4.6 Article

Women's childbirth experiences in the Swedish Post-term Induction Study (SWEPIS): a multicentre, randomised, controlled trial

Journal

BMJ OPEN
Volume 11, Issue 4, Pages -

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2020-042340

Keywords

obstetrics; maternal medicine; reproductive medicine

Funding

  1. Swedish government [ALFGBG-440301, ALFGBG-718721, ALFGBG-70940, ALFGBG-426401]
  2. Health Technology Centre at Sahlgrenska University Hospital
  3. Foundation of the Health and Medical care committee of the region of Vastra Gotaland, Sweden [VGFOUREG387351, VGFOUREG640891, VGFOUREG854081]
  4. Hjalmar Svensson Foundation
  5. foundation Mary von Sydow
  6. UppsalaOrebro Regional Research Council [RFR-556711, RFR-736891]
  7. Region Orebro County research committee [OLL-715501]
  8. ALF agreement in Stockholm [ALF-561222, ALF-562222, ALF-563222]
  9. Centre for Clinical Research Dalarna, Uppsala University, Sweden [CKFUU-417011]
  10. born Wijk donation fund

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The study compared childbirth experiences in women randomly assigned to induction of labor at 41 weeks or expectant management until 42 weeks in the Swedish Post-term Induction Study. The results showed no significant differences in childbirth experiences between the two groups, with women overall rating their childbirth experiences high.
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.

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