Preferences for induction of labor methods in India: a qualitative study of views and experiences of women, clinicians, and researchersAJOG Global Reports at a Glance

Background: Induction of labor (IOL) is an increasingly common intervention, but experiences and preferences of induction methods are under-researched particularly in low -and middle-income countries. Understanding these perspectives is important to improve the childbirth experience. Objective: To e...

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Main Authors: Lydia A. Hawker, MBChB, Shuchita Mundle, MD, Jaya P. Tripathy, MD, Pradeep Deshmukh, MD, Beverly Winikoff, MD, Andrew D. Weeks, MD, Carol Kingdon, PhD, Kate Lightly, PhD
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:AJOG Global Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S2666577824000832
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author Lydia A. Hawker, MBChB
Shuchita Mundle, MD
Jaya P. Tripathy, MD
Pradeep Deshmukh, MD
Beverly Winikoff, MD
Andrew D. Weeks, MD
Carol Kingdon, PhD
Kate Lightly, PhD
author_facet Lydia A. Hawker, MBChB
Shuchita Mundle, MD
Jaya P. Tripathy, MD
Pradeep Deshmukh, MD
Beverly Winikoff, MD
Andrew D. Weeks, MD
Carol Kingdon, PhD
Kate Lightly, PhD
author_sort Lydia A. Hawker, MBChB
collection DOAJ
description Background: Induction of labor (IOL) is an increasingly common intervention, but experiences and preferences of induction methods are under-researched particularly in low -and middle-income countries. Understanding these perspectives is important to improve the childbirth experience. Objective: To explore the experiences and preferences of IOL methods for women, clinicians, and researchers in the “Misoprostol or Oxytocin for Labour Induction” (MOLI) study. Study Design: This qualitative study was based in two government hospitals in the city of Nagpur, India—one tertiary referral hospital and one women's hospital. Fifty-three semi-structured interviews with women before and after induction (between days 1 and 5 postnatal), with women recruited to the “Misoprostol or Oxytocin for Labour Induction (MOLI)” randomized controlled trial (NCT03749902). Eight focus group discussions with doctors, nurses, and trial research assistants before and during trial delivery were conducted. Thematic analysis was conducted using the Framework approach. Results: Four themes emerged: (1) IOL methods, (2) impact of the study, (3) IOL and childbirth as one small part of the wider experiences in life, and (4) key moments in the childbirth experience. For women, the safety of their baby was more important than any IOL method. Clinicians had apprehensions over misoprostol use which could affect protocol implementation; they reported that changing perception is difficult as usual practice feels “comfortable.” Women wanted to share their experiences and reported key moments during childbirth including vaginal examinations, “trying for normal,” bearing the pain, waiting, and relationships with staff. Conclusion: Women did not have a strong preference for the IOL method and viewed childbirth positively when maternal and neonatal outcomes were good. Labor pain, vaginal examinations, a normal birth, and interactions with staff impacted women's experiences.
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spelling doaj-art-6a24dcb0cacd405b8c84540c5ac723982024-12-15T06:17:11ZengElsevierAJOG Global Reports2666-57782024-11-0144100389Preferences for induction of labor methods in India: a qualitative study of views and experiences of women, clinicians, and researchersAJOG Global Reports at a GlanceLydia A. Hawker, MBChB0Shuchita Mundle, MD1Jaya P. Tripathy, MD2Pradeep Deshmukh, MD3Beverly Winikoff, MD4Andrew D. Weeks, MD5Carol Kingdon, PhD6Kate Lightly, PhD7Department of Women and Children's Health, University of Liverpool, Liverpool, UK (Hawker); Corresponding author: Lydia A. Hawker, MBChBNagpurAll India Institute of Medical Sciences, Nagpur, India (Mundle)All India Institute of Medical Sciences, Nagpur, India (Tripathy and Deshmukh)All India Institute of Medical Sciences, Nagpur, India (Tripathy and Deshmukh)Gynuity Health Projects, New York, NY (Winikoff)University of Central Lancashire (UCLan), Lancaster, UK (Weeks, Kingdon, Lightly)University of Central Lancashire (UCLan), Lancaster, UK (Weeks, Kingdon, Lightly)University of Central Lancashire (UCLan), Lancaster, UK (Weeks, Kingdon, Lightly)Background: Induction of labor (IOL) is an increasingly common intervention, but experiences and preferences of induction methods are under-researched particularly in low -and middle-income countries. Understanding these perspectives is important to improve the childbirth experience. Objective: To explore the experiences and preferences of IOL methods for women, clinicians, and researchers in the “Misoprostol or Oxytocin for Labour Induction” (MOLI) study. Study Design: This qualitative study was based in two government hospitals in the city of Nagpur, India—one tertiary referral hospital and one women's hospital. Fifty-three semi-structured interviews with women before and after induction (between days 1 and 5 postnatal), with women recruited to the “Misoprostol or Oxytocin for Labour Induction (MOLI)” randomized controlled trial (NCT03749902). Eight focus group discussions with doctors, nurses, and trial research assistants before and during trial delivery were conducted. Thematic analysis was conducted using the Framework approach. Results: Four themes emerged: (1) IOL methods, (2) impact of the study, (3) IOL and childbirth as one small part of the wider experiences in life, and (4) key moments in the childbirth experience. For women, the safety of their baby was more important than any IOL method. Clinicians had apprehensions over misoprostol use which could affect protocol implementation; they reported that changing perception is difficult as usual practice feels “comfortable.” Women wanted to share their experiences and reported key moments during childbirth including vaginal examinations, “trying for normal,” bearing the pain, waiting, and relationships with staff. Conclusion: Women did not have a strong preference for the IOL method and viewed childbirth positively when maternal and neonatal outcomes were good. Labor pain, vaginal examinations, a normal birth, and interactions with staff impacted women's experiences.http://www.sciencedirect.com/science/article/pii/S2666577824000832birth experiencesinduction experiencelabor inductionmisoprostoloxytocinqualitative research
spellingShingle Lydia A. Hawker, MBChB
Shuchita Mundle, MD
Jaya P. Tripathy, MD
Pradeep Deshmukh, MD
Beverly Winikoff, MD
Andrew D. Weeks, MD
Carol Kingdon, PhD
Kate Lightly, PhD
Preferences for induction of labor methods in India: a qualitative study of views and experiences of women, clinicians, and researchersAJOG Global Reports at a Glance
AJOG Global Reports
birth experiences
induction experience
labor induction
misoprostol
oxytocin
qualitative research
title Preferences for induction of labor methods in India: a qualitative study of views and experiences of women, clinicians, and researchersAJOG Global Reports at a Glance
title_full Preferences for induction of labor methods in India: a qualitative study of views and experiences of women, clinicians, and researchersAJOG Global Reports at a Glance
title_fullStr Preferences for induction of labor methods in India: a qualitative study of views and experiences of women, clinicians, and researchersAJOG Global Reports at a Glance
title_full_unstemmed Preferences for induction of labor methods in India: a qualitative study of views and experiences of women, clinicians, and researchersAJOG Global Reports at a Glance
title_short Preferences for induction of labor methods in India: a qualitative study of views and experiences of women, clinicians, and researchersAJOG Global Reports at a Glance
title_sort preferences for induction of labor methods in india a qualitative study of views and experiences of women clinicians and researchersajog global reports at a glance
topic birth experiences
induction experience
labor induction
misoprostol
oxytocin
qualitative research
url http://www.sciencedirect.com/science/article/pii/S2666577824000832
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