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Abstract
Objective To compare childbirth experiences in women randomly assigned to either induction of labour at 41 weeks or to expectant management until 42 weeks, in the Swedish Post-term Induction Study.
Design A register-based, multicentre, randomised, controlled, superiority trial.
Setting Women were recruited at 14 hospitals in Sweden, 2016–2018.
Participants Women with an uncomplicated singleton pregnancy were recruited at 41 gestational weeks.
Interventions The women were randomly assigned to induction of labour at 41 weeks (induction group, n=1381) or expectant management until 42 weeks (expectant management group, n=1379).
Outcome measures As main outcome, women’s childbirth experiences were measured using the Childbirth Experience Questionnaire version 2 (CEQ2), in 656 women, 3 months after the birth at three hospitals. As exploratory outcome, overall childbirth experience was measured in 1457 women using a Visual Analogue Scale (VAS 1–10) within 3 days after delivery at the remaining eleven hospitals.
Results The total response rate was 77% (2113/2760). There were no significant differences in childbirth experience measured with CEQ2 between the groups (induction group, n=354; expectant management group, n=302) in the subscales: own capacity (2.8 vs 2.7, p=0.09), perceived safety (3.3 vs 3.2, p=0.06) and professional support (3.6 vs 3.5, p=0.38) or in the total CEQ2 score (3.3 vs 3.2, p=0.07), respectively. Women in the induction group scored higher in the subscale participation (3.6 vs 3.4, p=0.02), although with a small effect size (0.19). No significant difference was observed in overall childbirth experience according to VAS (8.0 (n=735) vs 8.1 (n=735), p=0.22).
Conclusions There were no differences in childbirth experience, according to CEQ2 or overall childbirth experience assessed with VAS, between women randomly assigned to induction of labour at 41 weeks or expectant management until 42 weeks. Overall, women rated their childbirth experiences high.
Trial registration number ISRCTN26113652.
- obstetrics
- maternal medicine
- reproductive medicine
Data availability statement
Data are available on reasonable request. Data will be made available, from the corresponding author, on reasonable request.
This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
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Data availability statement
Data are available on reasonable request. Data will be made available, from the corresponding author, on reasonable request.
Supplementary materials
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Footnotes
Twitter @HelenaFadl
Contributors AW, AD, HH, U-BW, VS and HE conceived and designed the study. HN, AW, HH, U-BW, HF, JW, A-KW and SS oversaw recruitment of study participants and collection of Childbirth Experience Questionnaire data at the local centres. U-BW and HN did the data cleaning together with statisticians Mattias Molin and Per Ekman. HN compiled and analysed the Childbirth Experience Questionnaire version 2 data. Per Ekman did the analysis regarding Visual Analogue Scale. HN wrote the first draft of the manuscript, which was then critically reviewed and revised by all coauthors (HN, AW, AD, HH, U-BW, HF, JW, VS, IL, CB, A-KW, SS and HE). All authors have approved the final version of the manuscript for submission. All authors have full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. HE is the guarantor.
Funding This study was supported by the Swedish state under the agreement between the Swedish government and the county councils, the ALF agreement (ALFGBG-440301, ALFGBG-718721, ALFGBG-70940 and ALFGBG-426401); the Health Technology Centre at Sahlgrenska University Hospital; the Foundation of the Health and Medical care committee of the region of Västra Götaland, Sweden (VGFOUREG387351, VGFOUREG640891 and VGFOUREG854081); Hjalmar Svensson Foundation; the foundation Mary von Sydow; born Wijk donation fund; Uppsala-Örebro Regional Research Council (RFR-556711 and RFR-736891); Region Örebro County research committee (OLL-715501); the ALF agreement in Stockholm (ALF-561222,ALF-562222 and ALF-563222); and Centre for Clinical Research Dalarna, Uppsala University, Sweden (CKFUU-417011).
Disclaimer The funders had no role in the study design, data collection, data analysis, data interpretation or writing of the report. The researchers were independent of the funders.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer-reviewed.
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