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Does introducing a dedicated early labour area improve birth outcomes? A pre-post intervention study
Williams, Lauren Jenkinson, Bec Lee, Nigel Gao, Yu Allen, Jyai Morrow, Jane Kildea, Sue
Williams, Lauren
Jenkinson, Bec
Lee, Nigel
Gao, Yu
Allen, Jyai
Morrow, Jane
Kildea, Sue
Abstract
Problem Women increasingly present to hospital in early labour, but admission before active labour contributes to overuse of interventions, poorer clinical and psychological outcomes, and higher healthcare costs. Background Innovative models of early labour care have so far not improved birth outcomes. Aim To examine if reconfiguring the early labour service in a large Australian maternity service improved (1) the birth outcomes of women who presented in early labour and (2) alleviated bed blockages by decreasing length of stay in the Pregnancy Assessment and Observation Unit. Methods Pre-post intervention design, using routinely collected clinical data before and after the implementation of the reconfigured early labour service. Findings There were 527 women in pre-intervention cohort and 747 in the post-intervention cohort. The two groups were similar in age, body mass index, marital status, education level and gestation at birth. Post intervention, epidural use did not change significantly, but rates of amniotomy (35.7% vs. 49.9%, p = <0.001), meconium-stained liquor (20.1% vs 26.1%, p = 0.04), and neonatal nursery admission (2.7% vs. 5.8% p = 0.01) increased. The proportion of women staying in the Assessment unit more than two hours decreased, but not significantly. Conclusion Changing the location and model of early labour care did not influence epidural use, nor improve women’s birth outcomes. For women in early labour, admission to any location within the hospital may be as problematic as admission to birth suite specifically.
Keywords
early labour, labour assessment, triage, hospital admission, epidural
Date
2019
Type
Journal article
Journal
Women and Birth
Book
Volume
33
Issue
3
Page Range
259-264
Article Number
ACU Department
School of Nursing, Midwifery and Paramedicine
Faculty of Health Sciences
Faculty of Health Sciences
Relation URI
Source URL
Event URL
Open Access Status
License
File Access
Controlled