Women's experiences and attitudes towards expectant management and induction of labor for post-term pregnancy

Authors

  • RUNA HEIMSTAD,

    Corresponding author
    1. Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
    2. Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
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  • PÅL R. ROMUNDSTAD,

    1. Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
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  • JON HYETT,

    1. Department of Fetal Maternal Medicine, Royal Brisbane Women's Hospital, Brisbane, Australia
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  • LARS-ÅKE MATTSSON,

    1. Department of Obstetrics and Gynecology, Sahlgrenska Academy, Gøteborg, Sweden
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  • KJELL Å. SALVESEN

    1. Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
    2. Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
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: Runa Heimstad, Department of Obstetrics and Gynecology, St. Olavs Hospital, Trondheim University Hospital, 7006, Trondheim, Norway. E-mail: runa.heimstad@ntnu.no

Abstract

Background. Clinical guidelines for post-term management differ, and studies on women's attitudes are lacking. We aimed to assess the experiences and attitudes among women managed with serial antenatal monitoring or induction of labor, and the effects of post-term pregnancy on self-reports of quality of life. Methods. Women were randomized at 41weeks to immediate induction of labor or antenatal fetal surveillance every third day. At inclusion women answered a questionnaire about their attitudes towards post-term pregnancy and health-related quality of life. This was repeated in a follow-up phone interview 6months later, including questions about their experiences of labor and perspective on future deliveries. Results. A total of 508women entered the study. At 41weeks 74% of all women preferred to be induced. Women reported good general and mental health, but physical health and vitality scores were low. In the induction group, 74% of women said they would prefer the same management in future pregnancies; only 38% of women who had serial antenatal monitoring would prefer this option again (p<0.001). In the induction group, contractions were reported as more intense (n = 157 versus n = 118, p<0.01) and frequent (n = 116 versus n = 87, p<0.01) compared to the monitored group. The majority (84%) reported a positive labor induction experience. Conclusion. Women preferred induction of labor to serial antenatal monitoring beyond 41weeks. Labors were shorter and contractions were reported to be more frequent and intense in the induction group compared with the monitored group. However, their experience with labor induction was positive.

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