Swedish maternity care professionals’ perception of labor induction

Abstract

Background: Sweden recently adopted new labor induction guidelines lowering the threshold for post-term pregnancies to 41+ weeks. Despite evidence-based foundation, these guidelines stirred controversy among maternity care professionals, who voiced concerns about potential risks and unintended consequences, such as a rising Caesarean section rate. Midwives also highlighted potential impacts on their roles, workload, and working environment; implications that could affect obstetricians and gynecologists as well. Investigating Swedish maternity care professionals’ views on labor induction could benefit policymakers, managers, and birthing women alike. Aim: The aim of this study was to describe and compare midwives to obstetricians/gynecologists, with regards to their views on labor induction, and how this relates to other work-related variables such as overall job satisfaction, clinical experience, gender, age, personality, and workload. Methods: Swedish midwives (N = 207, 99 % women, M = 45.2 years), and obstetricians/gynecologists (N = 240, 83 % women, M = 44.3 years) responded to an online questionnaire reflecting aspects of maternity care work. The data was analyzed using Welch’s t-test and Pearson’s correlation analysis. Results: A large difference was observed in labor induction views between midwives and obstetricians/gynecologists (d = 1.39), as well as lower job satisfaction with midwives (d = -0.26). Overall job satisfaction further correlated negatively with views on labor induction (r = -0.30). Conclusions: Labor inductions might pose challenges to midwives and could bring to light underlying tensions between obstetricians/gynecologists and midwives. Given the modest response rate of the study, we cautiously suggest that while the development of new maternity care guidelines should be grounded in evidence, they should also embrace concerns and insights from a diversity of professional perspectives.