Labor Induction Compared with Expectant Management

Allison Kilroy, Katherine Bryan, Alli Yant, Holly McKnight, Celeste Hutchisson

Do full-term, low-risk, pregnant women who are electively induced

have a higher rate of birth complications or cesarean delivery,
compared with expectant management?

Clinical Significance Review of Literature Recommendations for Practice

• Some studies showed benefits from
• Expectant management: the
induction of labor, including decreased rates
absence of interventions to
of unplanned cesarean section and more
augment the initiation of labor
positive outcomes compared to expectant
• Induction of labor: intervening to
management (Grobman et al., 2018).
initiate the onset of labor.
• This particular question was • There is evidence showing induction with
formulated to compare findings of synthetic oxytocin failed 8-50% of the time,
birth complications and rates of which caused increased maternal and fetal
cesarean deliveries in both elective morbidity and mortality (Demirel & Guler,
induction and expectant 2015).
management groups, in hopes of • Research shows that induction of labor is
determining more precise nursing beneficial to neonatal and maternal
clinical guidelines. outcomes; however, the benefits of induction
prior to this gestational period (37-39 weeks)
remain largely inconclusive (Sinkey et al.,
Search Strategy
2018).
Resources used: • Cesarean section delivery rates were lower
• CINAHL, PubMed, Cochrane in women that were electively induced,
Library compared with expectant management
Key words: across all gestational ages and parities
(Darney et al., 2013)
• “expectant management,”
“induction of labor,” “full-term,” “low- • Rates of NICU admission were higher in the
risk,” “pregnant women,” “birth induction of labor group at 37 weeks and 38
complications,” “outcomes,” weeks and lower at > 42 weeks respectively
“synthetic oxytocin” (Zhao et al., 2017).
RESEARCH POSTER PRESENTATION DESIGN © 2015
Registered nurses should be educated on all
methods of labor in order to adequately
educate patients on birth methods, such as
induction of labor or expectant management.
(Grade C)
• With proper education that is provided by a
registered nurse, patients can make educated
decisions that will keep themselves and their
infants from experiencing adverse maternal and
fetal outcomes.
• Personal health characteristics play a key role in
determining what method is best for each
patient.
• This requires that cervical and fetal status are
evaluated before an induction method is chosen.
Discussion
Ultimately, the nurse’s role in labor induction
or management is to be able to provide
quality patient education on all available
methods of delivery in order to ensure the
most positive patient outcomes for both
mother and infant.

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