Megan Cooper

Improving women's knowledge of prostaglandin induction of labour through the use of information brochures: A quasi-experimental study

RESEARCH QUESTION To gain a better understanding of womens baseline level of knowledge of induction of labour (IOL) and determine whether giving written information at the time IOL is decided, results in significant differences in knowledge and understanding of the process. METHODS Fifty pregnant women undergoing antenatal care at a small maternity hospital were recruited. A quasi experimental trial was conducted with non random selection of participants, 25 selected to act as the control group and 25 selected as the intervention group. The study was conducted to determine womens knowledge of IOL both before (non-intervention) and after (intervention) the introduction of a written information brochure. RESULTS Statistically significant increases in knowledge were evident in the intervention group for knowledge about action (p=0.002) and timing of prostaglandins (p=0.03), the number of side effects known (p<0.0001) as well as time to birth (p=0.001) indicating an increased understanding of the process as a result of reading an information brochure. DISCUSSION These results suggest that those in the non-intervention group lacked knowledge pertinent to IOL, even though they have consented to and actually arrived at the hospital prepared to undergo the IOL procedure. The most significant disparity noted between the intervention and non-intervention groups was womens knowledge of side effects of prostaglandin. Further to this, many women in the non-intervention group had unrealistic expectations of both the time for drug action and likely time from prostaglandin administration to birth. In contrast women in the intervention group knew about the common side effects of prostaglandin and possessed a more realistic understanding of the likely time to birth following this procedure. CONCLUSIONS The results indicate that a specifically designed information brochure explaining the process of IOL in plain language has the effect of enhancing womens knowledge. This area of study warrants further investigation, especially research into the role of written information to improve womens understanding across other areas of maternity care education provision.

Water immersion policies and guidelines: How are they informed?

BACKGROUND Water immersion for labour and birth is consistently challenged as a practice lacking support from high quality evidence. Despite this, the option is available to Australian women. Practitioners are guided by policies and guidelines however, given the research paucity, questions surround the way in which water immersion policies and guidelines are informed. AIMS The aims of the study were to determine how water immersion policies and/or guidelines are informed and to what extent the policy/guideline facilitates the option of water immersion for labour and birth with respect to womens choice and autonomy. METHODS Phase two of a three phase mixed methods study used critical, post structural interpretive interactionism to examine the process of development and implementation of water immersion policies and guidelines from informants experience. Semi-structured interviews were conducted with 12 Australian participants. FINDINGS Participants highlighted that the lack of randomised controlled trials had resulted in other forms of evidence being drawn upon to inform water immersion policies and guidelines. This was influenced in part by individual interpretations of evidence with medical views taking precedence. This sometimes resulted in policy and guideline documents that were restrictive with this impacting on womens ability to access the option. CONCLUSION Perceived limitations of research and the subsequent translation of this perceived paucity of evidence into policies and guidelines, has impacted on womens ability to exercise choice and autonomy with respect to water immersion and indeed, on the professional autonomy of practitioners who wish to facilitate it.