Primiparous women's preferences for care during a prolonged latent phase of labour

Ängeby, Karin; Wilde‐Larsson, Bodil; Hildingsson, Ingegerd; Sandin‐Bojö, Ann‐Kristin

doi:10.1016/j.srhc.2015.02.003

Cited by 22 publications

(21 citation statements)

References 38 publications

(54 reference statements)

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“…Marowitz suggested that midwives can provide a significant amount of individually adapted care and support in early labor in order to delay admission, but a tension exits between delaying admission and women's difficulty in handling early labor at home. Previous studies show that individual midwifery support for women during latent phase is important. Paul et al's suggestion of an early labor lounge to engage women in labor‐promoting activities as a potential approach in lowering the cesarean birth rate in nulliparous women may be a promising strategy.…”

Section: Discussionmentioning

confidence: 99%

“…The present study found that women with a prolonged latent phase regardless of parity are dominating the group of women being admitted at earlier stages of cervical dilatation. According to the findings from Ängeby et al and Cappelleti et al, women with a prolonged latent phase wanted individually adapted care but not necessarily admittance to the labor ward. In Sweden, as in many other countries, women have no options for a home visit from a midwife during the latent phase.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence of Prolonged Latent Phase and Labor Outcomes: Review of Birth Records in a Swedish Population

Ängeby¹,

Wilde‐Larsson²,

Hildingsson³

et al. 2018

J Midwife Womens Health

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Introduction:The prevalence of a prolonged latent phase of labor has been described as ranging from 5% to 6.5% in previous research. The aim of this study was to describe the prevalence of the prolonged latent phase of 18 hours or more, based on women's report, in women intending vaginal birth and who had spontaneous onset of labor. An additional aim was to compare the incidence of obstetric interventions, and the labor and neonatal outcomes in women with and without a prolonged latent phase. Methods:A descriptive and comparative study was performed in a mid-sized hospital in western Sweden. The sample consisted of 1343 birth records of women who intended vaginal births and who had spontaneous onset of labor at 37 or more weeks' gestation during a one-year period (2013)(2014). Background characteristics, obstetric interventions, and labor and neonatal outcomes were compared between women with latent phases lasting less than 18 hours and 18 hours or more, based on women's self-report. Odds ratios with 95% confidence intervals were calculated for the different exposure variables.Results: A prolonged latent phase lasting 18 hours or more occurred in 23% of all births analyzed (n = 1343). A prolonged latent phase was more common among nulliparous women (29.2%) but also common for multiparous women (17%). Nulliparous and multiparous women who experienced a prolonged latent phase were more often exposed to amniotomy during latent phase. For nulliparous women, the adjusted odds ratio (aOR) was 11.57 (95% confidence interval [CI], 5.25-25.51) and for multiparous women the aOR was 18.73 (95% CI, 9.06-38.69). Similarly, amniotomy during active phase was more common for both nulliparous and multiparous women who experienced a prolonged latent phase (aOR, 4.05; 95% CI, 2.53-6.47 and aOR, 3.93; 95% CI, 2.43-6.37, respectively). Women with latent phases of 18 hours or more, more often experienced augmentation of labor during all phases, especially during latent phase. For nulliparous women, the aOR was 10.13 (95% CI, 2.82-36.39) and for multiparous women, aOR was11.9 (95% CI, 3.69-38.71). A prolonged latent phase was associated with more instrumental vaginal births for multiparas (aOR, 2.58; 95% CI, 1.27-5.26) and emergency cesarean regardless of parity (nulliparous women: aOR, 3.21; 95% CI, 1.08-9.50 and multiparous women: aOR, 3.93; 95% CI, 1.67-9.26).Discussion: Based on women's self-report, the prevalence of a prolonged latent phase in women at term who planned a vaginal birth and had spontaneous onset of labor was higher than previously reported. Women with a prolonged latent phase were more likely to receive obstetric interventions. Assisted vaginal birth was more common for nulliparous women with prolonged latent phase and emergency cesarean occurred more frequently for both nulliparous women and multiparous women with a prolonged latent phase.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Prevalence of Prolonged Latent Phase and Labor Outcomes: Review of Birth Records in a Swedish Population

Ängeby¹,

Wilde‐Larsson²,

Hildingsson³

et al. 2018

J Midwife Womens Health

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“…However, assessing satisfaction is a complex process and we had not covered these secondary satisfaction outcomes comprehensively with the use of one-dimensional questions. A recent qualitative study shows that nulliparas with a prolonged latent phase of labor preferred woman-centred care with midwives playing an important role in support and the need for support increases as the time spent in latent phase increases [26]. A recent metasynthesis of the literature on first-time mothers’ experiences of early labour suggested that women’s needs when planning a hospital birth were not being adequately met at this stage of the labour process.…”

Section: Discussionmentioning

confidence: 99%

Induction of labor compared to expectant management in term nulliparas with a latent phase of labor of more than 8 hours: a randomized trial

Sargunam

Bak

Tan

et al. 2019

BMC Pregnancy Childbirth

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BackgroundProlonged latent phase of labor is associated with adverse maternal and neonatal outcomes. Preliminary data indicate that labor induction for prolonged latent phase may reduce cesarean delivery. We performed a study powered to Cesarean delivery to evaluate labor induction compared to expectant management in full term nulliparas hospitalized for persistent contractions but non-progressive to established labor after an overnight stay.MethodsFrom 2015 and 2017, nulliparas, ≥ 39 weeks’ gestation with prolonged latent phase of labor (persistent contractions after overnight hospitalization > 8 h), cervical dilation ≤3 cm, intact membranes and reassuring cardiotocogram were recruited. Participants were randomized to immediate induction of labor (with vaginal dinoprostone or amniotomy or oxytocin as appropriate) or expectant management (await labor for at least 24 h unless indicated intervention as directed by care provider). Primary outcome measure was Cesarean delivery.ResultsThree hundred eighteen women were randomized (159 to each arm). Data from 308 participants were analyzed. Cesarean delivery rate was 24.2% (36/149) vs. 23.3%, (37/159) RR 1.0 95% CI 0.7–1.6; P = 0.96 in induction of labor vs. expectant arms. Interval from intervention to delivery was 17.1 ± 9.9 vs. 40.1 ± 19.8 h; P < 0.001, intervention to active labor 9.6 ± 10.2 vs. 29.6 ± 18.5 h; P < 0.001, active labor to delivery 7.6 ± 3.6 vs. 10.5 ± 7.2 h; P < 0.001, intervention to hospital discharge 2.4 ± 1.2 vs. 2.9 ± 1.4 days; P < 0.001 and dinoprostone use was 19.5% (29/149) vs. 8.2% (13/159) RR 2.4 95% CI 1.3–4.4; P = 0.01 in IOL compared with expectant arms respectively. Intrapartum oxytocin use, epidural analgesia and uterine hyperstimulation syndrome, postpartum hemorrhage, patient satisfaction on allocated intervention, during labor and delivery and baby outcome were not significantly different across trial arms.ConclusionsInduction of labor did not reduce Cesarean delivery rates but intervention to delivery and to hospital discharge durations are shorter. Patient satisfaction scores were similar. Induction of labor for prolonged latent phase of labor can be performed without apparent detriment to expedite delivery.Trial registrationRegistered in Malaysia National Medical Research Register (NMRR-15-16-23,886) on 6 January 2015 and the International Standard Randomised Controlled Trials Number registry, registration number ISRCTN14099170 on 5 Nov 2015.

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“…To turn this decision around is difficult and a huge undertaking; therefore it is preferable to meet the woman's preferences to be in a safe place. If this means that she will spend early labour at the delivery ward then the midwife should make sure that she is met in a welcoming manner and ensured individual care (Ängeby, Wilde-Larsson, & Sandin-Bojö, 2015 ). Likewise, this care should be good care where professionals mitigate interventions and promote women's agency and well-being.…”

Section: Discussionmentioning

confidence: 99%

Being in a safe and thus secure place, the core of early labour: A secondary analysis in a Swedish context

Carlsson

2016

International Journal of Qualitative Studies on Health and Well

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BackgroundEarly labour is the very first phase of the labour process and is considered to be a period of time when no professional attendance is needed. However there is a high frequency of women who seek care at the delivery wards during this phase. When a woman is admitted to the delivery ward, one role for midwives is to determine whether the woman is in established labour or not. If the woman is assessed as being in early labour she will probably then be advised to return home. This recommendation is made due to past research that found that the longer a woman is in hospital the higher the risk for complications for her and her child. Women have described how this situation leaves them in a vulnerable situation where their preferences are not always met and where they are not always included in the decision-making process.AimThe aim of this study was to generate a theory based on where a woman chooses to be during the early labour process and to increase our understanding about how experiences can differ from place to place.MethodsThe method was a secondary analysis with grounded theory. The data used in the analysis was from two qualitative interview studies and 37 transcripts.ConclusionThe findings revealed a substantive theory that women needed to be in a safe and thus secure place during early labour. This theory also describes the interplay between how women ascribed their meaning of childbirth as either a natural live event or a medical one, how this influenced where they wanted to be during early labour, and how that chosen place influenced their experiences of labour and birth.

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Primiparous women's preferences for care during a prolonged latent phase of labour

Cited by 22 publications

References 38 publications

Prevalence of Prolonged Latent Phase and Labor Outcomes: Review of Birth Records in a Swedish Population

Prevalence of Prolonged Latent Phase and Labor Outcomes: Review of Birth Records in a Swedish Population

Induction of labor compared to expectant management in term nulliparas with a latent phase of labor of more than 8 hours: a randomized trial

Being in a safe and thus secure place, the core of early labour: A secondary analysis in a Swedish context

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