Induction of labour vs spontaneous labour onset and maternal and perinatal outcomes and maternal experiences: The Birth Experience Study (BESt)

BACKGROUND: Induction of labour (IOL) is rising around the world, with little known about consequent outcomes in large cohorts of childbearing women. AIM: To examine the impact of IOL vs spontaneous labour onset on maternal and perinatal outcomes, as reported by women in a national survey. DESIGN: A cross-sectional, online, maternal self-report survey, was open in Australia from March-December 2021. PARTICIPANTS: 7791 women who had a spontaneous onset (n = 5230), or IOL (n = 2561) were included. ANALYSIS: Labour, birth and postnatal outcomes were classified as binary variables and percentages. Univariable and multivariable logistic regression analyses were performed, controlling for likely confounders. RESULTS: Compared with spontaneous onset of labour, survey respondents having an IOL were significantly more likely to experience: forceps or vacuum; episiotomy; emergency caesarean; excessive blood loss; physical pain and/or poor or decreased physical health; birth as traumatic; regrets about their birth experience; diagnosis of PTSD; obstetric violence; and less skin-to-skin contact with their babies. Neonatal outcomes following IOL included: significantly higher odds of being distressed during labour; having jaundice; and being given formula when the mother had chosen to breast feed. There was no difference in major perineal injury or pelvic floor outcomes, or admission of the baby to special care nursery or neonatal intensive care. CONCLUSIONS: IOL was associated with significant negative physical and psychological health impacts for women and babies compared to spontaneous labour onset. There is a need for more research on clinical and psychological impacts of IOL for women, to ensure decision making is informed.