Abstract
Objective: To compare childbirth satisfaction in women with chronic or gestational hypertension, randomised to ‘planned early term birth at 38+0-3 weeks’ gestation’ (intervention) or ‘usual care at term’ (control).
Design: Randomised trial.
Setting: 42 consultant-led maternity units, United Kingdom.
Population: 357/403 women randomised completed the Childbirth Experience Questionnaire (CEQ).
Methods: Mixed-methods analysis of the 22-item CEQ, assessing: ‘Own capacity’, ‘Professional support’, ‘Perceived safety’, and ‘Participation’. Directed content analysis sorted free-text comments into themes covered by the CEQ and two additional themes.
Main outcome measures: CEQ scores overall and by domain.
Results: In intervention (vs. control) groups, the CEQ was completed by 177/202, 88.1% (vs. 180/202, 89.1%) participants, and 378 free-text comments were made by 93/177, 52.5% (vs. 98/180, 54.4%) participants. There was no significant difference in CEQ scores overall (3.1±0.4 vs. 3.1±0.4, respectively) or by domain (‘Own capacity’ [2.8±0.5 vs. 2.7±0.5, respectively]; ‘Professional support’ [3.7±0.5 vs. 3.7±0.6, respectively]; ‘Perceived safety’ [3.2±0.6 vs. 3.1±0.6, respectively]; ‘Participation’ [2.6±0.7 vs. 2.7±0.6]. Most comments were positive (222/378, 58.7%), and about ‘Relational care and care interactions’ (CEQ ‘Professional support’). Neither the number nor positivity of comments appeared to differ between groups.
Conclusion: For women with chronic or gestational hypertension who remain well at term, we found no difference in childbirth experience between women randomised to planned early term birth vs. usual care at term. Shared decisions about timing of birth may be more influenced by differences in clinical outcomes and costs.
Funding: National Institute of Health Research (16/167/123).
ISRCTN: 77258279: When to induce labour to limit risk in pregnancy hypertension
Design: Randomised trial.
Setting: 42 consultant-led maternity units, United Kingdom.
Population: 357/403 women randomised completed the Childbirth Experience Questionnaire (CEQ).
Methods: Mixed-methods analysis of the 22-item CEQ, assessing: ‘Own capacity’, ‘Professional support’, ‘Perceived safety’, and ‘Participation’. Directed content analysis sorted free-text comments into themes covered by the CEQ and two additional themes.
Main outcome measures: CEQ scores overall and by domain.
Results: In intervention (vs. control) groups, the CEQ was completed by 177/202, 88.1% (vs. 180/202, 89.1%) participants, and 378 free-text comments were made by 93/177, 52.5% (vs. 98/180, 54.4%) participants. There was no significant difference in CEQ scores overall (3.1±0.4 vs. 3.1±0.4, respectively) or by domain (‘Own capacity’ [2.8±0.5 vs. 2.7±0.5, respectively]; ‘Professional support’ [3.7±0.5 vs. 3.7±0.6, respectively]; ‘Perceived safety’ [3.2±0.6 vs. 3.1±0.6, respectively]; ‘Participation’ [2.6±0.7 vs. 2.7±0.6]. Most comments were positive (222/378, 58.7%), and about ‘Relational care and care interactions’ (CEQ ‘Professional support’). Neither the number nor positivity of comments appeared to differ between groups.
Conclusion: For women with chronic or gestational hypertension who remain well at term, we found no difference in childbirth experience between women randomised to planned early term birth vs. usual care at term. Shared decisions about timing of birth may be more influenced by differences in clinical outcomes and costs.
Funding: National Institute of Health Research (16/167/123).
ISRCTN: 77258279: When to induce labour to limit risk in pregnancy hypertension
| Original language | English |
|---|---|
| Journal | BJOG: An International Journal of Obstetrics and Gynaecology |
| Publication status | Published - 24 Jun 2025 |
Keywords
- chronic hypertension
- gestational hypertension
- hypertension in pregnancy
- labour induction
- maternal complications
- neonatal morbidity
- childbirth experience
