Background: Although induction of labour is a safe procedure for the pregnant woman at term, the process is not without risk. In recognition of these challenges associated with induction, an audit of local service provision was undertaken.
Aim: To identify problems with the existing induction service.
Methods: This was a retrospective analysis of women’s notes from May to December 2016. All patient records of pregnant women who had received induction during this time (n=870) were examined, as well as complaints and feedback received by the service.
Findings: The audit identified several issues that would need to be addressed if the service was to be improved. These concerns were divided into two groups: the pregnant woman’s perspective and service provision issues.
Conclusion: A new induction of labour pathway was created that aimed to address some of the concerns identified by the audit, and improve the care that women received. A further audit was conducted to assess the improvement in care as a result.
Cooper M, Warland J. Improving women’s knowledge of prostaglandin induction of labour through the use of information brochures: A quasi-experimental study. Women Birth. 2011;24(4):156–164. https://doi.org/10.1016/j. wombi.2010.10.003
Department of Health. NHS Internal Audit Standards. London: Department of Health; 2012
Downe S, Finlayson K, Fleming A. Creating a collaborative culture in maternity care. J Midwifery Womens Health. 2010;55(3): 250–4 Freeman G, Hughes J. Continuity of care and the patient experience: An Inquiry into the Quality of General Practice in England. London: The Kings Fund; 2010
Flottorp SA, Jamtvedt G, Gibis B, McKee M. Using audit and feedback to health professionals to improve the quality and safety of health care. Copenhagen: World Health Organisation; 2010
Gatward H, Simpson M, Woodhart L, Stainton MC. Women’s experiences of being induced for post-date pregnancy. Women Birth. 2010;23(1):3–9. https://doi.org/10.1016/j. wombi.2009.06.002
Gokturk U, Cavkayatar S, Danisman N. Can measurement of cervical length, fetal head position and posterior cervical angle can be an alternative method to Bishop Score in the prediction of successful labour induction? Journal of Maternal-Fetal and Neonatal Medicine. 2014;28(11): 1-6. https://doi.org/10.3109/1 4767058.2014.954538
Henderson J, Redshaw M. Women’s experience of induction of labor: a mixed methods study. Acta Obstet Gynecol Scand. 2013;92(10):1159–67
Hildingsson I, Karlström A, Nystedt A. Women’s experiences of induction of labour--findings from a Swedish regional study. Aust N Z J Obstet Gynaecol. 2011;51(2):151-7. https://doi. org/10.1111/j.1479-828X.2010.01262.x
Jozwiak M, Bloemenkamp KW, Kelly AJ, Mol BW, Irion O, Boulvain M. Mechanical methods for induction of labour. Cochrane Database Syst Rev. 2012;14(3):CD001233
Kent County Council. Kent County Council Housing Led Forecast (September 2017). Maidstone: Strategic Business Development Intelligence; 2017
McCarthy FP, Kenny LC. Induction of labour. Obstetrics, Gynaecol Reprod Med. 2014;24(1):9–15. https://doi.org/10.1016/j. ogrm.2013.11.004
National Institute for Health and Clinical Excellence. How to Change Practice: Understand, identify and overcome barriers to change. London: NICE; 2007
National Institute for Health and Clinical Excellence. Induction of Labour [CG70]. London: NICE; 2008
National Institute for Health and Care Excellence. Insertion of a double balloon catheter for induction of labour in pregnant women without previous caesarean section [IPG528]. London: NICE; 2015
National Maternity Review. Better Births: Improving Outcomes of Maternity Services in England. London: NHS England; 2016 NHS Digital.
NHS Maternity Statistics England 2016-17. 2017. http://digital.nhs.uk/catalogue/PUB30137 (accessed 20 February 2018)
Nicholas E, Qureshi H. Developing outcome-focused practice: examining the process. Research Policy and Planning. 2004;22(3):1-14
Schwarz C, Gross MM, Berger B. Women’s perceptions of induction of labour outcomes: Results of an online survey in Germany. Midwifery. 2016;35:3-10
Shetty A, Burt R, Rice P, Templeton A. Women’s perceptions, expectations and satisfaction with induced labour—A questionnaire-based study. Eur J Obstet Gynecol Reprod Biol. 2005;123(1):56-61. https://doi.org/10.1016/j. ejogrb.2005.03.004
Sidani S. Health Intervention Research: Understanding Research Design and Methods. London: Sage Publishing; 2015
Spiby H, Walsh D, Green J et al. Midwives’ beliefs and concerns about telephone conversations with women in early labour Midwifery. 2014;30: 1036-42.
Tsang JCK, Wyn Jones N. Antepartum fetal health Obstetrics, Gynaecology and Reproductive Medicine. 2014;24(3):80-4. https://doi.org/10.1016/j.ogrm.2014.01.002
Twycross A., Shorten A. Service evaluation, audit and research: what is the difference? Evidence Based Nursing. 2014;17(3):65-6