Does the way in which the latent phase (early labour) was experienced affect the process, duration and outcome of labour

Abstract

Title: Does the way in which the latent phase was experienced affect the process, duration and outcome of labour? Aims The aims of the study were to identify the symptoms women experience in the latent phase of labour and what influences their decision to seek hospital admission. The study also aimed to explain, if the way in which the latent phase was experienced affected the process, duration and outcome of labour. Research questions: 1. What symptoms do women experience during the latent phase of labour? 2. Of the symptoms experienced in early labour, do some more than others incite women to seek hospital admission? 3. What was the duration of time from the onset of symptoms to professionals’ diagnosing established labour? 4. Are there any associations between the duration of labour and the outcome? Design: A mixed method design involving questionnaires, interviews and clinical data collection. The study was conducted in two stages. In stage one, part one questionnaires were used to examine how women experience early labour. In stage one part two data were collected from the Maternity Information System (MIS) for women who completed the questionnaire. Stage 2 involved interviewing 10 women who had completed the stage one questionnaire. Sample: Inclusion criteria included low risk women, gestational age 37 to 41 completed weeks. 408 women consented to participate. 54 were lost for various reasons. 354 women who consented remained within the study until data collection were completed. Of these, 235 (66.4%) women completed and returned the questionnaire. Data Analysis: SPSS for quantitative and some qualitative data i.e. questionnaires, MIS. NVivo and colour coding for qualitative data i.e. questionnaires and interviews. Quantitative data were analysed using descriptive statistics and Cox regression analysis. Qualitative data were analysed thematically. Outcomes: Symptoms experienced in the latent phase of labour included irregular pain, regular pain, loss of water from the birth canal, blood loss, stomach upset, sleep disturbances or emotional upset. There was a significant time difference between the women’s experience of the onset of symptoms to the time professionals diagnosed established labour. There was poor agreement with women coinciding with their midwives assessment of the duration of the first stage of labour. While symptoms, particular pain played a part in women’s decision to go to the hospital there were many other influencing factors. Women felt they were not prepared and that they would like more information to help prepare them for latent phase labour. Also women wanted more care through latent phase labour. Conclusion: Women do not want to be left to their own devices in early labour and feel that care in early labour should be viewed as a continuum to the pregnancy. The most common symptoms experienced were regular pain, experienced by almost all women (91%) and blood loss experienced by 70% of women. Water loss and regular pain were important predictors of the duration of labour in multiparous women. Longer labours overall for both primiparous and multiparous women required operative births.