Achieving the best from care in early labour

The randomised controlled trial by Hodnett and colleagues (doi: 10.1136/bmj.a1021) compares outcomes and experiences between women who received a new programme of structured care in early labour versus those who received “usual care” in a hospital based labour assessment unit.1

The care given to women in labour can greatly affect their birth experience and birth outcomes. For example, continuous support for women in labour improves clinical and psychosocial aspects of labour and birth outcomes.2 Little is known, however, about the effects of care in early labour. This time is challenging—confirming that a woman is really in labour can be difficult both for women and for a midwife or obstetrician to do by phone contact. Repeated journeys between home and hospital,3 or spending time in hospital waiting for labour to start, are common experiences for women and their partners.

Women need information, advice, and reassurance around the onset of labour,4 and services need to know how best to provide cost effective …