Attitude of Pregnant Women Toward Induction of Labor in a Secondary Health Facility in Nigeria

Sunday, 28 July 2019: 1:00 PM

Juliana Ayafegbeh Afemikhe, PhD, RN, RM, RPHN
Department of Nursing Science/Centre of Excellence in Reproductive Health Innovation (CERHI), University Of Benin, Benin City, Nigeria
Tochukwu Michael Ugwumba, BNSc, RN, RM
Department of Clinical Nursing, University of Benin Teaching Hospital, Benin City, Nigeria

Purpose:

Childbirth is a major life experience and a significant life changing outcome that could have short and long term influences on the well-being of women (Reisz, Jacobvitz, George, 2015). The timely normal birth of a child for obstetrical, medical and social reason has been of great interest overtime. Situations however exist in which this is not possible and thus induction may be an option. Induction of labor is a procedure for creating artificial uterine contractions after 28 weeks of gestation prior to the onset of spontaneous labor with the aim of achieving a vaginal delivery (Bello & Akinyotu, 2016). The use of induction of labor has been on the increase globally with a prevalence of 20-30% in the developed countries (Zeitlin, Mohangoo, Delnord & Cuttini, 2013). Although the use is on the increase it is underutilized in Africa and in Nigeria, it accounts for about 6.3% of deliveries (Bukola, Idi, M′Mimunya, Jean-Jose, Kidza, Isilda, et al. 2012). Timely delivery of a baby through induction may be as a result of obstetrical, medical or social factors as well as a maternal request (Bello & Akinyotu, 2016). Induction of labor can be achieved using mechanical methods such as artificial rupture of membrane or amniotomy, Foley’s catheter, or pharmacologic method with the use Oxytocin and Prostaglandins (McCarthy & Kenny, 2014). These methods may be used singly or combined (Reisz, Jacobvitz, George, 2015). World Health Organization (WHO) (2012) recommends that indications for induction of labor should be a medical problem and when the expected benefits of an induction outweigh potential harm to mother and baby. In Nigeria women’s views and attitude particularly pregnant women, towards induction have not been very well researched. It is as a result that this study assessed the views and attitude of pregnant women towards induction of labor. It also examined the relationship between health education provision and attitude of pregnant women towards induction of labor.

Methods:

A descriptive cross sectional study was conducted in a Secondary Health Facility in Benin City in 2017. The population was estimated through collecting the number of patients for four consecutive months and applying Taro Yamane formula for determining sample size which gave 212 women attending the ante natal clinic, selected through convenient sampling method. A self-constructed questionnaire was utilized in collecting data on women’s demographic and obstetric data as well as their views and attitude towards induction of labor. The questionnaire consisted of three sections; Section A consisted of seven questions on demographic data, section B had seven items on obstetrics experiences and section C consisted of six items on their views and attitude towards induction. The reliability of the instrument was determined using test retest method and the co-efficient was 0.85. Ethical approval was obtained from the Research Ethics and Review Committee of the health facility and both written and oral consent was obtained from the respondents after adequate information on the research had been given. A total of 200 usable questionnaires were retrieved and analyzed using descriptive statistics of frequency and percentages to summarize the respondents’ responses and characteristics. Significant relationship between the provision of health education and attitude towards induction of labor was tested using chi square.

Results:

A majority of the respondents (64%) had positive attitude towards induction of labor and only 79% revealed that they will recommend it to other women. History of previous induction was found to be a predictor of positive attitude. Among the respondents 39% had induction of labor with previous deliveries and 76% of respondents in this group had positive attitude. Only 48% of respondents who had experienced induction were given health education before the induction. The chi-square calculated of 41.003 was significant at 0.009; hence the null hypothesis was rejected with the conclusion that there is a significant relationship between the provision of health education on induction of labor and the attitude of respondents.

Conclusion:

Induction of labor is of value to both mother and child as the benefits of early delivery usually outweigh the risk of delay through continuation of pregnancy. Adequate preparation of pregnant women for induction through health education and counselling is suggested as a strategy to improve patients’ attitude and probably satisfaction with the induction of labor.

See more of: O 12
See more of: Research Sessions: Oral Paper & Posters