Methods We undertook a prospective observational study of 1133 women undergoing induction of labour between 03/2009 and 08/2010 using three different models of in-patient care applied sequentially. Model A: no specific induction midwife and women admitted and treated as delivery suite work-load permitted (pre-existing model). Model B: Induction of labour midwife working 40h/week. Model C: Induction of labour midwife working 84h/week. For models B and C, women were given specific appointments and treated irrespective of delivery suite work-load. Outcome measures were admission-to-delivery interval and caesarean section rate.

Compared to Model A, model B resulted in a significant reduction in admission to delivery interval from 1405 (843.5 – 1805) minutes to 1124 (753 – 1542) minutes (p < 0.0001). Model C resulted in a significant reduction in admission to delivery interval when compared to models A and B [839.5 (608.5 – 1414) minutes, p < 0.0001]. The caesarean section rates were 27.4%, 25.1% and 18.7% for models A, B and C respectively (p = 0.014). The main contributor to reduced caesarean section rate was a reduction in caesarean sections for non-progressive first stage of labour.

Conclusions The availability of a dedicated induction of labour midwife is associated with shorter admission to delivery intervals and lower caesarean section rates.