Care seeking during the latent phase of labour--frequencies and birth outcomes in two delivery wards in Sweden

Abstract

Objective: To explore the frequency of women seeking care during the latent phase of labour at two delivery wards. Also, to investigate interventions during labour and birth outcomes in relation to parity and remaining in hospital or not during the latent phase.

Methods: A retrospective, population-based cohort study in two delivery wards in Sweden. The sample was based on electronic childbirth records of all births with spontaneous onset.

Results: Of 5797 women, 17.6% (n=1023) sought care during the latent phase. Of these, 57.8% (n=591) remained at the hospital, and 50.5% (n=517) had a prolonged latent phase. Nulliparae remaining in hospital had a lower rate of spontaneous vaginal births (p=0.007), more emergency Caesarean sections (CSs) (p<0.001) and more babies with Apgar <7 at 5 min (p=0.045) compared with those returning home. Nulliparae having a prolonged latent phase and remaining in hospital had fewer spontaneous vaginal births (p=0.045), more emergency CSs (p=0.002) and more babies with Apgar <7 at 5 min (p=0.023) compared with those returning home. For multiparous women with a previous vaginal birth, with or without prolonged latent phase, mode of delivery was not influenced by remaining in hospital or not.

Conclusion: These findings indicate a need for different guidelines for nulliparous and multiparous women seeking hospital care during the latent phase, and for special attention to be given to nulliparous with a prolonged latent phase remaining in hospital during the latent phase.

Keywords: Delivery; Delivery outcome; Labour; Latent phase of labour; Parity.