Antenatal education for self-diagnosis of the onset of active labour at term

Not enough evidence to prove the benefit of a specific set of criteria to self-diagnose active labour.

Sometimes it is difficult to tell when active labour has begun. A false diagnosis can mean multiple visits to the hospital, frustration and discomfort for the mother, decreased confidence in caregivers and additional financial burdens. Antenatal education of women has been developed to increase their confidence and decrease their anxiety. Providing a specific set of criteria to women may be an effective way of helping them recognise the onset of active labour. The review of trials found there was not enough evidence to show whether specific criteria are more beneficial than general guidelines in helping women determine their stage of labour.

Authors' conclusions: 

There is not enough evidence to evaluate the use of a specific set of criteria for self-diagnosis of active labour.

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Background: 

A specific program designed to teach women to recognise active labour may be beneficial through potentially decreasing the incidence of early admission to hospital, increasing women's confidence, feelings of control and empowerment, and decreasing their anxiety.

Objectives: 

The objective of this review was to assess the effects of teaching pregnant women specific criteria for self-diagnosis of active labour onset in term pregnancy.

Search strategy: 

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (October 2007). We updated this search on 30 November 2012 and added the results to the awaiting classification section of the review.

Selection criteria: 

Randomised trials comparing a structured antenatal education intervention for the identification of symptoms for self-diagnosis of active labour with usual care.

Data collection and analysis: 

Trial quality was assessed.

Main results: 

One study involving 245 women was included. Method of randomisation was unclear and 15% of the sample was lost to follow up in this trial. A specific antenatal education program was associated with a reduction in the mean number of visits to the labour suite before the onset of labour (weighted mean difference -0.29, 95% confidence interval -0.47 to -0.11). It is unclear whether this resulted in fewer women being sent home because they were not in labour.

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