation aiming for vaginal delivery at Helsinki University Hospital between January 2017 and December 2018. Maternal satisfaction in the childbirth experience was measured after delivery using a Visual Analog Scale (VAS) score. A low childbirth experience score was defined as VAS < 5. The characteristics and delivery outcomes of the study population were collected in the hospital database and analyzed by SPSS.

Results

A total of 18,396 deliveries were included in the study, of which 28.9% ( n = 5322) were induced and 71.1% ( n = 13 074) were of spontaneous onset. The total caesarean delivery rate was 9.3% ( n = 1727). Overall, 4.5% ( n = 819) of the women had a low childbirth experience VAS score. The women who underwent labor induction were less satisfied with their birth experience compared to women with spontaneous onset of labor [7.5% ( n = 399) vs. 3.2% ( n = 420); p < 0.001]. Poor childbirth experience was associated with primiparity [OR 2.0 (95% CI 1.6–2.4)], labor induction [OR 1.6 (95% CI 1.4–1.9)], caesarean delivery [OR 4.5 (95% CI 3.7–5.5)], operative vaginal delivery [OR 3.3 (95% CI 2.7-4.0)], post-partum hemorrhage [OR 1.3 (95% CI 1.1–1.6)], and maternal infections [OR 1.7 (95% CI 1.3–2.4)].

Conclusions

Poor childbirth experience was associated with labor induction, primiparity, operative delivery, and labor complications, such as post-partum hemorrhage and maternal infections. These results highlight the aspects of care for which patient experience may be improved by additional support and counselling.

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Most cited references 10

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Births: Final Data for 2017.

Joyce Martin, Brady E Hamilton, Michelle Osterman … (2018)

Objectives-This report presents 2017 data on U.S. births according to a wide variety of characteristics. Trends in fertility patterns and maternal and infant characteristics are described and interpreted. Methods-Descriptive tabulations of data reported on the birth certificates of the 3.86 million births that occurred in 2017 are presented. Data are presented for maternal age, livebirth order, race and Hispanic origin, marital status, tobacco use, prenatal care, source of payment for the delivery, method of delivery, gestational age, birthweight, and plurality. Selected data by mother's state of residence and birth rates by age also are shown. Trend data for 2010 to 2017 are presented for selected items. Trend data by race and Hispanic origin are shown for 2016 and 2017. Results- A total of 3,855,500 births were registered in the United States in 2017, down 2% from 2016. Compared with rates in 2016, the general fertility rate declined to 60.3 births per 1,000 women aged 15-44. The birth rate for females aged 15-19 fell 7% in 2017. Birth rates declined for women in their 20s and 30s but increased for women in their early 40s. The total fertility rate declined to 1,765.5 births per 1,000 women in 2017. Birth rates for both married and unmarried women declined from 2016 to 2017. The percentage of women who began prenatal care in the first trimester of pregnancy rose to 77.3% in 2017; the percentage of all women who smoked during pregnancy declined to 6.9%. The cesarean delivery rate increased to 32.0% following 4 years of declines. Medicaid was the source of payment for 43.0% of all births in 2017, up 1% from 2016. The preterm birth rate rose for the third straight year, as did the rate of low birthweight. Twin and triplet and higher-order multiple birth rates were essentially stable in 2017.

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A negative birth experience: prevalence and risk factors in a national sample.

Ulla Waldenström, Ingela Rådestad, Ingegerd Hildingsson … (2004)

A woman's dissatisfaction with the experience of labor and birth may affect her emotional well-being and willingness to have another baby. The aim of this study was to investigate the prevalence and risk factors of a negative birth experience in a national sample. A longitudinal cohort study of 2541 women recruited from all antenatal clinics in Sweden during 3 weeks spread over 1 year was conducted. Data were collected by three questionnaires, which measured women's global experience of labor and birth 1 year after the birth, and obtained information on possible risk factors during pregnancy and 2 months after the birth. Seven percent of the women had a negative birth experience. The following risk factors were found: (1) factors related to unexpected medical problems, such as emergency operative delivery, induction, augmentation of labor, and infant transfer to neonatal care; (2) factors related to the woman's social life, such as unwanted pregnancy and lack of support from partner; (3) factors related to the woman's feelings during labor, such as pain and lack of control; and (4) factors that may be easier to influence by the caregivers, such as insufficient time allocated to the woman's own questions at antenatal checkups, lack of support during labor, and administration of obstetric analgesia. Many risk factors were related to unexpected medical problems and participants' social background. Of the established methods to improve women's birth experience, childbirth education and obstetric analgesia seemed to be less effective, whereas support in labor and listening to the woman's own issues may be underestimated.

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Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis.

Ekaterina Mishanina, Ewelina Rogozińska, Tej Thatthi … (2014)

Induction of labour is common, and cesarean delivery is regarded as its major complication. We conducted a systematic review and meta-analysis to investigate whether the risk of cesarean delivery is higher or lower following labour induction compared with expectant management.

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Author and article information

Contributors

Heidi Kruit: heidi.kruit@hus.fi

Journal

Journal ID (nlm-ta): BMC Pregnancy Childbirth

Journal ID (iso-abbrev): BMC Pregnancy Childbirth

Title: BMC Pregnancy and Childbirth

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2393

Publication date (Electronic): 21 July 2020

Publication date PMC-release: 21 July 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 415

Affiliations

GRID grid.7737.4, ISNI 0000 0004 0410 2071, Department of Obstetrics and Gynecology, , University of Helsinki and Helsinki University Hospital, ; Haartmaninkatu 2, 00029 HUS Helsinki, Finland

Article

Publisher ID: 3106

DOI: 10.1186/s12884-020-03106-4

PMC ID: 7372821

PubMed ID: 32693773

SO-VID: f1e7281f-fee0-43b1-89c6-0ae3de4ac01a

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 26 May 2020

Date accepted : 9 July 2020

Custom metadata

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: induction of labor,childbirth experience,maternal satisfaction,visual analogue scale,operative delivery

Data availability:

ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: induction of labor, childbirth experience, maternal satisfaction, visual analogue scale, operative delivery

Maternal childbirth experience in induced and spontaneous labour measured in a visual analog scale and the factors influencing it; a two-year cohort study

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Abstract

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Conclusions

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Advocacy for Maternal and Women’s Health

Most cited references 10

Births: Final Data for 2017.

A negative birth experience: prevalence and risk factors in a national sample.

Use of labour induction and risk of cesarean delivery: a systematic review and meta-analysis.

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