title: Psychosocial outcomes of a randomized controlled trial of outpatient cervical priming for induction of labor.
abstract: BACKGROUND
  Induction of labor, an increasingly common intervention, is often preceded by the application of an agent to "prime" or "ripen" the cervix. We conducted a randomized controlled trial to compare clinical, economic, and psychosocial outcomes of inpatient and outpatient cervical priming before induction of labor. In this paper we present the psychosocial outcomes.
  
  
  METHODS
  Women participating in a randomized controlled trial in two Australian metropolitan teaching hospitals completed questionnaires to measure anxiety and depression at enrollment, and to examine satisfaction, experiences, depression, and infant feeding 7 weeks after giving birth. Data analysis was by intention to treat and by having received the intervention as intended (approximately 50% in each group).
  
  
  RESULTS
  Of 1,004 eligible women, 85 percent consented (n = 407, outpatient; n = 414 inpatient). No statistically significant or clinically relevant differences were found in immediate anxiety, depression, or infant feeding. Small, statistically significant differences favoring outpatient priming were found in seven of the nine subscales in the 7-week postpartum questionnaire. The direction of the effect was maintained, mostly with a larger effect size in women who received the intervention.
  
  
  CONCLUSIONS
  Women allocated to outpatient priming were more satisfied with their priming experience than women allocated to inpatient priming. Being informed that they could go home after cervical priming did not increase women's anxiety.
authors.affiliation: School of Psychology, University of Adelaide, Adelaide, South Australia.
authors.forename: Deborah
authors.initials: D
authors.lastname: Turnbull
authors.forename: Pamela
authors.initials: P
authors.lastname: Adelson
authors.forename: Candice
authors.initials: C
authors.lastname: Oster
authors.forename: Robert
authors.initials: R
authors.lastname: Bryce
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fereday
authors.forename: Chris
authors.initials: C
authors.lastname: Wilkinson
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods* / Q000523:psychology; D001007:Anxiety / Q000523:psychology*; D020070:Cervical Ripening; D003863:Depression / Q000523:psychology*; D015232:Dinoprostone; D005260:Female; D006760:Hospitalization; D006801:Humans; D007751:Labor, Induced / Q000379:methods* / Q000523:psychology; D010120:Oxytocics; D017060:Patient Satisfaction; D011247:Pregnancy; D013021:South Australia; D011795:Surveys and Questionnaires
chemical_list: D010120:Oxytocics; D015232:Dinoprostone
keywords: cervical priming; induction of labor; psychosocial outcomes; randomized controlled trial; women's satisfaction