Women's knowledge, expectations and experience of induction of labour and the association with maternal anxiety

University of Technology, Sydney. Faculty of Nursing, Midwifery and Health.Induction of Labour (IOL) is one of the fastest growing procedures in childbirth in the developed world with one in four women now being induced. The primary purpose of this study was to further develop the understanding of women's knowledge, expectations and experiences of IOL in order to identify whether women's views may be contributing factors to the increasing rate of IOL. A descriptive and correlational study design, using pre and post IOL surveys, captured the views of a convenience sample of pregnant women booked for any type of IOL at Blacktown Hospital in 2009 and 2010. Consenting women were given self-administered, pre and post-IOL questionnaires and the Spielberger State-Trait Anxiety Inventory. One hundred and nine women experienced IOL and completed both pre and post IOL surveys; of these, 98 linked surveys were eligible to be analysed using SPSS v 18. Both simple descriptive and multivariate analyses were undertaken. The majority of participants (85.7%) acknowledged they agreed to have an IOL because they were worried about problems with their baby if the pregnancy continued. Most (59.1%) acknowledged a midwife as their most important care provider as well as the most common source of information (61.2%). Although 96.9% of women expressed the importance of information concerning IOL, only 75% were satisfied with the information they received prior to the process. While the majority of participants (97.9%) were satisfied with the care they received from midwives, overall, 13.4% did not have a satisfying IOL experience. More than 21% of women expected to give birth within six hours and only 15% of participants expressed the length of their labour was around what they expected. While 7.1% came with no expectation regarding labour pain, 67.8% rated their pain as 'much more/ more painful' than they expected. These results revealed that many women did not have realistic expectations of IOL. Satisfaction with childbirth was higher for women who had a birth experience that was better than expected. In addition, there was a significant relationship between women's realistic expectations and their satisfaction with IOL. However a positive relationship between women's knowledge and their satisfaction with IOL was not found in this study. There was a significant relationship between women's level of knowledge and their State anxiety level before undergoing IOL. Furthermore women who had more realistic expectations were less anxious after experiencing IOL. Being well informed by the midwife was the strongest predictor for satisfaction in this study (p