MAGNITUDE OF FAILED INDUCTION AND ASSOCIATED FACTORS AMONG MOTHERS WHO GAVE BIRTH AFTER INDUCTION OF LABOR AT PUBLIC HOSPITALS OF HARAR CITY AND DIRE DAWA CITY ADMINISTRATION, EASTERN ETHIOPIA

Abstract

Background: One of the potential risks of labor induction is failure of labor induction. In Ethiopia, more than one-third of mothers who undergo induction of labor encounter failures. A studies done in Ethiopia revealed that failed induction of labor contributed to 61.2% of indication for Cesarean section. However, there is a paucity of information related to the failed induction of labor in the Public hospitals of Harar town and Dire Dawa city administration. Objective: To assess the magnitude of failed induction of labor and associated factors among mothers who gave birth after induction of Labor from 1st March, 2022 to February 28, 2023 at public hospitals in Harar town and Dire Dawa city, Eastern Ethiopia from June 10/2023- July 10/2023. Methods: A hospital-based cross-sectional study design (retrospective chart review) was conducted. A total of 614 medical charts of mothers who gave birth from 1stmarch ,2022 to February 28, 2023 after induction of labor were manually extracted. The mother’s medical charts were selected using systematic random sampling. The data was collected using a pretested structured check list. The collected data was entered into Epi-data version 3.1 and exported to SPSS version 20 for further analysis. The model fitness was checked by the Hosmer- Lemeshow and Omnibus goodness test while collinearity was diagnosed using the variance inflated factor and tolerance test. Bivariate logistic regression was performed for the selection of candidate variables for multivariable logistic regression. A multivariable logistic regression analysis was performed to test the association between independent and dependent variables. A variable with a P< 0.05 was considered as statistically significant in multivariable logistic regression analysis. Results: In this study, the magnitude of failed induction of labour was 24.8% with 95%CI (21.5% -28.2%). Factors such as being nulliparous (AOR= 5.52; 95% CI:3.31, 9.19) at (P-value=.000) , having gestational age of >41weeks (AOR= 4.93; 95% CI:1.93,12.59) at (P-value=0.001), maternal age >30 years (AOR= 3.51 ;95% CI:2.15,5.74), maternal anaemia (AOR= 3.49; 95%CI: 2.23,5.46) at (P-value=.000), magnesium sulphate supplementation (AOR= 3.07; 95%CI: 1.84, 5.14) at (P-value= .000) and birth weight >4.0kg (AOR= 2.76; 95%CI: 1.12, 6.84) at (P-value= .028) were associated with failed induction of labor. Conclusions: Nearly one-fourth of mothers undergoing induction at Public hospitals of Harar town and Dire Dawa city administration had failed induction of labor. Factors such as Parity, gestational age, maternal anemia, magnesium sulphate and birth weight had positive association with failed induction of labor. Thus, the government and all the concerned entities should made unreserved efforts and dedication in taking collaborative and integrative action which plays a role in alleviating all factors that leads failed inductions of the labor