First-time mothers safe to spend first 24 hours of induced labour at home

First-time mothers are safe to spend the first 24 hours of induced low-risk labour in the comfort of their own homes, a study conducted by researchers from the Royal College of Surgeons and the Rotunda Hospital has suggested.

The RCSI-Rotunda HOME INDUCTION study examined what happens when first-time mothers choose to have labour induced as an outpatient at 39 weeks and then return home to wait for labour to start. 

The findings, published in The Lancet, showed that the mothers’ experiences were generally positive, and that there were no additional risks for the birth.

The study comprised a randomised trial which compared methods of induction at 39 weeks in the outpatient setting for 271 normal-risk first-time mothers. Each mother had labour induced as an outpatient, either with a prostaglandin gel or a device that dilates the cervix, then went home for 12-24 hours before returning to the hospital to give birth.

The study showed that both induction approaches were safe and effective in the outpatient setting. Three-quarters of the mothers in the study successfully delivered their babies vaginally, which meant there was no increased risk of Caesarean delivery compared to women who choose to continue their pregnancy. Patient surveys demonstrated high levels of patient satisfaction on the study. 

Fergal Malone, professor of obstetrics and gynaecology, RCSI and consultant in obstetrics and gynaecology, Rotunda Hospital, said: “Induction of labour at 39 weeks’ gestation has been shown to be safe and effective for first-time mothers, and it minimises the chances of Caesarean section while maximising safety for mother and baby, and if mothers would like to start the process of induction in an outpatient setting, it could help to alleviate the pressure on busy maternity hospitals,”

Prof Malone, who was the lead author of the study, continued: “But until now, there has been minimal data available to guide mothers, midwives and obstetricians on how safe and effective it is to start the induction of labour as an outpatient.” 

“Given that more patients are now choosing induction of labour, this is causing challenges for busy maternity hospitals which struggle to manage these large patient numbers while trying to optimise patient comfort and safety. Outpatient induction of labour is an emerging system that might enable larger numbers of patients to choose induction if that is their preference, while remaining in the comfort of their own home.”