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

Johanna M Joensuu; Hannu Saarijärvi; Hanna Rouhe; Mika Gissler; Veli-Matti Ulander; Seppo Heinonen; Paulus Torkki; Tomi S Mikkola

doi:10.1186/s12884-022-04830-9

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

BMC Pregnancy Childbirth. 2022 Jun 23;22(1):508. doi: 10.1186/s12884-022-04830-9.

Authors

Johanna M Joensuu^{1

2}, Hannu Saarijärvi³, Hanna Rouhe⁴, Mika Gissler^{5

6

7}, Veli-Matti Ulander⁴, Seppo Heinonen⁴, Paulus Torkki⁸, Tomi S Mikkola^{4

9}

Affiliations

¹ Helsinki University Hospital, Obstetrics and Gynecology, Haartmaninkatu 2 PL 140, Helsinki, 00029, Finland. johanna.joensuu@hus.fi.
² Department of Public Health, University of Helsinki, Helsinki, Finland. johanna.joensuu@hus.fi.
³ Tampere University, Faculty of Management and Business, Tampere, Finland.
⁴ University of Helsinki and Helsinki University Hospital, Obstetrics and Gynecology, Helsinki, Finland.
⁵ Finnish Institute for Health and Welfare, Information Services Department, Helsinki, Finland.
⁶ Karolinska Institute, Department of Molecular Medicine and Surgery, Stockholm, Sweden.
⁷ Academic Primary Health Care Centre, Stockholm, Region Stockholm, Sweden.
⁸ Department of Public Health, University of Helsinki, Helsinki, Finland.
⁹ Folkhälsan Research Center, Biomedicum, Helsinki, Finland.

Abstract

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.

Keywords: Delivery method; Giving birth; Induced labour; Maternal experience; Maternity; Pregnancy.

MeSH terms

Cesarean Section*
Cohort Studies
Delivery, Obstetric / methods
Female
Finland
Humans
Labor, Induced / methods
Labor, Obstetric*
Pregnancy
Retrospective Studies