A systematic review of supportive interventions to promote women's comfort and well‐being during induction of labour

Abstract

Aims To evaluate the effectiveness of non‐pharmacological non‐invasive supportive interventions for impacts on women's comfort and well‐being during induction of labour. Design A quantitative systematic review without meta‐analysis. Data Sources Databases were searched for primary research published in English between 2000–2019: AMED, CINAHL, Medline, Maternity and Infant Care database, PsycINFO, and ProQuest. The quality of studies was evaluated using JBI levels of evidence and established critical appraisal tools. Studies describing measures of comfort, coping, and well‐being for women during induction of labour were included. Results Two articles met the criteria for inclusion. There is limited evidence to suggest that women having outpatient cervical priming were more satisfied with their experience than women having inpatient cervical priming and that outpatient cervical priming did not increase women's anxiety. A specifically designed information brochure explaining the induction process improved women's knowledge and understanding. Review Methods The quantitative systematic review followed the Centre for Reviews and Dissemination guidelines and Cochrane Effective Practice and Organisation of Care guidance. Quality appraisal was conducted using JBI levels of evidence, Cochrane Risk of Bias, and other established tools. A narrative description of the quantitative data was undertaken. There was insufficient evidence to perform a narrative synthesis or meta‐analysis due to the nature of the study designs and insufficient outcome data. Conclusions Globally, the number of women having an induction of labour is increasing and there is a lack of evidence on the effectiveness of supportive interventions. Components of supportive care for women having induction of labour require urgent evaluation. Measurement tools which capture the complexity of supportive care for women having induction of labour need to be developed and validated. Impact This is the first review to evaluate non‐pharmacological, non‐invasive supportive interventions for women having induction of labour. The findings of this review identify the urgent need to develop an evidence base for effective supportive.

Attitudes of pregnant women and healthcare professionals to labour induction and obtaining consent for labour induction

“…Dissatisfaction with induction of labour in nulliparous women has been associated with antenatal classes not discussing IoL( 9), but there is insufficient evidence to determine when and by what method, information about IoL should be given to women. A systematic review of nonpharmacological interventions to support women experiencing IoL found only two eligible studies, one of which suggested that providing women with written information about IoL as they arrive for the procedure increased their knowledge about how the induction agent worked, timings, and side effects, however women had consented to IoL prior to receiving this information (35,36). Women also need to be informed about each sequential step of the induction process, the possibility of further interventions and pain (4,33).…”

Outpatient labor induction—Exploring future potential by assessing eligibility in a historical cohort

“…In several countries, women are offered IOL as outpatients if their pregnancy is classified as low risk 9–14 . Outpatient management of IOL is associated with better maternal satisfaction and might reduce the use of maternity care resources 8–10,15,16 . In Norway, national guidelines recommend a sequential IOL method, with Foley catheter as the initial method followed by low‐dose misoprostol, administered either vaginally or orally 17 .…”

“… 9 , 10 , 11 , 12 , 13 , 14 Outpatient management of IOL is associated with better maternal satisfaction and might reduce the use of maternity care resources. 8 , 9 , 10 , 15 , 16 In Norway, national guidelines recommend a sequential IOL method, with Foley catheter as the initial method followed by low‐dose misoprostol, administered either vaginally or orally. 17 Although women receive outpatient care during Foley catheter treatment, they are admitted to hospital during the misoprostol phase.…”