The GebStart tool is an instrument developed by Susanne Grylka and her team to support nulliparous women in early labor by assessing their physical and emotional state to help them decide whether to go to the hospital. Initially comprising 32 items derived from focus groups and a scoping review, the tool was tested in a multicentre study involving n=394 women. Due to its complex and formative nature, traditional factor analysis was not used; instead, items were categorized into four domains: physical symptoms, emotional state, self-management, and resources. Statistical analyses, including adjusted Cox and multinomial regressions, were used for item reduction and assess its validity. The final version of the GebStart-tool contained 15 items with score thresholds at 22 and 33 points. Higher total scores were significantly associated with shorter times to hospital admission, onset of active labour, and use of both medical and alternative pain management. However, a higher score did not significantly reduce the likelihood of being advised to “stay home” but did increase the likelihood of “hospital admission” compared to “keep in contact.” The study concludes that the GebStart-tool is a promising, evidence-based instrument, though further validation in larger samples and implementation research, including translation into other languages, is recommended.

Publications for the study can be found below: 

1. Development and preliminary validation of the GebStart-tool for advising nulliparous women in early labour
2. Self‑management, care needs and clinical management of primiparous mothers during early labour – a qualitative content analysis
3. A salutogenic approach to early labor midwifery care in Denmark, Sweden, and Switzerland: A qualitative study
4. Development and validation of a tool for advising primiparous women during early labour: study protocol for the GebStart Study
5. The application of a tool for supporting shared decision making in primiparous women during early labour – a descriptive survey of obstetric health care professionals’ opinion
6. Primiparous women’s expectations and experiences of early labour: A qualitative study
7. Symptoms of onset of labour and early labour: A scoping review
8. Pregnant Women's Care Needs During Early Labor–A Scoping Review