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Patient Education to Reduce Elective Labor Inductions

Simpson, Kathleen Rice PhD, RNC, FAAN; Newman, Gloria MSN, RNC; Chirino, Octavio R. MD, FACOG, FACS

MCN, The American Journal of Maternal/Child Nursing: July-August 2010 - Volume 35 - Issue 4 - p 188–194
doi: 10.1097/NMC.0b013e3181d9c6d6

Purpose: To reduce elective inductions among nulliparous women in a community hospital by adding standardized education regarding induction risks to prepared childbirth classes.

Study Design and Methods: Elective induction rates were compared between class attendees and nonattendees before and after the standardized content was added to prepared childbirth classes. A survey of nulliparous women's decisions regarding elective induction was conducted.

Results: Elective induction rates of 3,337 nulliparous women were evaluated over a 14-month period (n = 1,694, 7 months before adding content to classes; n = 1,643, 7 months after). Rates did not differ between class attendees (35.2%, n = 301) and nonattendees (37.2%, n = 312, p = .37) before the content was included. However, after standardized education was added, class attendees were less likely to have elective induction (27.9%, n = 239) than nonattendees (37%, n = 292, p < .00). Sixty-three percent of women who attended the classes and did not have elective induction indicated that the classes were influential in their decision. Physicians offered the option of elective induction to 69.5% (n = 937) of survey participants. This was a factor in women's decisions; 43.2% (n = 404) of those offered the option had elective induction, whereas 90.8% (n = 374) of those not offered the option did not have elective induction.

Clinical Implications: Education regarding elective induction offered during prepared childbirth classes was associated with a decreased rate among nulliparous women who attended classes when compared to those who did not attend. Patient education may be beneficial in reducing elective inductions.

Everyone in our field is now coming to an understanding about the dangers of elective inductions without medical indication, yet these procedures continue to occur. Who is teaching the patients about their choices? Dr. Simpson is, and has done this study to show you that the women can make the best choice for their health when given the total information.

Kathleen Rice Simpson is a Perinatal Clinical Nurse Specialist, Gloria Newman is Manager, Women's and Children's Education, and Octavio R. Chirino is Chairman, Department of Obstetrics and Gynecology, St. John's Mercy Medical Center, St. Louis, MO. Dr. Simpson can be reached via e-mail at

The authors have disclosed that there are no financial relationships related to this article.

Funding provided by Lamaze International and the Department of Obstetrics and Gynecology at St. John's Mercy Medical Center in St. Louis, MO.

For 15 additional continuing nursing education articles on topics related to obstetrics, go to

© 2010 Lippincott Williams & Wilkins, Inc.