Analisi qualitativa dei vissuti delle donne sottoposte ad induzione di travaglio di parto

Introduction It is estimated that 25% of labor delivery is medically induced in Italy. This procedure requires hospitalization and this means that the woman has to stay in a different environment and not at home with her family. As we all know in hospitals there are many healthcare professionals and other patients with their families waiting for active labor. Induction includes medical and pharmacological interventions aimed at determining the onset and maintenance of labor. What the woman remembers of her experience can therefore be profoundly influenced by everything that happens from the hospitalization. Aim of the study This qualitative research aims to provide an overview of what has been experienced by women from hospitalization for the induction of labor to the moment when they enter the delivery room in active labor, through the ward of Obstetric Observation. The researcher has drawn the attention on the themes identified by women as facilitating and hindering their experience of induced labor. The goal is to improve the obstetric assistance so that all the procedures are carried out properly. Methods The study was carried out in July 2018 at Mangiagalli Clinic in Milan, IRCCS Cà Granda Ospedale Maggiore Policlinico Foundation. Women complying with the following inclusion criteria were recruited: induction of labor for delivery from the 37th gestational week, with single fetus, regardless of indication of induction or woman’s parity. It was possible to carry out a semi-structured interview with 37 out of 45 women identified. The researcher has then written down all the answers precisely just after the interview. Results This research enabled us to identify 5 Themes and 29 Categories. The five themes are "Information", "Intimacy", "Midwife's assistance", "Pain and methods to contain it" and “Expectations". According to the stories of women about their experience of labor induction, the information provided by professionals appear to be incomplete and late. In addiction to the lack of information, the most highlighted aspect was the duration of the induction and this determines a discrepancy between their expectations and the actual experience. Although it was possible to recognize the tendency of women to enhance the attention and the care of the medical staff, women highlighted in some cases the lack of physical presence or listening by the medical staff. Furthermore, the discretion of the midwife protecting the privacy of the couple was very appreciated by women. Women highlighted the presence of the midwife even if she didn’t offer them some non pharmacological methods to contain the pain. This methods have also been considered as usefulness and palliative. Conclusion and practical relevance During pregnancy it is essential that women receive complete information about the induction in order to feel really involved in the decision-making process. The theme of induction should be treated starting from the Childbirth Classes with specific methods according to the needs of the group. It is also necessary that doctors and the midwife provide complete information. Moreover, the effective understanding of information by the woman should be tested. The obstetric staff is valued for its real presence next to the woman and, therefore, it is important to promote and to recognize the centrality of women and couples, based on accompaniment, support and listening. The midwife is also the health professional who can act to protect the privacy of the couple.At last, it is her responsibility to ensure that all women have access to the resources to face the induction of labor. According to the SIGO Guidelines, non-pharmacological methods of pain relief should be offered to all women at the beginning of painful contractile activity