Background. In 1985, the World Health Organization (WHO) stated that no country should have an induction rate higherthan 10%. Inappropriate use of induction technology in childbirth is leading to higher rates of induction, more instrumentalbirth and lower rates of vaginal birth. Many countries do not routinely collect data on induction and this study wasundertaken in Jordan in 2004, where this type of data were not collected.Aim. This paper provides a description of one small aspect of a large doctoral study and presents the first baseline data onbirth outcomes for a prospective, self-selected cohort of 200 primiparous women, who gave birth in one major maternityhospital in Northern Jordan.Method. An exploratory, descriptive approach was necessary to collect data from a prospective cohort of women booking fortheir first pregnancy at one large maternity unit. A convenience sample was selected and all women who booked for their firstpregnancy in one major unit during the 12-week period allocated to recruitment were eligible to participate (n=530). Datawere analysed using SPSS version 11 and will be presented in this paper descriptively. Ethical approval was granted from theHuman Subject Committee at Jordan University of Science and Technology.Findings. Although 530 primiparous women booked during the study period, a full data set of three entries for eachparticipant was available for only 200 women. Of these, the majority (n=161, 81%) underwent induction of labour. Half(n=100) of the babies were admitted to the neonatal intensive care unit for resuscitation after birth and 19 were re-admittedto hospital within the first four weeks, mainly due to respiratory problems. A total of 25 mothers (13%) were re-admittedto hospital within four weeks of birth with urinary tract infection, anaemia, mastitis and wound infection. This research waslimited due to the lack of randomisation, geographical clustering and the need for multi-centre involvement. However, itdemonstrates sufficient evidence to support the recommendation for the development of a national data set on maternal andinfant morbidity and mortality (including induction rates), as well as the development of a national policy for the promotionof ‘normal’ birth. Further international research in this area is required in order to pool data.
|Journal||Evidence Based Midwifery|
|Publication status||Published - 2008|
Bibliographical noteReference text: Abu-Ekteish F, Daud A, Sunna E, Obeidat A, Al-Rimawi HS. (1997) Perinatal
mortality at Princess Badia’ Teaching Hospital, northern Jordan. Annals of
Saudi Medicine 17(1): 120-3.
Alexander J, MCIntire D, Leveno JK. (2000) Forty weeks and beyond: pregnancy
outcomes by week of gestation. Obstetric and Gynaecology 96(2):
Bade’a Hospital. (2004) Type and number of deliveries. Annual Report.
Bade’a Hospital Statistics Office: Irbid.
Bailit JL, Downs SM, Thorp JM. (2002) Reducing the caesarean delivery
risk in elective inductions of labour: a decision analysis. Paediatr Perinat
Epidemiol 16(1): 90-6.
Boulvain M, Marcoux S, Bureau M, Fortier M, Fraser W. (2001) Risks of
induction of labour in uncomplicated term pregnancies. Paediatric and
Prenatal Epidemiology 15: 131-9.
Boulvain M, Stan C, Irion O. (2005) Membrane sweeping for induction of
labour. Birth 32(2): 152.
Chamberlain G, Zander L. (1999) ABC of labour care: induction. BMJ
Central Intelligence Agency. (2006) The world factbook – Jordan. Central
Intelligence Agency: Washington.
Department of Statistics. (2002) Population and family health survey.
id=18&SrvyTp= (accessed 25 November 2008).
Dosa L. (2001) Caesarean section delivery, an increasingly popular option. Bull
World Health Organ 79(12): 1173.
Dublin S, Lydon-Rochelle M, Kaplan RC, Watts DH, Critchlow CW. (2000)
Maternal and neonatal outcomes after induction of labor without an
identified indication. Am J Obstet Gynecol 183(4): 986-94.
Duff C, Sinclair M. (2000) Exploring the risks associated with induction of labour:
a retrospective study using the NIMATS database. Northern Ireland
maternity system. Journal of Advanced Nursing 31(2): 410-7.
Enkin M, Keirse M, Renfrew M, Neilson J, Crowther C, Duley L, Hofmeyr
G. (2000) A guide to effective care in pregnancy and childbirth. Oxford
University Press: Oxford.
Fraser WD, Turcot L, Krauss I, Brisson-Carrol G. (2000) Amniotomy for
shortening spontaneous labour: In: Cochrane Database Syst Rev. The
Cochrane Library Issue 2: CD000015. John Wiley and Sons: Chichester.
Goldberg J, Holtz D, Hyslop T, Tolosa J. (2002) Has the use of routine episiotomy
decreased? Examination of episiotomy rates from 1983 to 2000.
Obstetric and Gynaecology 99(3): 395-400.
Haggerty LA. (1999) Continuous electronic fetal monitoring: contradictions
between practice and research. J Obstet Gynecol Neonatal Nurs 28(4):
Hannah WJ. (1996) Induction of labour: post-term pregnancy and term prelabour
rupture of membranes – evidence for practice. Journal of Society of
Obstetricians and Gynaecologist of Canada 18: 85-9.
Heffner LJ, Elkin E, Fretts RC. (2003) Impact of labor induction, gestational
age, and maternal age on cesarean delivery rates. Obstet Gynecol 102(2):
Hoffman MK, Vahratian A, Sciscione AC, Troendle JF, Zhang J. (2006). Comparison
of labor progression between induced and noninduced multiparous
women. Obstet Gynecol 107(5): 1029-34.
King Abdullah University Hospital. (2004) Type and number of deliveries. Annual
Report. King Abdullah University Hospital Statistics Office: Irbid.
Kelly AJ, Tan B. (2001) Intravenous oxytocin alone for cervical ripening
and induction of labour: In: Cochrane Database Syst Rev. The Cochrane
Library Issue 3: CD003246. John Wiley and Sons: Chichester.
National Institute for Health and Clinical Excellence. (2001a) Induction of
labour. NICE: London.
National Institute for Health and Clinical Excellence. (2001b) The use of
electronic fetal monitoring. NICE: London.
Oakley A. (1984) The captured womb: a history of the medical care of pregnant
women. Blackwell: Oxford.
Parahoo K. (1997) Nursing research: principles processes and issues. Macmillan:
Seyb S, Berka R, Socol M, Dooley S. (1999). Risk of cesarean delivery with
elective induction of labor at term in nulliparous women. Obstetrics and
Gynecology 94(4): 600-7.
Sinclair M. (1999) Midwives’ readiness to use high technology in the labour
ward. Implications for Education and Training. Queen’s University Belfast
(unpublished PhD thesis).
Sinclair MK. (2001a) Midwifery managers’ perspectives on midwives’ use
of birth technology. All Ireland Journal of Nursing & Midwifery 1(6):
Sinclair MK. (2001b) Birth technology: observations of high usage in the
labour ward. All Ireland Journal of Nursing & Midwifery 1(3): 83-8.
Sinclair MK. (2001c) Midwives’ attitudes to the use of the cardiotocograph
machine. Journal of Advanced Nursing 35(4): 559-606.
Sinclair MK, Gardner J. (2001) Midwives’ perceptions of the use of technology
in assisting childbirth in Northern Ireland. Journal of Advanced
Nursing 36(2): 229-36.
Sinclair M, Crozier K. (2004) Medical device raining in maternity care: part 2.
British Journal of Midwifery 12(8): 509-13.
Sinclair MK, Boreland, Z, McCabe, N. (2007) Less intervention. RCM Midwives
Journal 10(4): 214.
Tan BP, Hannah ME. (2000a) Oxytocin for prelabour rupture of membranes
at or near term: In: Cochrane Database Syst Rev. The Cochrane Library
Issue 2: CD000157. John Wiley and Sons: Chichester.
Tan BP, Hannah M. (2000b) Prostaglandins for prelabour rupture of membranes
at or near term: In: Cochrane Database Syst Rev. The Cochrane
Library Issue 2: CD000178. John Wiley and Sons: Chichester.
Thacker S, Stroup C. (1999). Continuous electronic heart rate monitoring
versus intermitten auscultation for assessment during labor: In: Cochrane
Database Syst Rev. The Cochrane Library Issue 4. Update Software:
Wagner M. (1994) Pursuing the birth machine – the search for appropriate
birth technology. ACE Graphics: Camperdown.
World Health Organization Regional Office for Europe. (1985) Joint Interregional
Conference on Appropriate Technology for Birth. WHO: Fortaleza,
World Health Organization. (1996) Care in normal birth: a practical guide.
World Health Organization. (2004) Making pregnancy safer statistics in EMR
– part one. WHO: Geneva.
World Health Organization. (2006) Reproductive health indicators – guidelines
for their generation, interpretation and analysis for global monitoring.
Yeast JD, Jones A, Poskin M. (1999) Induction of labour and the relationship
to caesarean delivery: a review of 7001 consecutive inductions. American
Journal of Obstetrics and Gynecology 180(3): 628-33.