The impact of outpatient priming for induction of labour on midwives' work demand, work autonomy and satisfaction

Deborah Turnbull, Pamela Adelson, Candice Oster, Judy Coffey, John Coomblas, Robert Bryce, Christopher Wilkinson

    Research output: Contribution to journalArticlepeer-review

    13 Citations (Scopus)


    Background: Induction of labour often begins with the application of a priming agent to soften the cervix, generally requiring women to stay in hospital overnight (inpatient priming). An alternative is outpatient priming by a midwife, where women are allowed to go home following priming. This approach has the potential to impact, either positively or negatively, on the midwives involved. Question: To what extent did the introduction of outpatient priming influence midwives' work demands, work autonomy, stress and job satisfaction. Methods: A before-after study (with two separate cross-sectional samples) was conducted alongside a randomized controlled trial of outpatient versus inpatient priming, conducted at two metropolitan teaching hospitals in Australia. Midwives completed a questionnaire before the introduction of outpatient priming and again approximately two years later. Findings: 208 midwives participated (response rates-time 1:81% (87/108); time 2:78% (121/156)). A mixed model analysis test of pre-post intervention differences found no changes in work demand, work autonomy and satisfaction. At time 2, over 80% of midwives reported that the introduction of the practice had reduced or made no difference to their work stress and workload, and 93% reported that outpatient priming had increased or had no impact on their job satisfaction. Furthermore, 97% of respondents were of the opinion that the option of outpatient priming should continue to be offered. Conclusion: Results suggest that outpatient priming for induction of labour is viable from a midwifery practice perspective, although more research is needed.

    Original languageEnglish
    Pages (from-to)207-212
    Number of pages6
    JournalWomen and Birth
    Issue number3
    Publication statusPublished - Sept 2013


    • Cervical ripening
    • Induced
    • Job satisfaction
    • Labor
    • Midwifery
    • Outpatients
    • Professional autonomy


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