Recognizing active labor : A test of a decision-making guide for pregnant women

The identification of the onset of labor is difficult for even the most knowledgeable, prepared woman, particularly the first time labor is experienced. For many women, the difficulty of this decision means more than one trip to the hospital, as women are often sent home due to false labor or very early labor. At one Los Angeles medical center, providers felt that this was a particularly difficult situation for women of Latin American origin, where language barriers often made it difficult to explain why they were being sent home and how to know when to return. A booklet entitled 'Understanding Labor' was developed on the basis of research on birth in Latin women, and tested by conducting postpartum interviews with two sets of women, 69 who had not received the booklet during their last month of pregnancy and 50 who had. The findings showed no statistically signif trips with or without the booklet, but that the booklet improved women's understanding of labor and facilitated communication between staff and patients during the trips to the hospital. There was a statistically significant differences between the number of trips made by English speaking and Latin women, with primiparous Latin women making fewer trips; a finding which contrasts with staff impressions. This is true despite the fact that significantly more of the English speaking women had childbirth education. Women having their second babies made fewer trips to the hospital irrespective of cultural background. Differences between Latin and non-Latin women's perceptions of the onset of labor and terminology for phases of the birth process are also described, as are women's ways of identifying the onset of labor and making the decision to go to the hospital. The study concludes that the problem of 'repeated trips' to the hospital was reduced to a need for more information on when and how to make those trips, and on a vehicle to facilitate communication between patients and staff who did not share a common language.