Recognizing the Onset of Labor

Bonovich, Leah

doi:10.1111/j.1552-6909.1990.tb01632.x

Cited by 20 publications

(12 citation statements)

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“…Women may not be aware of the implications of early admission and/or lack confidence for managing pain or uncertainty at home. A number of small trials have demonstrated that systematised clinician and consumer decision-making support tools can reduce rates of admission to hospital in early labour [16,29,[35][36][37][38][39]. However, these studies are old, were conducted in non-representative samples and/or involve cost-and time-intensive interventions that are unsuitable for wide-scale implementation in a public hospital system.…”

Section: Discussionmentioning

confidence: 99%

Variations in outcomes for women admitted to hospital in early versus active labour: an observational study

Miller

Armanasco

McCosker

et al. 2020

BMC Pregnancy Childbirth

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Background: There is no available evidence for the prevalence of early labour admission to hospital or its association with rates of intervention and clinical outcomes in Australia. The objectives of this study were to: estimate the prevalence of early labour admission in one hospital in Australia; compare rates of clinical intervention, length of hospital stay and clinical outcomes for women admitted in early (< 4 cm cervical dilatation) or active (≥4 cm) labour; and determine the impact of recent recommendations to define early labour as < 5 cm on the findings. Methods: We conducted a retrospective cohort study using medical record data from a random sample of 1223 women from live singleton births recorded between July 2013 and December 2015. Analyses included women who had spontaneous onset of labour at ≥37 weeks gestation whilst not a hospital inpatient, who had not scheduled a caesarean section before labour onset or delivered prior to hospital admission. Associations between timing of hospital admission in labour and clinical intervention, outcomes and hospital stay were assessed using logistic regression. Results: Between 32.4% (< 4 cm) and 52.9% (< 5 cm) of eligible women (N = 697) were admitted to hospital in early labour. After adjustment for potential confounders, women admitted in early labour (< 4 cm) were more likely to have their labour augmented by oxytocin (AOR = 3.57, 95% CI 2.39-5.34), an epidural (AOR = 2.27, 95% CI 1.51-3.41), a caesarean birth (AOR = 3.50, 95% CI 2.10-5.83), more vaginal examinations (AOR = 1.73, 95% CI = 1.53-1.95), and their baby admitted to special care nursery (AOR = 1.54, 95% CI = 1.01-2.35). Defining early labour as < 5 cm cervical dilatation produced additional significant associations with artificial rupture of membranes (AOR = 1.41, 95% CI = 1.02-1.95), assisted vaginal birth (AOR = 1.96, 95% CI = 1.12-3.41) neonatal resuscitation (AOR = 1.73, 95% CI = 1.01-2.99) and longer maternal hospital stay (AOR = 1.21, 95% CI = 1.04-1.40). Conclusions: Findings provide preliminary evidence that a notable proportion of labouring women are admitted in early labour and are more likely to experience several medical procedures, neonatal resuscitation and admission to special care nursery, and longer hospital stay.

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Section: Discussionmentioning

confidence: 99%

Variations in outcomes for women admitted to hospital in early versus active labour: an observational study

Miller

Armanasco

McCosker

et al. 2020

BMC Pregnancy Childbirth

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“…Education for self-diagnosis of active labor is associated with a decrease in the number of visits to the labor suite compared with no such education (RCT; 208 women). 5 Education in antenatal classes is also associated with arriving to the L&D ward more often in active labor (RCT; 1193 women) 6 and with the use of less epidural analgesia (RCT; 1087 women). 7 In summary, education regarding selfdiagnosis of active labor and labor in general in antenatal classes is recommended (weak recommendation).…”

Section: Education Regarding Self-diagnosis Of Active Labor and Labormentioning

confidence: 99%

Evidence-based labor management: before labor (Part 1)

Berghella

Mascio

2020

American Journal of Obstetrics & Gynecology MFM

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In preparation for labor and delivery, there is high-quality evidence for providers to recommend perineal massage with oil for 5e10 minutes daily starting at 34 weeks until labor; 1 daily sets of repeated voluntary contractions of the pelvic floor muscles, performed at least several days of the week starting at approximately 30e32 weeks gestation; no x-ray pelvimetry; sweeping of membranes weekly starting at 37e38 weeks gestation; for women with a risk factor for abnormal outcome plans should be made to deliver in a hospital setting; for low-risk women, alongside birth center birth is associated with maternal benefits and higher satisfaction, compared with hospital birth; midwife-led care for low-risk women; continuous support by a professional such as doula, midwife, or nurse during labor; and training of birth attendants in low-and middle-income countries.

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“…We excluded a total of 14 studies. Of these studies, five trials were not RCTs (Dowding 2011; IRCT138903063078N4; Janssen 2013; Lumluk 2011; Memon 2015), one trial included participants who were only at risk for depression (Werner 2016), one trial included participants who were not pregnant women but healthcare providers (Cheyne 2008a), and seven trials were excluded because the intervention or participants did not match our inclusion criteria (Bonovich 1990…”

Section: Excluded Studiesmentioning

confidence: 99%

“…No instructions or advice were given regarding labour before admission to the labour ward. Bonovich 1990 This trial examined an intervention in the antenatal period.…”

Section: Additional Referencesmentioning

confidence: 99%

Assessment and support during early labour for improving birth outcomes

Kobayashi

Hanada

Matsuzaki

et al. 2017

Cochrane Database of Systematic Reviews

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Assessment and support in early labour does not have a clear impact on rate of caesarean section or instrumental vaginal birth, or whether the baby was born before arrival at hospital or in an unplanned home birth. However, evidence suggested that interventions may have an impact on reducing the use of epidural anaesthesia, labour augmentation and on increasing maternal satisfaction with giving birth. Evidence about the effectiveness of early labour assessment versus immediate admission was very limited and more research is needed in this area.

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Recognizing the Onset of Labor

Cited by 20 publications

References 1 publication

Variations in outcomes for women admitted to hospital in early versus active labour: an observational study

Variations in outcomes for women admitted to hospital in early versus active labour: an observational study

Evidence-based labor management: before labor (Part 1)

Assessment and support during early labour for improving birth outcomes

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