An evaluation of late attenders in labour in Alexandra

To study why women present in late labour we interviewed 70 parturients in our labour room for a period of 8 days in March 1990. When presenting 19% were 8-10 cm dilated and 81% were 0-7 cm dilated. The group was stratified into those in early labour (0-7 cm of cervical dilatation) and in late labour (8 cm or more) and compared for all variables studied. Only a few differences were statistically significant. Early comers were less likely to have strong uterine contractions and more likely to have intact membranes at presentation. Late comers were more likely to report a number of delaying factors or to have financial worries. Twenty nine percent of Alexandra residents and only 6% of outsiders reported difficulty in finding transport to labour room after the onset of labour. Almost half of Alexandra residents did not have access to public transport, ambulance or own transport. The relative risk for late coming was: 9 for women reporting a number of delaying factors outside their control; 6 for those with financial worries or with ruptured membranes; 4 for unbooked cases or with current addresses in Alexandra; 3 for women with a normal past obstetric history or with a previous delivery outside the AHC; 2 for those worried with hospital referrals, with a previous rural address, for less than 1 year in Alexandra or with a normal current ANC. Women who came late in labour were more likely to need hospital referral or to have come to the labour unit walking.