Related Experiment Videos
Assessment and support during early labour for improving birth outcomes
Shinobu Kobayashi1, Nobutsugu Hanada1, Masayo Matsuzaki2
1Department of Health Policy, National Center for Child Health and Development, 10-1, Okura 2 chome, Tokyo, Tokyo, Japan, 157-8535.
The Cochrane Database of Systematic Reviews
|April 21, 2017
Summary
Supportive care during early labor may reduce epidural use and increase maternal satisfaction. However, evidence for interventions like early labor assessment versus immediate hospital admission remains limited, necessitating further research.
Area of Science:
- Obstetrics and Gynecology
- Maternal and Fetal Medicine
- Evidence-Based Midwifery
Background:
- Early labor is often slow and can cause distress and loss of confidence in women.
- Previous reviews on support and assessment interventions in early labor are outdated.
- This review synthesizes current evidence on interventions during the latent phase of labor.
Purpose of the Study:
- To evaluate the effectiveness of assessment and support interventions for women in early labor.
- To compare the duration of labor, rates of obstetrical interventions, and maternal/neonatal outcomes.
Main Methods:
- Systematic review and meta-analysis of randomized controlled trials (RCTs).
- Searches conducted in major clinical trial registries and databases up to October 2016.
- Independent assessment of trials for inclusion, risk of bias, and data extraction.
- GRADE approach used to assess the quality of evidence.
Main Results:
- Early labor assessment may reduce labor duration and epidural anesthesia use, increasing maternal satisfaction.
- Home visits by midwives did not significantly impact labor duration or rates of cesarean/instrumental birth.
- One-to-one structured midwifery care showed no clear differences in cesarean rates, instrumental births, or maternal morbidity compared to usual care.
- Evidence quality varied, with many outcomes assessed as low to very low due to study limitations and imprecision.
Conclusions:
- Assessment and support interventions in early labor show potential for reducing epidural use and augmenting labor, and increasing maternal satisfaction.
- No clear impact was found on cesarean section rates, instrumental vaginal births, or unplanned home births.
- Evidence regarding early labor assessment versus immediate hospital admission is very limited, highlighting the need for more research.