Work

Women's experience and acceptability of elective late-term induction of labour: A systematic review and meta-synthesis of qualitative studies using GRADE CERQual

Year: 2025

Type: review

Abstract: BACKGROUND: Systematic reviews of patient perspectives are crucial in the evidence to decision process when developing clinical guidelines. OBJECTIVE: To identify and synthesise qualitative evidence of women's experiences of late-term induction of labour. METHOD: A prespecified protocol in Danish was registered at the Danish Health Authority homepage, 2020. Several databases including Medline, EMBASE and CINAHL were searched from inception until May 2023. Study quality was appraised using JBI checklists and findings were extracted and synthesised in accordance with the meta-aggregation approach. Certainty in the evidence was evaluated using GRADE-CERQual. RESULT: Out of 1421 records, 11 qualitative studies were included. The study population consisted of 521 nulliparous or multiparous women who were scheduled for or experienced induction of labour. The 94 findings were aggregated into six findings: 1) Induction of labour can be difficult to handle, 2) The decision to start induction of labour leads to a shift in birth expectations, 3) During birth, the safety of the baby is prioritised over the woman's personal expectations and experiences, 4) Information about the induction of labour process is important for women's experience of the process, 5) Attention from healthcare professionals is important for the women's experience of having their needs seen and heard, 6) Women experience induction of labour as a fixed procedure which cannot be deviated from. The GRADE CERQual assessment showed moderate to high confidence in all findings. CONCLUSION: This meta-synthesis highlights that women undergoing induction of labour prioritise their baby's safety and often accept the procedure despite discomfort or limited autonomy. The review suggests that healthcare providers should adopt a personalised approach.

Source: Women and Birth

DOI: 10.1016/j.wombi.2025.102141