Wilson, B. L. (2007). Journal of Nursing Scholarship, 39, 208-213.
This retrospective, descriptive, correlational study was performed to evaluate whether race, ethnicity, socioeconomic status, maternal education, age, and induction of labor increased the likelihood of cesarean delivery in primigravid and multigravid pregnant women. The sample consisted of 1,325 women who were scheduled for induction of labor at a large tertiary care facility over the course of one calendar year. The author reviewed inpatient scheduling logs to determine whether the induction was elective or performed for clinical indications. For primigravidas, elective inductions significantly increased the risk of cesarean delivery, but this was not true for multigravidas. In both groups, age and length of gestation were significantly associated with cesarean birth. Women who experienced elective inductions had shorter gestational lengths than women who were induced for clinical indications. There was no relationship between either ethnicity or socioeconomic status and increased likelihood of cesarean delivery among either multiparas or primiparas. Maternal educational level was a significant predictor for increased risk of cesarean delivery among multiparas. The author concluded that the current practice of elective inductions, especially in primigravidas, should be reviewed in light of the findings of increased risk for cesarean delivery. This is especially true for women who are of advanced maternal age because of the independent association of advanced maternal age and increased likelihood of cesarean birth.
Judith A. Lewis