Expectations, perceptions, and management of labor in nulliparas prior to hospitalization.

This ethnographic qualitative study was designed to explore the phenomenon of prehospitalization labor from the perspective of nulliparous women. Twenty-three women were interviewed in the early postpartum period using a semistructured interview guide. The participants recounted their experiences with labor onset recognition and management before being admitted to the hospital for birthing. Qualitative analyses included verbatim transcription of audiotaped interviews, line-by-line coding, and categorization of data into codes and categories. Interpretive analyses were validated with a collaborative research team and the participants themselves. The central theme that emerged from this study was confronting the relative incongruence between expectations and actual experiences. Supporting categories included: expectations about the labor experience, identifying labor onset, managing the physical and emotional responses to labor, supportive resources, and decision making about hospital admission. Early labor experiences in nulliparas offer insight into the contributions of both expectations and environment to adaptation in labor. Midwives and perinatal nurses are in a unique position to design interventions that support and reinforce laboring women's activities outside of the hospital setting.