Hawker Lydia A, Mundle Shuchita, Tripathy Jaya P, Deshmukh Pradeep, Winikoff Beverly, Weeks Andrew D, Kingdon Carol, Lightly Kate
Department of Women and Children's Health, University of Liverpool, Liverpool, UK (Hawker).
NagpurAll India Institute of Medical Sciences, Nagpur, India (Mundle).
AJOG Glob Rep. 2024 Aug 17;4(4):100389. doi: 10.1016/j.xagr.2024.100389. eCollection 2024 Nov.
Induction of labor (IOL) is an increasingly common intervention, but experiences and preferences of induction methods are under-researched particularly in low -and middle-income countries. Understanding these perspectives is important to improve the childbirth experience.
To explore the experiences and preferences of IOL methods for women, clinicians, and researchers in the "Misoprostol or Oxytocin for Labour Induction" (MOLI) study.
This qualitative study was based in two government hospitals in the city of Nagpur, India-one tertiary referral hospital and one women's hospital. Fifty-three semi-structured interviews with women before and after induction (between days 1 and 5 postnatal), with women recruited to the "Misoprostol or Oxytocin for Labour Induction (MOLI)" randomized controlled trial (NCT03749902). Eight focus group discussions with doctors, nurses, and trial research assistants before and during trial delivery were conducted. Thematic analysis was conducted using the Framework approach.
Four themes emerged: (1) (2) (3) , and (4) For women, the safety of their baby was more important than any IOL method. Clinicians had apprehensions over misoprostol use which could affect protocol implementation; they reported that changing perception is difficult as usual practice feels "comfortable." Women wanted to share their experiences and reported key moments during childbirth including vaginal examinations, "trying for normal," bearing the pain, waiting, and relationships with staff.
Women did not have a strong preference for the IOL method and viewed childbirth positively when maternal and neonatal outcomes were good. Labor pain, vaginal examinations, a normal birth, and interactions with staff impacted women's experiences.
引产是一种越来越常见的干预措施，但引产方法的经验和偏好研究不足，尤其是在低收入和中等收入国家。了解这些观点对于改善分娩体验很重要。
在“米索前列醇或缩宫素引产”（MOLI）研究中，探讨女性、临床医生和研究人员对引产方法的经验和偏好。
这项定性研究在印度那格浦尔市的两家政府医院进行，一家是三级转诊医院，一家是妇女医院。对参与“米索前列醇或缩宫素引产（MOLI）”随机对照试验（NCT03749902）的女性在引产前后（产后第1至5天之间）进行了53次半结构化访谈。在试验分娩前和期间，与医生、护士和试验研究助理进行了8次焦点小组讨论。采用框架法进行主题分析。
出现了四个主题：（1）（2）（3），以及（4）对女性来说，宝宝的安全比任何引产方法都更重要。临床医生对米索前列醇的使用有所顾虑，这可能会影响方案的实施；他们报告说，改变观念很困难，因为通常的做法让人感觉“舒服”。女性希望分享她们的经历，并报告了分娩期间的关键时刻，包括阴道检查、“尝试顺产”、忍受疼痛、等待以及与医护人员的关系。
女性对引产方法没有强烈的偏好，当母婴结局良好时，她们对分娩持积极态度。分娩疼痛、阴道检查、顺产以及与医护人员的互动影响了女性的体验。
