Effectiveness of Birthing Ball upon Labor Pain and coping in Primi gravid Women

Transcription

1 Effectiveness of Birthing Ball upon Labor Pain and coping in Primi gravid Women Dr. Latha Venkatesan Principal, Apollo College of Nursing Chennai, India

2 Labor Pain & Birthing Ball

3 Statement of the problem An Experimental Study to Assess the Effectiveness of Birthing ball upon Labor pain and Coping during First Stage of Labor in Primi parturient Women at Andhra Mahila Sabha Hospital, Chennai.

4 Objectives of the study 1. To assess the level of labor pain, coping and feto-maternal parameters during the first stage of labor before and after use of birthing ball among the control and experimental group of Primi parturient women. 2. To assess the effectiveness of birthing ball by comparing the level of pain, coping and feto-maternal parameters during first stage of labor before and after use of birthing ball among the control and experimental group of Primi parturient women.

5 Contd 3. To determine the level of satisfaction upon use of birthing ball in experimental group of Primi parturient women. 4. To find out the association between the demographic variables and the level of labor pain and coping in control and experimental group of Primi gravid women before and after the use of birthing ball. 4. To find out the association between the Obstetric variables and the level of labor pain and coping in control and experimental group of Primi gravid women before and after the use of birthing ball.

6 Operational Definitions Effectiveness The outcome of the birthing ball as measured in terms of the level of labor pain and feto maternal parameters of Primi parturient Women before and after use of birthing ball.

7 Birthing ball It is a large air filled rubber ball (about 60 cm in diameter) made up of extra tough non slip burst proof PVC that is easily wiped and clean. The women will be sitting over the birthing ball after 2cm of cervical dilatation in a sitting position for 15 minutes in an interval of 2cm, 4cm, and 6cm of cervical dilatation

8 Cont.. Labor Pain In this study, it was the pain experienced by the Women during the first stage of labor as measured by numeric pain rating scale First stage of labor In this study, it refers from the starting of true uterine contractions to till full cervical dilatation of the cervix. Approximately the duration of this period for Primi Parturient woman is 12 hours.

9 Feto-maternal Parameters The parameters which are measured by the researcher through modified WHO partograph namely fetal heart rate, maternal blood pressure, duration and frequency of uterine contraction per ten minutes and cervical dilatation Primi Parturient Women In this study, it refers to the Women who is going to deliver the baby for first time between the age of with gestational age of37-42 weeks are in the first stage of labour

10 Cont Level of satisfaction In the study level of satisfaction is a feeling of gratification attained or achieved by birthing ball in Primi parturient women as measured by rating scale prepared by researcher

11 Hypothesis H 01 There will be no significant difference in the level of pain, coping and feto-maternal parameters during first stage of labor before and after use of birthing ball in the control and experimental group of Primi parturient women. H 02 There will be no significant association between the selected demographic variables and level of labor pain and coping before and after use of birthing ball in the control and experimental group of Primi parturient women. H 03 There will be no significant association between the selected obstetric variables and level of pain and coping before and after use of birthing ball in the control and experimental group of Primi parturient women.

12 Research methodology Experimental approach Research design: Time series with multiple Institution of treatment R O1 X O2, O3 X O4, O5 X O6 O1,O3,O5: R O1 - O2, O3 - O4, O5 - O Assessment before use of birthing ball at 2cm, 4cm, 6cm of cervical dilatation X : Administration of birthing ball O2, O4,O6: Assessment after use of birthing ball at 2cm, 4cm, 6cm of cervical dilatation

13 Sample size 60 patients ( 30- control & 30-experimental) Sampling technique Systematic Random Sampling Technique.

14 Inclusion criteria Exclusion criteria Sampling criteria Women with first stage of labor Women available during the time of data collection Who were willing to participate in the study Between age of years Women with in the gestational age of weeks With the cervical dilatation of 2 cm 6 cm Women with second and third stage of labour Women induced with Cervi prime gel Women who adopted any other non pharmacological method Women who are posted for Lower segmental caesarean section Women with underline diseases such as pregnancy induced hypertension, diabetes mellitus

15 Study Instruments Demographic Variable Proforma. Obstetrical Variable Proforma. Modified pain intensity scale Pain coping scale Modified WHO Partograph Rating scale on satisfaction of birthing ball

16 Data Collection Procedure A group of 60primi parturient women (30 in each group) were selected by systematic sampling method and consent was obtained from participants Yoga mat has been placed on the floor over that birthing ball has been kept. Then the mother was made to sit over the ball. The researcher held the mother and started initially with breathing techniques for 1 to 10 counts after that the fro and through movement has been provided with the gentle back massage.

17 Cont,, Birthing ball was provided for 15 minutes in the interval of cervical dilation of 2cm, 4cm, and 6cm for experimental group of Primi parturient women. The pain level, coping level and feto maternal parameters were assessed after intervention and with the cervical dilatation of 2cm, 4cm, and 6cm for both groups with the same tools. The level of satisfaction on use of birthing ball was assessed in the experimental group of Primi parturient women using rating scale after delivery.

18 RESULTS

19 Demographic Variables in Control and Experimental Group of Primi parturient Women During First Stage of Labor All the women were home makers (100%,100%), didn t received any previous knowledge regarding birthing ball (100%,100%) and majority of the women were homogenously distributed between the age group of 21-25years (70%,60%) had completed their secondary education (60%,70%) with monthly income of rupees (70%,50%) and living in urban (50%,60%) in the control and experimental group respectively.

20 Frequency and Percentage Distribution of Obstetric Variables in Control and Experimental Group of Primi parturient Women during First Stage of Labor. All the women attended more than 8 ante natal visits (100%,100%) None received any pain management during labour (100%,100%) Majority of them were in the gestational age of weeks (70%,70%) No fetal and maternal complications during labour (100%,100%) Had normal vaginal delivery (70%,90%) Duration of first stage labour was 9-10 hours (60%,70%) Duration of second stage of labour was minutes (70%,90%) Normal APGAR score of the new born (100%,100%) in control and experimental group respectively.

21 Comparison of Mean and Standard Deviation of Level of Labor Pain Before and After use of birthing ball in Control and Experimental Group of Primi parturient Women. Level of labour pain Before therapy N = 30 t value After therapy N = 30 t value Control group Experimental group fff

22 Comparison of Mean and Standard Deviation of Level of Coping Before and After use of birthing ball in Control and Experimental Group of Primi parturient Women Level of coping Before therapy N = 30 t value After therapy N = 30 t value Control group Experimental group fff

23 Association between the Selected Demographic Variables and Level of Labor Pain and Coping Before and after use of Birthing ball in Control and Experimental Group of Primi parturient Women There was no significant association between the level of labor pain and coping with the selected demographic variables of the control and experimental group of Primi parturient women. Hence null hypothesis H 01 & H 02 were retained.

24 Association between the Selected Obstetric Variables and Level of Labor Pain and Coping Before and after use of birthing ball in Control and Experimental Group of Primi parturient Women There was no significant association between the selected Obstetric variables and the level of labor pain and coping in Control and experimental group of Primi gravid women Hence the null hypothesis H 03 & H 04 were retained.

25 Recommendations.. The same study can be conducted with larger number of samples. A comparison can be made between Primi and Multi gravid. A comparison can be made with different stages of labor. The same study can be conducted at different settings. A comparison can be made between different types of alternative and complementary therapies.

26 Conclusion.. This study shows that use of birthing ball was effective in reducing the labour pain perception and improving the coping level. The experimental group of women who received birthing ball had decreased pain perception and was highly satisfied with the therapy. The birthing ball is a non invasive procedure and has no adverse effects on the mother and the fetus and hence the midwives could be encouraged to use this as a pain relief method during labour.

27 THANK YOU