Swedish maternity care professionals' perception of labor induction

Gabriel Raoust; Stefan Rocco Hansson; Petri Kajonius

doi:10.1016/j.midw.2024.103997

Swedish maternity care professionals' perception of labor induction

Midwifery. 2024 Apr 11:133:103997. doi: 10.1016/j.midw.2024.103997. Online ahead of print.

Authors

Gabriel Raoust¹, Stefan Rocco Hansson², Petri Kajonius³

Affiliations

¹ Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, BMC C14, 221 84 Lund, Sweden; Women's Health Clinic, Ystad Hospital, Kristianstadsvägen 3A, Ystad 271 33, Sweden. Electronic address: gabriel.raoust@med.lu.se.
² Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, BMC C14, 221 84 Lund, Sweden; Women's health clinic, Skåne University Hospital, Klinikgatan 12, Lund 221 85, Sweden.
³ Department of Psychology, Lund University, Box 213, Lund 221 00, Sweden.

PMID: 38636350
DOI: 10.1016/j.midw.2024.103997

Abstract

Background: Sweden recently adopted new labor induction guidelines lowering the threshold for post-term pregnancies to 41+ weeks. Despite evidence-based foundation, these guidelines stirred controversy among maternity care professionals, who voiced concerns about potential risks and unintended consequences, such as a rising Caesarean section rate. Midwives also highlighted potential impacts on their roles, workload, and working environment; implications that could affect obstetricians and gynecologists as well. Investigating Swedish maternity care professionals' views on labor induction could benefit policymakers, managers, and birthing women alike.

Aim: The aim of this study was to describe and compare midwives to obstetricians/gynecologists, with regards to their views on labor induction, and how this relates to other work-related variables such as overall job satisfaction, clinical experience, gender, age, personality, and workload.

Methods: Swedish midwives (N = 207, 99 % women, M = 45.2 years), and obstetricians/gynecologists (N = 240, 83 % women, M = 44.3 years) responded to an online questionnaire reflecting aspects of maternity care work. The data was analyzed using Welch's t-test and Pearson's correlation analysis.

Results: A large difference was observed in labor induction views between midwives and obstetricians/gynecologists (d = 1.39), as well as lower job satisfaction with midwives (d = -0.26). Overall job satisfaction further correlated negatively with views on labor induction (r = -0.30).

Conclusions: Labor inductions might pose challenges to midwives and could bring to light underlying tensions between obstetricians/gynecologists and midwives. Given the modest response rate of the study, we cautiously suggest that while the development of new maternity care guidelines should be grounded in evidence, they should also embrace concerns and insights from a diversity of professional perspectives.

Keywords: Childbirth; Labor induction; Midwives; Obstetrics; Personality; Physicians; Social psychology; Stress; Work Satisfaction.