‘Should I come in now?’: a study of women's early labour experiences

Abstract

In spite of the advice from midwives to stay at home for as long as possible after the perceived onset of labour, many women still present at hospital in the very early stages of labour. In this qualitative study, 21 women discussed their early labour experiences, and factors which influenced their decisions regarding when to go to hospital. The data were transcribed and analysed using latent content analysis. We found a combination of uncertainty, pain and anxiety influenced women's early labour decisions. While many felt they were coping well with their labour on admission, women often wanted to be in hospital ‘just in case’ and lacked the confidence to cope with labour at home. We suggest that the relationship between anxiety and timing of admission should be investigated further and that the value of midwifery support and reassurance in the latent and early stages of labour should not be underestimated.

First-time mothers’ experiences of early labour in Italian maternity care services

“…Supporting the findings of the present study, other authors highlighted uncertainty, the need for reassurance, anxiety and lack of confidence as central issues for women in early labour and are the main factors that drive them to access the hospital triage (Barnett et al, 2008;Nolan et al, 2009;Nolan and Smith, 2010). The reassurance from midwives about the normality of the slow evolution of this phase seems to be a key factor in encouraging women to stay home during early labour (Cheyne et al, 2007). It is evident that midwives often advise women in the latent phase to remain or return home in order to avoid unnecessary interventions (Bailit et al, 2005;Holmes, 2001;Rahnama et al, 2006).…”

“…In line with existing evidence, the physical and instinctive reaction of women was associated with the need for a more rational understanding of the labour progress, resulting initially in the attentive monitoring and recording of uterine contractions and, subsequently, in the access to the hospital maternity triage in order to seek confirmation and reassurance from healthcare professionals (Barnett et al, 2008;Carlsson et al, 2009;Cheyne et al, 2007). Supporting the findings of the present study, other authors highlighted uncertainty, the need for reassurance, anxiety and lack of confidence as central issues for women in early labour and are the main factors that drive them to access the hospital triage (Barnett et al, 2008;Nolan et al, 2009;Nolan and Smith, 2010).…”

“…Regarding the ambivalent feeling reported by the participants when being admitted to hospital or sent home after triage assessment, previous research highlighted feelings such as disappointment, anger, fear, discouragement and anxiety when women were advised to return home in early labour (Barnett et al, 2008;Cheyne et al, 2007;Janssen and Desmarais, 2013). Conversely, women admitted to hospital may have a greater sense of control when compared to women being sent home (Barnett et al, 2008).…”

“…Eri et al (2010) found that first-time mothers try to negotiate their credibility with the midwives, emphasising the regularity of uterine contractions as an objective 'proof' of labour and showing their vulnerability in an attempt to avoid being sent home. The reassurance from midwives about the normality of the slow progression of early labour seems to be a key factor in encouraging women to stay at home (Beebe and Humphreys, 2006;Cheyne et al, 2007). Greulich and Tarrant (2007) suggest that midwives should provide pregnant women with information about different stages of labour, including when to go to hospital for birth; consequences related to early hospitalisation; and the inclination of professionals to admit women to hospital when they are in the active phase of labour.…”

Complex interventions in midwifery care: Reflections on the design and evaluation of an algorithm for the diagnosis of labour

“…In the following section, we briefly describe our approach and the challenges we faced as the study evolved from what was first anticipated to be a small study to an 'all Scotland' CRT. The full details of the design of the algorithm and the trial results have been published elsewhere (Cheyne et al, 2007(Cheyne et al, , 2008a. Key stages of the framework and the stages of our trial are summarised in Table 1.…”