"I'm Ready for You. Why Won't You Come, Baby?" A Narrative Study of Induction of Labour for Prolonged Pregnancy

Abstract

The voice of women's experience of prolonged pregnancy and induction of labour is largely absent in the literature. This research relays and reflects upon the stories of four women who were induced because their pregnancies were overdue. The date a woman's baby is due has assumed huge significance. However our methods for dating a pregnancy remain imprecise. Despite this, a very precise timing is recommended by some practitioners as to when to induce, since increasing length of pregnancy increases level of risk of morbidity or mortality to some babies. For the women awaiting the onset of labour and their families, the undercurrents, which affect the milieu as the days pass, include powerful dichotomies. For example the best available research makes a clear recommendation to intervene but reinforces the woman's choice of management, suggesting that it is acceptable to choose to wait. Women experience emotional vulnerability due to apprehension both about continuing to wait, and about having the increasing likelihood of an induced labour. This is a decision that comes closer and closer, yet may not be necessary - a tense 'race' of sorts is in progress. Women experience mounting physical and social pressures, and a generalised, escalating frustration. Some of the common assumptions made about what it is like for women are that it is a struggle to accept the concept of the unreliability of the due date, to parry well meaning but unhelpful comments and the associated pressure, and to remain confident and phlegmatic when there is an alternative to waiting. An increasing number of women go on to be induced. The primary indication cited is 'prolonged pregnancy'. I have employed a narrative approach, using a feminist process and story telling, to convey the experience of being overdue and being induced, together with commentary informed by the literature and reflection on practice. Here women are speaking to women. The vivid detail and openness of the stories engrave messages to caregivers regarding women's needs for support while waiting, and for more information. The stories repeat messages documented in research carried out 25 years ago. Women require best available information, wish to be included in decision making, and should be encouraged to question their midwives and other caregivers on all aspects of pregnancy and proffered interventions.