Home induction may not reduce midwife workload

Inducing labour at home may not help midwives manage their workload, according to a new analysis.

About a third of births in the UK are induced, with the rate rising in recent years.

The first stage of induction is usually cervical ripening with prostaglandin applied to the woman’s cervix. Returning home for a period of time after this stage is proposed as a potential solution to manage workload and improve women’s experience. But there is limited evidence on the safety and acceptability of this approach.

Professor Christine McCourt of City, University of London, UK, and colleagues explored home induction from a staff perspective.

They undertook five case studies, together with focus groups and interviews with staff including 49 midwives, 22 obstetricians, and two other maternity staff members.

Analysis of the findings showed a range of practices and views regarding induction.

In PLoS ONE, the authors report: “The integration of home cervical ripening is not always straightforward. Findings highlighted ways in which expectations might not be borne out in practice.”

Professor McCourt said: “Although interventions like induction of labour may have good intentions, they can have unintended consequences for both the quality of care provided and the workload of staff members.

“To address these issues, targeted and effective approaches to induction of labour are needed, including the promotion of genuine informed choice. Additionally, maternity services must be adequately resourced to ensure the provision of safe care.”

Yuill, C. et al. Clinicians’ perspectives and experiences of providing cervical ripening at home or in-hospital in the United Kingdom. PLoS ONE 18 May 2023; doi: 10.1371/journal.pone.0284818


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