The experience of labor (EOL) has immediate and long-lasting implications for the well-being of the mother, the infant, and the entire family. Induction of labor (IOL) rates are rising and approximately one third of the labors are induced. However, women with IOL have higher risk of a negative EOL than women with spontaneous onset of labor (SOL). In addition, during pregnancy, maternal sleep quality typically deteriorates, and depressive symptoms become frequent, so both symptoms may interfere with the EOL.

This thesis addresses associations between maternal sleep quality and depressive symptoms during pregnancy, general experiences of labor and experiences of IOL. The importance of the IOL setting (OP or inpatient [IP]) was evaluated. Two different study cohorts were studied, the FinnBrain Birth Cohort Study (Studies I and II and the Clinical Hospital Cohort Study (Studies III and IV). The FinnBrain Birth Cohort Study was a longitudinal follow-up study of low-risk full-term pregnancies. The Study I, which included 1778 women (IOL group n=331, SOL group n=1447), aimed to evaluate whether sleep quality is associated with the likelihood of ending with IOL. The Study II, which included 2405 women (IOL group n=419, SOL group n=1876), aimed to evaluate whether sleep quality and depressive symptoms during pregnancy are associated with the EOL. The Clinical Hospital Cohort Study was a randomized controlled trial (RCT) that included 117 women with full-term non-complicated pregnancies scheduled for IOL, which was carried out with a catheter. Experiences during and after IOL were assessed using Visual Analogue Scale (VAS) questionnaires. The aim in Study III was to evaluate the experiences of catheter IOL in OP and IP settings. The aim in Study IV was to evaluate the experiences of IOL and its associations with maternal sleep quality and depressive symptoms.

While deterioration in sleep quality was noticeable in pregnant women, it was unconnected to the likelihood to ending with IOL. Compared to women with SOL, those with IOL reported a poorer EOL. Furthermore, sleep disturbances and depressive symptoms per se were connected with a poorer EOL. Women with sleep disturbances were more likely to report more negative experiences during the catheter IOL. And additionally, although catheter IOL was well accepted in both settings, women in the OP setting were less satisfied and more anxious than those in the IP setting.

In conclusion, IOL is associated with a poorer EOL. The results of this thesis also highlight the association between maternal sleep disturbances and depressive symptoms during pregnancy and a poorer EOL, with symptomatic women reporting a more negative EOL. Therefore, the preferences and experiences of the women themselves should lead decisions regarding IOL.