Maternal childbirth experience and induction of labour in each mode of delivery: a retrospective seven-year cohort study of 95,051 parturients in Finland

Background Childbirth experience has been shown to depend on the mode of delivery. However, it is unclear how labour induction influences the childbirth experience in different modes of delivery. Thus, we assessed the childbirth experience among mothers with spontaneous and induced labours. Design A retrospective cohort study. Setting Childbirths in four delivery hospitals in Helsinki and Uusimaa District, Finland, in 2012-2018. Sample 95051 childbirths excluding elective caesarean sections. Methods Obstetric data combined to maternal childbirth experience measured by Visual Analogue Scale (VAS) was analysed with univariate linear modelling and group comparisons. The primiparas and multiparas were analysed separately throughout the study due to the different levels of VAS. Main outcome measures Maternal childbirth experience measured by VAS. Results The negative effect of labour induction on the childbirth experience was discovered in each mode of delivery. Operative deliveries were perceived more negatively when they were preceded by labour induction. The rate of poor childbirth experience (VAS <= 5) was higher for mothers with labour induction (ORs varying from 1.43 to 1.77) except in emergency caesarean sections. The negative effect of labour induction was smaller than the effect of mode of delivery, while successful vaginal delivery with induction (mean(PRIMI)=8.00 [95% CI 7.96-8.04], mean(MULTI)=8.50 [8.47-8.53]) was perceived more positive than operational deliveries with spontaneous labour (means(PRIMI)<= 7.66 [7.61-7.70], means(MULTI)<= 7.96 [7.89-8.03]). However, labour induction more than doubled the risk of caesarean section for both primiparas and multiparas. Conclusions Labour induction generates more negative experiences for both primiparas and multiparas. The negative effect of labour induction is detected for all modes of delivery, being worst among labour induction resulting in operative delivery. The parturients facing cumulative obstetric interventions require special support and counselling during and after delivery.

Automated summary

This study assessed the impact of spontaneous labor and labor induction on maternal childbirth experience. The findings revealed that labor induction had a negative effect on childbirth experience in all modes of delivery, especially in cases of operative delivery. Labor induction also more than doubled the risk of caesarean section.