(640) Association between induction of labor and birth experience: a national population-based study

Thursday, January 30, 2025

4:00 PM – 6:00 PM

Submitting Author and Presenting Author(s)

Sophia Braund, MD, N/A (she/her/hers)

Université paris cité, inserm, CRESS, EPOPE
Paris, Ile-de-France, France

Coauthor(s)

FG

Francois Goffinet, MD, PhD

Professor
Université Paris Cité, Inserm, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé)
Paris, Ile-de-France, France
AS

Aurélien Seco, MSc

Statistician
Université Paris Cité, Inserm, Centre for Research in Epidemiology and StatisticS (CRESS), Obstetrical Perinatal and Pediatric Epidemiology Research Team (EPOPé),
Paris, Ile-de-France, France
Camille Le Ray, MD, PhD (she/her/hers)

Professor
INSERM 1153, APHP, Port Royal maternity unit, Université de Paris
Paris, Ile-de-France, France

Objective: Induction of labor (IOL) is rising in high income countries. The ARRIVE trial, with a selected population due to randomized trials, found increased satisfaction among induced women. However, birth experience in case of IOL should be assessed in real life. Our objective is to assess the association between IOL and birth experience using a national population-based survey

Study Design: Using the French national perinatal survey 2021, we included women with a term singleton cephalic infant and a trial of labor. At 2 months, women answered the question “What kind of memories do you have about your childbirth?”. We used univariate and multivariate analyses to assess the association between IOL and birth experience, and weighting to account for missing data. We identified and assessed as potential mediators prolonged labor ≥12 hours and ‘birth with intervention or complication’ (caesarean and/or operative vaginal delivery and/or PPH and/or OASIS and/or NICU), and estimated the indirect and residual effects using mediation modelling.

Results: Of the 6271 women included in the main analysis, 1800 (28.7 %) underwent IOL. Overall, women with IOL had more often a bad birth experience than women with spontaneous onset of labor (SOL) (16.4% vs 8.8%, p< 0.01), and the association remained significant after adjustment (ORa 1.78 (1.47-2.16)). In case of cervix ripening, the rate of bad birth experience rose to 18.8%. Analyses on a subgroup of women at low maternal risk found similar results. Prolonged labor explained only 6% of the association between IOL and bad experience. Birth with complications or interventions concerned 43.8% of women with IOL and 31.1% with SOL (p< 0.01) and explained 26% of this association.

Conclusion: IOL was associated with a higher risk of bad birth experience than SOL. Only a small part of this association is mediated by medical complications or interventions and prolonged labor. In the context of increase in inductions, our findings underline the importance of considering birth experience in the decision-making and information for women and the need to explore consequences of IOL.