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Elective labor induction, Nulliparous women, Patient education, Prepared childbirth classes



  1. Simpson, Kathleen Rice PhD, RNC, FAAN
  2. Newman, Gloria MSN, RNC
  3. Chirino, Octavio R. MD, FACOG, FACS


Purpose: To reduce elective inductions among nulliparous women in a community hospital by adding standardized education regarding induction risks to prepared childbirth classes.


Study Design and Methods: Elective induction rates were compared between class attendees and nonattendees before and after the standardized content was added to prepared childbirth classes. A survey of nulliparous women's decisions regarding elective induction was conducted.


Results: Elective induction rates of 3,337 nulliparous women were evaluated over a 14-month period (n = 1,694, 7 months before adding content to classes; n = 1,643, 7 months after). Rates did not differ between class attendees (35.2%, n = 301) and nonattendees (37.2%, n = 312, p = .37) before the content was included. However, after standardized education was added, class attendees were less likely to have elective induction (27.9%, n = 239) than nonattendees (37%, n = 292, p < .00). Sixty-three percent of women who attended the classes and did not have elective induction indicated that the classes were influential in their decision. Physicians offered the option of elective induction to 69.5% (n = 937) of survey participants. This was a factor in women's decisions; 43.2% (n = 404) of those offered the option had elective induction, whereas 90.8% (n = 374) of those not offered the option did not have elective induction.


Clinical Implications: Education regarding elective induction offered during prepared childbirth classes was associated with a decreased rate among nulliparous women who attended classes when compared to those who did not attend. Patient education may be beneficial in reducing elective inductions.