Outpatient Settings for Induction of Labour
Publication Date: October 5, 2022
Last Updated: October 25, 2022
Recommendations
Routine outpatient induction of labour is not recommended for improving birth outcomes (low-certainty evidence).
Remarks:
- The evidence reviewed for this recommendation was derived from high-income country settings and defined the outpatient setting as the “home”, where home induction is defined as cervical ripening at home. Most commonly, after the induction agents have been administered in a hospital/health-care facility, the woman spends time at home before being admitted back to the facility once in labour. Inpatient inductions are defined as induction in health-care facilities (hospitals or birth centres, or midwife-led units), such that the woman remains there following induction while awaiting the start of labour.
- The GDG noted that outpatient induction of labour might not be expected to improve birth outcomes. Low-certainty evidence in the systematic review indicated no difference in birth outcomes when comparing labour induction between inpatient and home settings.
- The GDG noted that in some settings, women considered to be at low risk for complications during induction are offered outpatient induction of labour when they have good transportation options and live near the delivery facility. Considering the potential preference of pregnant women to return to their home setting following placement of a cervical ripening agent or initiation of induction, outpatient induction of labour may be undertaken where feasible, following shared decision-making between the provider and the woman. If outpatient induction of labour is considered, this should be in the context of a well organized programme, with adequate staff resources available to remotely monitor/assess and/or reassure women at home. Women should have suitable arrangements in place to return rapidly to the hospital/facility if and when needed.
6731
Recommendation Grading
Overview
Title
Outpatient Settings for Induction of Labour
Authoring Organization
World Health Organization
Publication Month/Year
October 5, 2022
Last Updated Month/Year
August 9, 2023
Supplemental Implementation Tools
Document Type
Guideline
Country of Publication
US
Inclusion Criteria
Female, Adult
Health Care Settings
Ambulatory, Outpatient
Intended Users
Healthcare business administration, nurse, nurse midwife, nurse practitioner, physician, physician assistant
Scope
Management
Diseases/Conditions (MeSH)
D006700 - Home Childbirth
Keywords
labor and delivery, labor, labour, childbirth
Source Citation
WHO recommendations on outpatient settings for induction of labour. Geneva: World Health Organization; 2022. Licence: CC BY-NC-SA 3.0 IGO.