SUCCESS OF INDUCTION OF LABOR AND ASSOCIATED FACTORS AMONG MOTHERS WHO DELIVERED AFTER INDUCTION OF LABOR IN HARAR CITY PUBLIC HOSPITALS, EASTERN ETHIOPIA

Abstract

Background: Induction of labor is the artificial initiation of labor or uterine contraction either through surgical or medical methods before the onset of true labor. This will be done in situations when the benefits of delivery of the fetus are outweighing the continuing of the pregnancy. However, there is limited evidence on the success of induction of labor and associated factors in low-income countries like Ethiopia including the study area. Objective: The aim of this study was to assess the magnitude of success of induction of labor and associated factors among mothers after induction labor of in Harar city public hospitals. Method: Institutional based cross-sectional study design was used among 717 mothers who delivered after induction of labor in Harar city public hospitals from January 1st , 2017 to December 30th, 2018. Simple random sampling technique and pre-tested structured checklist were used to collect data. The collected data were entered into Epi-data 3.1 and exported to Statistical Package for Social Science version 20.0 for analysis. Binary logistic regression was used to analyze the outcome variable and each independent variable. Multivariable analyses were done in order to control cofounders between independent variables and p-value less than 0.05 was considered as statistically significant. Results: The magnitude of successful rate of induction of labor in this study was 65% (95% CI: 61.5, 68.5) and the most indication for induction were pre-eclamsia/eclamsia (46.1%) and pre-labor rupture of membrane (33.5%). Maternal age less than or equals to 24 years old(AOR=1,93, 95% CI:1.14, 3.26), nulipara (AOR=0.34, 95% CI:0.19, 0.59), unfavorable Bishop score (AOR=0.06, 95% CI: 0.03, 0.12) intermediate Bishop score (AOR=0.08, 95% CI:0.04, 0.14), misoprostol only method (AOR=2.29, 95% CI:1.01, 5.19), non-reassuring fetal heart beat pattern (AOR=0.14, 95% CI: 0.07, 0.25) and newborn weight 3500 grams and above(AOR=0.32, 95% CI: 0.17, 0.59) were significantly associated with outcomes of induction of labor. Conclusion and recommendation: This study revealed that greater than three-fifths of the mothers had a success rate. Maternal age, parity, Bishop Score, method of induction, non-reassuring fetal heartbeat pattern and newborn weight at birth were independent predictors of the outcomes of induction of labor. Therefore, much works are needed to improve the success of induction of labor by assessing and monitoring maternal and fetal status as well as by following induction protocols, standards and guidelines for induction of labor.