Many low-income women with false labor want to remain in hospital

In the first study looking at latent labor experiences among disadvantaged populations of women, researchers at Baylor University’s Louise Herrington School of Nursing and Parkland Health & Hospital System found that 41% of low-income women discharged from the hospital due to a diagnosis of false or early labor did not want to be sent home.

From October 12, 2011 to January 2, 2012, investigators surveyed via telephone 100 low-income pregnant women who presented for care while in latent labor and consented to participating in the survey. Forty-seven percent of the surveyed women were Hispanic; 31% were African-American. Medicaid was the payer for 30% of the participants, while 26% were under charity care. Questions were based on research on care of women in early labor and the Donabedian quality improvement framework.

Common reasons for not wanting to be discharged from the hospital included being in too much pain or living a considerable distance from the hospital. When asked what would have made them feel better while in the hospital, more than 60% had responses. Of those who responded, the most common answers were: the ability to eat (68%), the ability to drink (95%), or the ability to walk (72%).

Better pain management was a priority for 44% of respondents and 36% wanted clearer instructions about when to return to the hospital. However, 97% of the respondents felt that they had received adequate attention before being discharged and 82% said that a longer hospital stay would have no impact on perception of care.

When asked what would have made them happier about being discharged, 86% of the respondents indicated that they would like a follow-up phone call after discharge; 66% wanted written instructions for how to remain comfortable at home; 47% wanted explicit instruction about when to return to the hospital; and 36% wanted pain medication before being sent home.

The investigators concluded that hospitals should adopt best practices that involve policies on comfort measures for women undergoing admission assessment. They urged providers to listen to patients and provide them with all the necessary information and guidance about what is happening and what will happen as their labor progresses.

Hosek C, Faucher MA, Lankford J, Alexander J. Perceptions of care in women sent home in latent labor. MCN Am J Matern Child Nurs. 2014;39(2):115-21.