Outpatient induction of labour in the UK: a survey of practice

Abstract

Objective: To identify the current UK use of outpatient procedures for cervical ripening prior to induction of labour.

Study design: Postal survey of consultant led obstetric units within the United Kingdom. A questionnaire was sent by post to 210 NHS consultant led obstetric units within the UK. Units that provided outpatient induction of labour (OP IOL) were asked complete a series of questions defining their protocol for risk stratification and management.

Results: The survey had a 78% response rate. 17.6% of units stated that they currently or soon will provide OP IOL. All units were willing to provide OP IOL for post-dates singleton pregnancies and none provided this service for women with a previous caesarean or multiple pregnancy. 96% of inductions were initiated in a hospital setting prior to discharge home. 84% of units used Propess(®) to initiate OP IOL and 96% had a fetal assessment with CTG. Only 40% of units had a clear mechanism for assessment once the woman had gone home. 72% of units performed regular audit of their practice.

Conclusions: We suggest that robust comparative research within a UK context is urgently required to establish the safety and cost effectiveness of outpatient induction of labour before this technique becomes fully embedded in clinical care without an adequate evidence base.

Keywords: Induction of labour; Outpatient induction of labour.