School of Health Sciences

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

We developed an evidence-based tool for advising first-time mothers during early labour (latent phase) on hospital admission decisions.

Women giving birth to their first child often have difficulties coping with contractions and other symptoms of early labour (latent phase).

While early hospital admission is associated with increased rates of interventions and Caesarean sections, staying at home during labour can, on the other hand, lead to anxiety and insecurity.

Consequently, care during early labour is often unsatisfactory for women in labour and challenging for health care professionals. Therefore, the GebStart-Study aims to develop and validate an evidence-based decision-making tool to support the decision “admitted versus non admitted to hospital” for primiparous women during early labour.

Background

Pregnant women experience early labour as the first phase of labour with different physical and emotional symptoms. While early admission to hospital has been associated with increased rates of interventions and Caesarean sections, many primiparous women still contact the hospital before labour has progressed. This is often due to difficulties coping with labour pain and uncertainty at home. However, previous studies on early labour care have not resulted in increased spontaneous birth rates, nor have they provided evidence on optimal care during early labour.

There is a clear need for an evidence-based instrument that assesses both the physical and emotional state of women in early labour, as well as their overall wellbeing and need for support. Such a tool could support informed decision-making regarding hospital admission versus remaining at home.

Objectives

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

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

Findings

We developed a standardised, evidence-based questionnaire to assist decision-making in clinical practice. The final questionnaire comprises 15 items (questions) and covers a broad spectrum of relevant dimensions, including physical symptoms (contractions, exhaustion, etc.), emotional factors (confidence, sense of control, etc.), as well as preparation for childbirth, well-being and support at home during early labour.

Further studies with larger sample sizes are necessary for a comprehensive evaluation. In addition, its use in clinical practice – ideally accompanied by implementation research – and its translation into other languages should be promoted.

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