Outpatient cervical ripening: A survey of patient perspectives

Background: Induction of labour in Australia is common, with 31.2% of term births undergoing induction of labour in 2016. The induction process is usually undertaken as an inpatient, and can be lengthy, particularly if the cervix is unfavourable and as such require cervical ripening. In addition to increased length of stay, other disadvantages of inpatient cervical ripening include an uncomfortable environment, and separation of the patient from their partner. Particularly, in the context COVID-19, it is essential to reduce the length of hospital stay and therefore potential virion exposure. Kruit et al. describes 85.3% satisfaction rate of patients undergoing outpatient cervical ripening, without a significant difference in maternal or neonatal infections or caesarean section delivery rate.1 Furthermore McKenna et al. describes a saving of USD $750 per patient with outpatient cervical ripening.2 Given these findings, outpatient cervical ripening has the potential to be economically and psychosocially beneficial to our patients, so it is pertinent to determine local patient population attitudes and perspectives towards outpatient cervical ripening. Aim: Our primary objective was to assess the attitudes and opinions towards outpatient cervical ripening in women undergoing induction at a peripheral Obstetrics unit in Perth, Western Australia. Methods: Questionnaires were distributed over a three-month period and data obtained include demographic data, pregnancy and obstetric history, attitudes towards cervical ripening and willingness to undergo cervical ripening in the outpatient setting. Results: Data collection and analysis is still ongoing;however, preliminary results indicate that patients would be happy to undergo cervical ripening in the outpatient setting. Conclusions: Patient acceptance of outpatient cervical ripening has huge potential economic and psychosocial benefits for the healthcare system and patients, respectively.