European study highlights need to improve the quality of conversations about induction of labour (IoL) in clinical settings

Norgine B.V. (Norgine), a leading European specialist pharmaceutical company, today presented the findings of a survey at the EBCOG European Congress in Obstetrics and Gynaecology, in Krakow, Poland.

• Almost 1 in 2 women (49%) felt the experience of IoL differed from their expectations
• The majority of expectant mothers (65%) did not feel fully involved in choosing which method of IoL they prefer
• Findings emphasize the importance of collaborative decision-making between healthcare professionals and expectant mothers

This study highlights the need to increase quality conversations and informed shared decision-making between expectant mothers and their healthcare professionals when it comes to induction of labour (IoL). [1]

IoL is one of the most frequently performed obstetric interventions globally [2] . The survey findings suggest that obstetricians and midwives make a difference by actively enhancing the dialogue with expectant mothers to support the collaborative decision-making process. [1] The study demonstrates a clear need to increase the provision of more detailed and timely information about IoL to expectant mothers, to further support their informed choices about IoL. [1]

The online survey was conducted across five European countries: Austria, France, Germany, the Netherlands and Sweden. It included mothers aged 18-44 years, who had undergone IoL and had a singleton birth within the previous two months of completing the survey questionnaire. [1]

Induction of labour is a very common procedure in pregnancy. Expectant mothers need to feel actively involved in their care and empowered to hold in-depth conversations with healthcare professionals. Providing comprehensive information about the IoL options available and taking into account women's preferences are important to enable mothers to make informed choices of what's best for them and their baby.

Dr David Gillen, Chief Medical Officer of Norgine, added: "This study highlights an unmet need for information and enhanced dialogue around the induction of labour. Shared decision-making in healthcare is vital and we should make every effort to support healthcare professionals with better tools to facilitate collaborative decisions with expectant mothers."

Key findings include:

Addressing the impact of lack of information about IoL remains an unmet need

• A third of women did not know what to expect from IoL [1]
• 49% felt their experience differed from what they expected [1]
• About half (51%) researched additional information by themselves [1]

Encouraging quality conversations on IoL between expectant mothers and their healthcare professionals is key

• Over a third (36%) disagreed that IoL methods were discussed thoroughly with them [1]
• 41% disagreed that they had a full understanding of the various IoL methods [1]

Supporting women and birthing people to receive better information to make informed choices about IoL in collaboration with their HCPs

• The majority (65%) did not feel they were fully in charge of choosing their IoL method [1]
• Only 56% felt satisfied with the medical support they had received during the IoL process and 36% stated that communication about the variety of induction methods and their benefits and risks could have been improved [1]
• Those who did not feel fully informed were more likely to state they did not have a full understanding of IoL options and feel less involved in the final decision making [1]

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Notes to Editors:

About induction of labour (IoL)

Induction of labour is defined by the World Health Organisation (WHO) as the process of artificially stimulating the uterus to start labour. There are a number of methods to achieve this and may include pharmacological treatment such as administering prostaglandins or oxytocin or by manually rupturing the amniotic membranes. [3]

There are a number of circumstances where the considered risk to foetal or maternal health outweigh the wait for spontaneous labour. These may include gestational age of 41 completed weeks or more, pre-labour rupture of amniotic membranes, hypertensive disorders, maternal medical complications and fetal death among others. Each case is considered on its own merit. [3]

Induction of labour, may cause discomfort due to the procedure itself and due to the woman's restricted mobility. To avoid any potential risks, the woman and her baby should be monitored closely. [3]

About the study

Introduction and aims: Rates of induction of labour (IoL) are rising and there is increasing awareness of the importance of taking into account women's preferences regarding how they will be induced. However, evidence suggests that women currently do not feel sufficiently involved in the decision-making process. This study evaluated women's experience with IoL prior to giving birth, focussing on their interaction with healthcare professionals, the level of knowledge they had before IoL and the kind of information they received. Methods: An online questionnaire was carried out in Austria, France, Germany, the Netherlands and Sweden. Respondents were recruited through social media platforms and included if they were aged 18–44 years, had IoL and a singleton birth ≤8 weeks ago. Results: Of the 3,800 women who started the questionnaire, 350 (9%) met the inclusion criteria and completed it. One-third of women did not know what to expect from IoL and 49% felt the experience differed from their expectations. Over a third (36%) disagreed that IoL methods were discussed thoroughly with them, 41% disagreed that they had a full understanding of the various methods and 51% researched additional information by themselves. The majority (65%) did not feel they were fully in charge of choosing the IoL method, only 56% felt satisfied with the medical support they had received, and 36% stated that medical support/communication could have been improved. Those who did not feel fully informed were more likely to state they did not have a full understanding of IoL options and felt less involved in the final decision making. Conclusions: Despite the inherent risk of a selection bias, many women do not seem to know what to expect from IoL due to the lack of information. Providing more detailed and timely information may allow for a more informed and collaborative decision-making process. [1]

About Norgine

Norgine is a leading European specialist pharmaceutical company that has been bringing transformative medicines to patients for over a century. Our commitment to transforming people's lives drives everything we do and our European experience, fully integrated infrastructure and exceptional partnership approach enable us to quickly apply creative solutions to bring life-changing medicines to patients that they may not otherwise be able to access. Norgine is proud to have helped 24 million patients around the world in 2021 and generated €505 million in net product sales, a growth of 10% over 2020.

Norgine has a direct presence in 16 European countries, as well as Australia and New Zealand. We also have a strong global network of partnerships in non-Norgine markets. We are a flexible and fully integrated pharmaceutical business, with manufacturing (Hengoed, Wales and Dreux, France), third party supply networks and significant product development capabilities, in addition to our sales and marketing infrastructure. This enables us to acquire, develop and commercialise specialist and innovative products that make a real difference to the lives of patients around the world.

NORGINE and the sail logo are trademarks of the Norgine group of companies.

References

[1] Johal G., Watson M. Are expectant mothers sufficiently involved in the decision-making process regarding induction of labour? A European survey, Accepted by EBCOG for publication as an abstract in the European Journal of Obstetrics and Gynaecology, 2023

[2] Marconi AM. Recent advances in the induction of labor. F1000Res. 2019 Oct 30;8:F1000 Faculty Rev-1829. doi: 10.12688/f1000research.17587.1. PMID: 31723412; PMCID: PMC6823899

[3] WHO Recommendations for Induction of Labour 2011, WHO Press, World Health

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