‘Not in labour’: impact of sending women home in the latent phase

Abstract

Women who were sent home from hospital in the latent phase of labour were asked to keep a diary to reflect on their experiences. Twenty-one women consented to complete the diary but only six returned it. These six women were approached to participate in a one-to-one interview at home to further explore the effects of being discharged home. Five women agreed to be interviewed. Interviews were tape-recorded and transcribed verbatim. The data were analyzed using latent content analysis. Five themes were identified: influence of others, reassurance, coping/pain, sleep deprivation and undervaluing of the latent phase. Women were strongly influenced regarding when to go into hospital by the anxiety of family and partners. Most women sought reassurance but being sent home made them feel unsupported and this may have increased their anxiety. Further research is needed into how best to support women planning a hospital delivery who in the latent phase of labour at home.

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

“…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). 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).…”

“…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).…”

“…However, this may lead to a gap between women's expectations and their actual experience of maternity services during early labour. Furthermore, women admitted to hospital may have a greater sense of control when compared to women being sent home in the latent stage of labour (Barnett et al, 2008). Janssen et al (2003) argued that women supported by midwives during the latent phase at home showed an association with admission to the health facility in the active phase of labour, a reduction of the use of analgesia, and a lower rate of neonatal morbidity.…”

“…The importance of women's experiences of early labour is often underestimated, in part because they are often thought not to require care at this time (Greulich and Tarrant, 2007;Barnett et al, 2008). However, uncertainty seems to be a central issue for women in early labour, accompanied by anxiety and lack of confidence in the ability to cope with pain.…”

“…However, uncertainty seems to be a central issue for women in early labour, accompanied by anxiety and lack of confidence in the ability to cope with pain. These seem to be the main factors that drive mothers to go to the hospital (Barnett et al, 2008;Nolan et al, 2009;Nolan and Smith, 2010). 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.…”