BACKGROUND: Induction of labour (IOL) is one of the most commonly performed interventions in maternity care, with outpatient cervical ripening increasingly offered as an option for women undergoing IOL . The COVID-19 pandemic has changed the context of practice and the option of returning home for cervical ripening may now assume greater significance . This work aimed to examine whether and how the COVID-19 pandemic has changed practice around IOL in the UK .
METHOD: We used an online questionnaire to survey senior obstetricians and midwives at all 156 UK NHS Trusts and Boards that currently offer maternity services . Responses were analysed to produce descriptive statistics, with free text responses analysed using a conventional content analysis approach . FINDINGS: Responses were received from 92 of 156 UK Trusts and Boards, a 59% response rate . Many Trusts and Boards reported no change to their IOL practice, however 23% reported change in methods used for cervical ripening; 28% a change in criteria for home cervical ripening; 28% stated that more women were returning home during cervical ripening; and 24% noted changes to women's response to recommendations for IOL . Much of the change was reported as happening in response to attempts to minimise hospital attendance and restrictions on birth partners accompanying women .
CONCLUSIONS: The pandemic has changed practice around induction of labour, although this varied significantly between NHS Trusts and Boards . There is a lack of formal evidence to support decision-making around outpatient cervical ripening: the basis on which changes were implemented and what evidence was used to inform decisions is not clear.