Background: Fatigue accumulates throughout the labor period and often occurs in conjunction with pain and anxiety during childbirth, resulting in negative effects on laboring women. Objective: The purpose of this study is to investigate the effectiveness of an integrated symptom-related fatigue management program (ISFMP) on pain, anxiety, fatigue score and lactate levels in a low-risk pregnant woman during childbirth. Method: This quasi-experimental study was conducted from August of 2021 to March of 2022 at Prachuap Khiri Khan Hospital. Sixty-five low-risk pregnant women with 32–41+6 weeks gestation were selected by the stratified random-sampling and matching techniques. They were then randomly assigned to either comparison or intervention groups. Data were collected using a demographic questionnaire and a visual analogue scale for pain, anxiety and fatigue. Lactate Pro 2 was used to evaluate lactate levels. Data were analyzed through statistical software (SPSS-26) using independent t-test, chi-square, repeated measure ANOVA and repeated measure multivariate analysis of variance (MANOVA). The significance level was set at p <.05. Results: The participants in the comparison and experimental groups had varying pain, anxiety, fatigue scores and lactate levels throughout their progression of labor. Pain, anxiety and fatigue in the experimental group were significantly lower than in the comparison group (p < 0.001). There were no statistically significant differences in lactate levels between the two groups. Conclusion: The ISFMP was shown to be effective in lowering the symptoms of pain, anxiety and fatigue in women in labor. Midwives should apply the ISFMP in their clinical practice when caring for low-risk pregnant women.

Background: Fatigue is a complex phenomenon. It is a common problem that occurs at all periods of childbearing. Pregnancy and labor are recognized as a normal physiological process, and fatigue, a common symptom that occurs frequently throughout the childbearing experience, has the potential to negatively affect the woman’s prenatal and birth experience. Fatigue is often overlooked by health professionals. Objective: The aim of this systematic review is to review the literature regarding the factors influencing maternal fatigue during childbirth and its management. Methods: The Joanna Briggs Institute (JBI) systematic review was used to guide this study. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was performed to report this systematic review. The database was searched from CINALH, Pubmed, PsyInfo, ThaiJO, and other sources for grey literature from 1990-2021. The methodological quality process used the critical appraisal tool for RCT study and MINORS (Methodological Index for Non-randomized Studies). Nine published articles were selected for this study. Results: The factors influencing maternal fatigue during childbirth were found to be physiological, psychological, and situational. The physiological factors were age, parity, uterine contractility, available energy substrate, nutrition adequacy, and prenatal exercise. The psychological factors were pain and anxiety. The situational factors were childbirth education, pain medication, prenatal employment, sleep, breathing technique, and pushing intervention. The managing of fatigue during childbirth were 1) assessing maternal fatigue in early pregnancy; 2) childbirth preparation; 3) conservation of energy; 4) shortened duration of labor; and 5) reduced labor pain and anxiety. Conclusion: Maternal fatigue during childbirth impacts the mother, the child, and the family. It is important for nurses to understand the deleterious effects of fatigue on childbearing women and to promote interventions that reduce or prevent fatigue during pregnancy and childbirth.

Background: Childbirth is often conducted in a traditional biomedical paradigm. Nature’s simple plan for birth has been replaced by a maternity care system that increases unnecessary risks for mother and child. Strategies of comfort management can guide nurse professionals to face serious challenges and help a woman get benefits from normal birth. Objective: The purpose of this article is to determine strategies of comfort management in pregnant women during childbirth. Methods: Published articles from the electric database, including CINAHL, PsyINFO, Pubmed, Cochrane, ThaiJO and other sources, were conducted from January 1, 2009, to March 1, 2019. The PICo mnemonics were used to guide the research question. The PICo tool was applied for search strategies. Two authors evaluated title, abstract and quality. The JBI Critical Appraisal Checklist for Qualitative Research has been used as a methodology for appraising the quality of all studies. Data were extracted by using a standard data extract tool from the JBI-Qualitative Appraisal tool by two independent researchers. Ten published articles have been selected to study by the PRISMA process. Results: Six themes of the strategy of comfort management emerged: 1) encourage a strong sense of self-control 2) support and continuous attendance 3) education and information 4) multidisciplinary approach 5) environment preparation 6) attending a woman’s need. Conclusion: This study adds new knowledge about the strategies of comfort management that may guide the midwife with expanded options for women during childbirth, give the midwife understanding of their role and can provide comfort in effective childbirth.

Contraception information and services are the basis of the health and human rights of everyone. Young girls who become pregnant are at greater risk for problems arising from early child deliveries. Contraception in older women likewise results in increased risk. It was found from the particulars of contraception use that the male partner has a great deal of influence, and that the same is true of the perspectives and experiences of the people surrounding his partner, the expectations of her family and her desire for more children. In Thailand, there are ethnic groups of numerous tribes, among whom are the Karen, who make up the largest of any such group. The Karens have a low rate of contraception use and low incomes with reduced resources. Thus, family planning is an important key in reducing their population growth and the impact on their economy, environment and development. The purpose of this study was to explore the determining influence of contraception among minority women in Thailand in the form of descriptive qualitative research. Data were analyzed using Colaizzi's method. The research showed that the use of contraceptive services by Karen women was restricted by the culture, beliefs and social conditions characteristic of their ethnic origin. The husband and extended family influenced their contraceptive decisions. The prevailing belief was that contraception is the duty of women. Some women used herbs for contraception. They had difficulty communicating when receiving contraceptive services. Karen people have little income; so they cannot afford expenses related to contraceptive services requiring them to pay for travel costs. Furthermore, the road conditions make the trip awfully difficult, and their houses are situated far from the hospitals. In conclusion, determining the influence of birth control among minority women in Thailand must be based on their beliefs, society and ability to access health services.