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School of Health Sciences

Development and validation of a tool for advising primiparous women during early labour (GebStart-Study)

To inform the decision “admitted versus non admitted to hospital” for primi-parous women during early labour.

Women giving birth to their first child often have difficulties to cope with contractions and other symptoms of early labour. If hospital admission occurs before the birth progresses, this is associated with increased rates of intervention and caesarean section. However, staying at home in labour can cause anxiety. Care during early labour is often unsatisfactory for women in labour and challenging for health professionals. The study aims therefore to develop and validate a tool to inform the decision “admitted versus non admitted to hospital” for primi-parous women during early labour.

Background

Pregnant women experience early labour as the first phase of labour with different physical and emotional symptoms. Early admission to hospital has been found to be associated with increased intervention and caesarean section rates. However, primiparous women often contact the hospital before labour progresses because they might have difficulties coping with labour pain at home. Previous studies investigating early labour care have not resulted in increased spontaneous birth rates and have not provided evidence regarding the appropriate care during early labour. An evidence-based instrument assessing the physical and emotional state within the early labour process and the wellbeing of woman and thereby, their need for support, is required to inform the decision “admitted versus not admitted to hospital”.

Objectives

This study aims to develop and validate a tool for advising primiparous women during early labor.

Design

A multi-stage scale development procedure with a mixed-methods study design will be conducted.

Methods

The study will last three years and include the following phases:

1. Preparatory Phase

2. Development Phase

3. Data Collection Phase
Multicentre data collection in six sites in the Zurich region as well as Central and Northwest Switzerland with a sample size of approximately n = 400 women:

4. Analysis and Finalization Phase

Benefits

The tool will provide an instrument to advise primiparous women during early labour. It can be applied by midwives and doctors for the initial telephone or face to face contact. The use of the instrument is of great interest because it has the potential to shorten hospital stays, increase spontaneous birth rates and decrease intervention rates and thereby, lower costs. Additionally, this study will make an important contribution to the scientific discussion for optimising early labour care and provide a basis for further research.

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