OPTION – Outpatient induction: Labour induction in an outpatient setting - a multicentre randomised controlled trial

Purpose and aim: The Swedish induction rate was 19%.

Due to recently published results showing decreased perinatal mortality for induction at 41 instead of 42 weeks, an increase to about 30% is expected. Induction is associated with longer stay at the delivery unit.

It has been suggested that women could return home and be re-admitted at start of active labor, so-called outpatient induction. Outpatient induction could increase patient satisfaction and save healthcare resources. However, safety and efficacy have not been established.

We aim to fill this knowledge gap by investigating safety, efficacy, acceptability, and cost-effectiveness of outpatient compared to hospital induction in low-risk pregnancies.Study design: A national, multicentre register-based randomized controlled trial utilizing data from several registries in Sweden.

Additional data will be collected using validated questionnaires and interviews.Population:Low-risk women planned for induction (n=8890)Intervention: Outpatient inductionControl:Hospital inductionOutcomes:Primary: 1) composite outcome of severe neonatal morbidity or mortality, 2) efficacy (vaginal delivery)Secondary: further neonatal and maternal health outcomes; the woman’s, partner’s and caregiver’s experiences; health economics; future pregnancy outcomesImpact: If safety and efficacy can be established, outpatient induction has the potential to increase patient satisfaction while contributing to a better use of healthcare resources.