Can an educational web-intervention, co-created by service users alongside self-efficacy theory, affect nulliparous women’s experiences of early labour? A study protocol for a randomised control trial (the L-TEL Trial).

Abstract

Background. ‘Early labour’ refers to the beginning phase of a woman’s labour. It is the period of time where there are painful contractions and the cervix changes in preparation for active labour and subsequent childbirth. In UK clinical practice, cervical dilatation of four centimetres is commonly accepted as when active labour begins. Low-risk women, with uncomplicated pregnancies, have less unnecessary medical intervention if they remain at home in early labour. Despite recent efforts to improve labour triage, assessment and diagnosis in an attempt to reduce early-labour admission rates, women remain fearful and under-confident to remain at home during this time and continue to seek admission to their birth place. Thus, further research is required to evaluate new interventions aimed at improving women’s experiences of remaining at home in early labour. Methods. This trial is a pragmatic, randomised control trial with mixed-method data collection. The trial will evaluate the effect of a co-created, educational web-intervention on women’s early labour experiences. The trial aims to recruit 140 low-risk, pregnant nulliparous women from a single National Health Service (NHS) Hospital Trust in England. Participants randomised to the intervention group will receive a link to the web-intervention, alongside routine maternity care provisions. The control group will receive only routine maternity care provisions. Discussion. It is hypothesised that the group that receive the intervention will score higher in the Early Labour Experience Questionnaire (ELEQ, Janssen and Desmarais, 2013), indicating an improved early labour experience when compared with those in the control group. It is anticipated that findings from this trial will contribute to the knowledge base around how to improve first time mothers’ experiences of early labour, particularly the time spent at home prior to admission. Keywords. Pregnancy, childbirth, early labour, latent, self-efficacy, experience, education, website, online, protocol, randomised control trial, evidence-based midwifery