Objectives: To analyse if it’s feasible to time most of our deliveries to happen during office hours and reduce the night time deliveries for the benefit of the patient, fetus and labour ward staff.

Methods: Patients who fulfilled the inclusion criteria were randomized into 8 a.m. or 8 p.m. induction group according to the randomized sealed envelope given at the time of recruitment. These patients were admitted to labour ward 1 hour before the induction time. 3 mg dinoprostone vaginal tablet was used and the standard induction protocol was applied. The social demographic data, induction details, delivery outcome and satisfaction score were then recorded in the case record form. Post partum patients and labour ward staff in-charge would be asked to complete a questionnaire assessing aspects of quality of care, their satisfaction with regards to timing of admission and patient review and overall satisfaction.

Results: Total 164 patients were recruited in the study group where 78 were in 8 a.m. group and 86 were in 8 p.m. group. Both groups have the similar baseline characteristics. No significant difference between the 8 a.m. and 8 p.m. induction groups in terms of induction of labour to vaginal delivery interval (delivery within 8 a.m. – 5 p.m.: 35.9% vs 44.2 %, p= 0.339). Instrumental delivery accounted for 13.0% of the deliveries in 8 a.m. group and 14.1% deliveries in 8 p.m. group. No significant difference (p=1.000) in terms of time of induction and the indication for instrumental delivery. Lower segment caesarean section (LSCS) was slightly lower in 8 a.m. group (23.4%) than in 8 p.m. group (30.6%). Based on the results, no significant differences were observed in terms of the pregnancy outcome (mode of delivery) with p>0.05. Overall, all the neonatal outcomes tested showed no significant difference between the study groups (p>0.05) meaning there’s no significant difference in neonatal outcome (Apgar score and Cord PH) in terms of time of induction. Mean maternal satisfaction level in 8 a.m. and 8 p.m. groups were 3.90 (SD=0.92) and 3.98 (SD=0.90) respectively. Mean staff satisfaction level in 8 a.m. and 8 p.m. groups were 3.18 (SD= 1.20) and 3.82 (SD=1.15) respectively. Staff satisfaction level in 8 a.m. group was significantly lower (p=0.001) than the 8 p.m. group. There was significant difference between the staff satisfaction level and the time of induction (p<0.001). There was no significant difference found between the maternal satisfaction level and the time of induction (p=0.053).

Conclusion: This study shows that there is no significant difference between the two induction groups in terms of time of delivery, mode of delivery, neonatal outcomes and maternal satisfaction. There is however significant difference in terms of delivery staff satisfaction, which favors 8 p.m. induction group (p < 0.001).