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Potential benefits of applying the GebStart-tool for advising primiparous women during early labor: A comparative
Susanne Grylka-Baeschlin1,2, Nadine Pauli3, Catherine Rapp4
1Research Institute of Midwifery and Reproductive Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland.
Introduction:
Early labor care is complex because of women's individual needs. To consider varying experiences and distinguish between parturients who are well at home and those who require increased support, the GebStart-tool was developed. It intends to advise primiparous women during early labor, enhance the quality of care, and improve perinatal outcomes. The aim of this study was to assess the potential benefits and risks of applying the GebStart-tool.
Methods:
Applying the preliminary version of the GebStart-tool, we compared labor and birth data from n=303 study participants with spontaneous onset of labor with baseline data of n=1635 births that occurred in the six months preceding the study across six centers. Descriptive statistics and odds ratios were calculated.
Results:
GebStart-study participants had significantly lower odds for labor augmentation with oxytocin (OR=0.65; 95% CI: 0.51-0.84, p<0.001), epidural analgesia (OR=0.56; 95% CI: 0.43-0.72, p<0.001), and cesarean section (OR=0.52; 95% CI: 0.36-0.76, p<0.001) compared to baseline data. In contrast, the odds for opioid administration (OR=1.37; 95% CI: 1.02-1.83, p=0.028) and a spontaneous vaginal birth (OR=1.33; 95% CI: 1.02-1.72, p=0.028) were significantly higher. Apgar scores at one minute and arterial umbilical cord pH did not differ substantially between groups.
Conclusions:
Compared to baseline data, GebStart-study participants had a higher chance of fewer intrapartal interventions and a spontaneous vaginal birth. Therefore, using the GebStart-tool seems promising for improving labor and birth outcomes. In a future larger study, the effectiveness of applying the final version of the GebStart-tool should be investigated.CLINICAL TRIAL REGISTRATION: The study was registered in the Swiss National Clinical Trials Portal and the German Clinical Trial Register.IDENTIFIERS: SNCTP000004555 and DRKS00025572.
