If a patient claims to be in active labor and your facility lacks a labor and delivery unit, what is the next appropriate action?

When a patient presents claiming to be in active labor, and the facility does not have a labor and delivery unit, the most appropriate next step is to have an emergency department provider perform a medical screening examination. This step is crucial for several reasons.

First, the medical screening examination allows healthcare providers to assess the patient's status more thoroughly. This evaluation can confirm whether the patient is indeed in active labor and rule out any potential complications that may require immediate intervention. Active labor can present various challenges, including the risk of delivery complications or fetal distress, which must be identified as soon as possible to ensure the safety of both the patient and the fetus.

Furthermore, conducting a medical screening exam aligns with the legal requirements under the Emergency Medical Treatment and Labor Act (EMTALA), which mandates that hospitals provide a medical screening to determine whether an emergency medical condition exists. By completing this examination, the provider is adhering to these regulations and protecting both the patient and the institution.

In contrast, sending the patient home without appropriate evaluation could expose the patient to significant risks if she is indeed in labor or experiencing complications. Starting labor induction medications in a facility without a labor and delivery unit can lead to unsafe situations for both the mother and baby. Immediate transfer without a full evaluation also carries