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More choice for parents at Derriford Maternity Department

Parents whose labours are due to be induced may be given the choice to wait for established labour at home, as ‘outpatient induction of labour’ service is relaunched.

As long as they do not have any medical or obstetric complications within the exclusion criteria and live within 30 minutes of the hospital, expectant mothers can now have the pessary given at the start of their induction of labour, go home, and come back within 24 hours.

Lauren Graham Midwife Lauren Graham Midwifery Team Lead, part of the team who launched the project a year ago said: “Nationally there are more and more inductions taking place, due to increased rates of gestational diabetes and complex pregnancies.

"But mothers were telling us they were bored and lonely, waiting for a number of days in the department for their babies to arrive after they’d been induced.

“We also received some feedback from women who wanted to wait for labour at home but the previous inclusion criteria for outpatient induction of labour was quite restrictive. This was because it was a new service, so it was trialled nationally on women with the least medical and obstetric complications.

“However, over time we have found that for the majority of women outpatient induction of labour is safe, and we are able to offer the same level of monitoring at home.

“If you start contracting, your waters break, or you have any other concerns including reduced fetal movements then we ask you to call maternity triage and to return to the hospital.

"You can also choose to be admitted to the hospital at any point if you change your mind about staying at home.”

Early results show that 120 women have already used the service with positive feedback. In one year the reduced inpatient admission time equates to over 2000 hours in total. Less people in the department also helped with infection prevention and control.

Lauren adds: “We had been planning the relaunch of the service prior to the onset of COVID-19 to provide more choice for women; however when hospital visiting was restricted after the start of the pandemic, we found many women were keen to be at home with their partner.”

Lauren advises that parents discuss their options at an antenatal clinic appointment with their obstetrician or midwife. This will give them time to think about their choices before attending for induction of labour.

Unfortunately for safety reasons, parents with small babies or reduced fetal movements do not meet the eligibility criteria.

Due to the success of the outpatient induction of labour service at University Hospitals Plymouth NHS Trust, other maternity departments in the UK have expressed interest in learning from the UHP service.

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