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Perceptions of care in women sent home in latent labor
Claire Hosek1, Mary Ann Faucher, Janice Lankford
1Claire Hosek is Staff Nurse-Midwife, Parkland Health and Hospital Service, Dallas, TX. Mary Ann Faucher is an Associate Professor, Baylor University-Louise Herrington School of Nursing, Dallas, TX. She can be reached via e-mail at Maryann_faucher@baylor.edu Janice Lankford is Nurse-Midwifery Manager, Parkland Health and Hospital Service, Dallas, TX. James Alexander is the Chief of Obstetrics, Parkland Hospital, and Professor, University of Texas Southwestern Health Science Center (UTSW), Dallas, TX.
Purpose:
To assess perceptions of care from woman discharged from an obstetrical (OB) triage unit or a labor and delivery unit with a diagnosis of false or latent labor in order to determine factors that may increase or decrease the woman's satisfaction with care.
Study Design:
Descriptive, convenience sample.
Methods:
One hundred low-income pregnant women at term presenting for care in latent labor consented to participate in a telephone survey. The survey was based on the relevant research about care of women in early labor and the Donabedian quality improvement framework assessing structure, process, and outcomes of care.
Results:
Forty-one percent of women did not want to be discharged home in latent labor. Common reasons included women stating they were in too much pain or they were living too far from the birth setting. Eating, drinking, and comfort measures were the most common measures women cited that would have made them feel better when in the hospital. A reoccurring response from women was their desire for very clear and specific written instructions about how to stay comfortable at home and when to return to the hospital.
Clinical Implications:
Comfort measures in the birth setting, including in triage, should include a variety of options including ambulation and oral nutrition. Detailed and specific written instructions about early labor and staying comfortable while at home have value for women in this survey regarding their perceptions of care. Results from this survey of low-income women suggest that a subset of women in latent labor just do not want to go home and this may be related to having too much pain and/or travel distance to the hospital. Hospital birth settings also have an opportunity to create a care environment that provides services and embodies attributes that women report as important for their satisfaction with care in latent labor.
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