Pregnant Women's Labor Progress, Childbirth Outcome, and Childbirth Satisfaction according to the Presence or Absence of Labor Induction

Yun Ah Jeong; Chae Weon Chung

doi:10.4069/kjwhn.2018.24.1.58

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Jeong and Chung: Pregnant Women's Labor Progress, Childbirth Outcome, and Childbirth Satisfaction according to the Presence or Absence of Labor Induction

Orginal Article

Korean J Women Health Nurs 2018;24(1):58-70.

Published online: 20 March 2018

DOI: https://doi.org/10.4069/kjwhn.2018.24.1.58

Pregnant Women's Labor Progress, Childbirth Outcome, and Childbirth Satisfaction according to the Presence or Absence of Labor Induction

Yun Ah Jeong^1,, Chae Weon Chung²

¹Seoul Metropolitan Government Boramae Medical Center, Seoul, Korea

²College of Nursing · The Research Institute of Nursing Science, Seoul National University, Seoul, Korea

Corresponding author: Jeong, Yun Ah Department of Nursing, Boramae Medical Center, 20 Boramae-ro, 5-gil, Dongjak-gu, Seoul 07061, Korea. Tel: +82-2-870-3252, Fax: +82-2-831-0715, E-mail: yuna1202@snu.ac.kr

Received 26 December 20171 March 2018 Accepted 5 March 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To provide accurate information on induced labor and find strategies to enhance women's childbirth satisfaction.

Methods

Participants were pregnant women expected to have normal vaginal delivery. A total of 113 women with induced labor and 61 women with spontaneous labor were surveyed. Data were collected using a questionnaire and electronic medical records.

Results

The following variables related to labor progress showed significant differences between the induced labor group and the spontaneous labor group: length of the first stage of labor in primigravidas, use of analgesic, incidence of uterine hyperstimulation, incidence of fetal distress, and medical treatment for the expectant mother. Delivery type and the incidence of postpartum complications showed significant difference between the two groups. Induced labor women's childbirth satisfaction was mainly affected by the process of labor whereas spontaneous labor women's childbirth satisfaction was affected by the outcome of childbirth.

Conclusion

Medical staff should have accurate information on the risk of induced labor and the benefits of a natural delivery. Moreover, medical staff should provide necessary information and environment for women to participate in the decision-making process.

Keywords: Induced labor, Spontaneous labor, Pregnant woman

References

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Table 1.

Differences in Demographic Characteristics between Induced Labor and Spontaneous Labor Groups (N=174)

Variables	Categories	Induced labor (n=113)		Spontaneous labor (n=61)		x² or t	p
Variables	Categories	n (%)	M±SD (Range)	n (%)	M±SD (Range)	x² or t	p
Age (year)	＜20	1 (0.9)	32.30±4.2	0 (0.0)	33.05±3.8	–1.16	.247
	20∼29	25 (22.1)	(18∼42)	8 (13.1)	(23∼41)
	30∼39	81 (71.7)		49 (80.3)
	≥40	6 (5.3)		4 (6.6)
Educational	＜High school	2 (1.1)		1 (1.6)		1.04	.834
level	High school	15 (13.3)		6 (9.8)
	College	79 (45.4)		47 (77.0)
	＞College	17 (15.0)		7 (11.5)
Employment	Yes	62 (54.9)		30 (49.2)		0.51	.526
	No	51 (45.1)		31 (50.8)
Marital status	Married	113 (100.0)		60 (98.4)		1.86^†	.351
	Single	–		1 (1.6)
Gestational age			38.93±1.12		38.99±.90	–0.35	.729
			(36⁺⁰∼41⁺¹)		(36⁺⁰∼41⁺⁴)
Parity	Nulliparous	86 (76.1)		31 (50.8)		11.50	.001
	Multiparous	27 (23.9)		30 (49.2)
Reason for	Labor pain	19 (16.8)		45 (73.8)		16.83^†	.000
admission	Rupture of membrane	33 (29.2)		15 (24.6)
	Induction	60 (53.1)		–
	Etc	1 (0.9)		1 (1.6)

^† Fisher's exact test.

Table 2.

Differences in Labor Progress between Induced Labor and Spontaneous Labor Groups (N=174

		Induced labor	Spontaneous labor
Variables	Categories	(n=113)	(n=61)	x² or t	p
		n (%) or M±SD	n (%) or M±SD
Duration of labor (min)^†
Nulli-parous	1st stage	353.81±250.84	511.03±317.33	–2.62	.010
	2nd stage	65.80±73.71	69.00±33.65	–0.23	.771
Multi-parous	1st stage	168.92±134.49	263.21±266.95	–1.60	.116
	2nd stage	18.56±10.4	19.86±18.25	–0.32	.754
Epidural anesthesia	Yes	63 (55.8)	26 (42.6)	2.73	.113
	No	50 (44.2)	35 (57.4)
Pethidine use	Yes	67 (59.3)	17 (27.9)	15.67	＜.001
	No	46 (40.7)	44 (72.1)
Epidural anesthesia +	Yes	44 (38.9)	7 (11.5)	14.42	＜.001
Pethidine use	No	69 (61.1)	54 (88.5)
Frequency of uterine contraction	＜5	35 (32.7)	39 (69.6)	20.23	＜.001
per 10 minutes (numbers)^‡	≥5	72 (67.3)	17 (30.4)
Duration of each uterine	＜2 mins	102 (95.2)	53 (94.6)	0.02	.622
contraction^‡	≥2 mins	5 (4.8)	3 (5.4)
Fetal distress^§	Yes	29 (40.8)	12 (19.7)	6.87	.020
	No	42 (59.2)	49 (80.3)
Medical management	Yes	104 (92.0)	37 (60.7)	25.38	＜.001
	No	9 (8.0)	24 (39.3)

^† Except cesarean section → Induced labor (n=89), Spontaneous labor (n=60);

^‡ Except missing data → Induced labor (n=107), Spontaneous labor (n=56);

^§ Except from Induced labor group the reason for performing induction of labor is fetal growth retardation, fetal unusual condition, obstetric complication → Induced labor group (n=71), Spontaneous labor group (n=61).

Table 3.

Differences in Delivery Outcomes between Induced Labor and Spontaneous Labor Groups (N=174)

Variables		Categories	Induced labor (n=113)	Spontaneous labor (n=61)	x² or t	p
Variables		Categories	n (%)	n (%)	x² or t	p
Maternal	Delivery mode	NFSD	69 (61.1)	53 (86.9)	15.35	.000
outcomes		NFVED	20 (17.7)	7 (11.5)
		C/S	24 (21.2)	1 (1.6)
	Postpartum	Yes	12 (13.5)	1 (1.7)	6.28	.015
	complication^‡	No	77 (86.5)	59 (98.3)
	Postpartum	Yes	28 (31.5)	17 (28.3)	0.17	.719
	hemorrhage^‡	No	61 (68.5)	43 (71.7)
Infant	Apgar score (1 min)	＜7	5 (4.4)	2 (3.3)	0.14^†	1.000
outcomes		≥7	108 (95.6)	59 (96.7)
	Apgar score (5 min)	＜7	1 (0.9)	0 (0.0)	0.54^†	1.000
		≥7	112 (99.1)	61 (100.0)
	Cord blood pH^§	＜7.10	2 (1.9)	2 (3.4)	0.40^†	.613
		≥7.10	105 (98.1)	56 (96.6)
	O₂apply or intubation	Yes	4 (3.5)	1 (1.6)	0.51^†	.658
		No	109 (96.5)	60 (98.4)
	Meconium staining	Yes	5 (4.4)	4 (6.6)	0.37^†	.721
		No	108 (95.6)	57 (93.4)

^† Fisher's exact test;

^‡ Except cesarean section ․ Induced labor (n=89), Spontaneous labor (n=60);

^§ Except missing data ․ Induced labor (n=107), Spontaneous labor (n=58); NFSD=normal full term spontaneous delivery; NFVED=normal full term vacuum extractor delivery; C/S=cesarean section.

Table 4.

Differences in Satisfaction of Childbirth between Induced Labor and Spontaneous Labor Groups (N=174)

Variables	Induced labor (n=113)	Spontaneous labor (n=61)	x² or t	p
Variables	M±SD	M±SD	x² or t	p
Satisfaction of childbirth	42.06±7.95	42.61±7.90	–0.45	.651

Table 5.

Differences of Childbirth Satisfaction by Labor Progress and Delivery Outcomes between Induced Labor and Spontaneous Labor Groups (N=174)

Variables		Categories	Induced labor (n=113)				Spontaneous labor (n=61)
			n	Satisfaction	t or F or r	p	n	Satisfaction	t or F or r	p
			n	M±SD	t or F or r	p	n	M±SD	t or F or r	p
Labor progress	Duration of labor^†		89		–.27	.010	60		–.14	.278
	Pain killer use	Yes	86	41.51±8.22	–1.25	.213	36	42.03±8.26	–0.68	.499
		No	27	43.70±6.91			25	43.44±7.45
	Uterine	Yes	76	41.56±7.74	0.94	.349	19	42.63±8.04	0.07	.944
	hyperstimulation^‡	No	31	43.13±7.86			37	42.78±6.60
	Fetal distress^§	Yes	54	40.54±7.28	–1.96	.050	12	43.08±8.16	0.23	.818
		No	59	43.50±8.34			46	42.49±7.92
	Medical	Yes	104	41.39±7.66	–3.02	.003	37	41.68±8.79	–1.15	.257
	management	No	9	49.44±7.84			24	44.04±6.20
Delivery outcomes	Delivery mode	NFSD	69	42.97±7.40	2.37	.099	53	43.11±7.83	3.52	.036
		NFVED	20	42.50±7.66			7	41.57±4.96
		C/S	24	38.98±9.19			1	23.00
	Postpartum	Yes	34	44.18±6.82	1.32	.190	17	42.76±4.24	–0.14	.888
	complication^†	No	55	42.05±7.71			43	43.00±8.54
	Infant outcome	Abnormal	11	41.91±9.16	–0.06	.952	6	35.40±10.21	–2.19	.032
		Normal	102	42.05±7.86			55	43.40±7.57

^† Except cesarean section → Induced labor (n=89), Spontaneous labor (n=60);

^‡ Except missing data → Induced labor (n=107), Spontaneous labor (n=56);

^§ Except missing data → Induced labor (n=113), Spontaneous labor (n=58).

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