The cesarean section (C-section) rate has risen dramatically in the past several decades both in the United States and throughout the world. Domestically, the C-section rate has risen from 4.5% in 1965 to 32.2% in 2014 (National Partnership for Women & Families [NPWF], 2016a). Worldwide, roughly 19% of births occur via C-Section (Betrán et al., 2016). Concurrently, the induction rate has also increased, doubling in the United States between 1990 – 1998 (Davey & King, 2016). As of 2014, about 23% of all women had their labors induced in the United States (NPWF, 2016b). Furthermore, the trend toward electively inducing labor is gaining traction with patients choosing to induce labor for logistical reasons, and physician or patient convenience (Tam, Conte, Schuler, Malang, & Roque, 2013).
There are many drugs used to induce or augment labor, oxytocin and misoprostol being two of the most common. Labor and delivery nurses administer these drugs on a regular basis and usually have developed biases regarding each. However, new graduate labor and delivery nurses as well as student nurses have not had time to develop any preconceived notions and may very well be unaware of the evidence surrounding oxytocin and misoprostol which led to the following PICOT question: In nursing students and new graduate labor and delivery nurses (P), how does education regarding delivery outcomes of labor inducing agents, oxytocin and misoprostol specifically, (I) compare to no education about labor inducing agents (C) affect their perceptions of labor experiences (O) over 3 months following education (T)?
The literature is conflicted regarding the effects oxytocin has on labor outcomes but presents misoprostol conferring significant benefits on achieving a vaginal delivery. Presenting the evidence to new graduate labor and delivery nurses as well as nursing students gleaned regarding the effects oxytocin and misoprostol have on delivery outcomes gleaned from 12 scholarly articles will hopefully educate these nurses and guide them into forming their own opinions, based on the evidence, regarding the safety and efficacy of these labor inducing agents. After the evidence is presented, the participants can see the actual effects oxytocin and misoprostol have through 3 months of clinical experience. Then, the participants can engage in meaningful dialogue about ways to optimize the labor and delivery experience using the perceptions they have formed based on the education provided and clinical experience. Finally, the participants can take what they have learned, bring it to their bedside care, and find innovative ways to promote a healthy, safe delivery for both mother and baby with the hope and possibility of reducing the C-section potential through their nursing interventions.
Date of publication
MSN Capstone Project
Masters of Science in Nursing - Education
Fontenot, Sherrie, "Enhancing Perceptions of Labor Experiences through Evidence-Based Education" (2020). MSN Capstone Projects. Paper 20.