Effect of Ambulation during First Stage of Labor on Labor Pain and Outcome of Labor among the Primigravida Mothers in a Selected Hospital, Mangalore

Abstract

Objectives • To assess the intensity of labor pain and outcome of labor among the control group. • To assess the effectiveness of ambulation on intensity of labor pain and outcome of labor among the experimental group. • To assess the usefulness of ambulation by opinionnaire among experimental group. • To compare the effectiveness of ambulation on the intensity of labor pain and outcome of labor among experimental and control groups. • To find an association between the intensity of labor pain with selected demographic variables. Materials and methods An experimental research approach was used for the study. Random sampling technique was used to allocate the subjects into experimental and control groups. Visual analog scale was used to assess the intensity of pain and observational check list was used to assess the outcome of labor. The study comprised of 40 primigravida mothers and they were grouped as experimental and control through randomization. One group received ambulation treatment, the other did not. The researcher then observed the groups to determine the effect of the treatment. Results The collected data was analyzed by descriptive and inferential statistics. The intensity of pain revealed that 40% in the experimental and 55% in the control groups experienced severe pain. The labor augmentation revealed that both oxytocin and cerviprime gel was used for 30% in the experimental and 35% in the control groups. On the mode of delivery, majority of mothers (60%) had normal vaginal delivery both in experimental and control groups. On the duration of the first stage of labor revealed that 50% in the experimental and 20% in the control groups were between 10 to 12 hours. Second stage of labor revealed that majority were between 1 and 2 hours in both the control and experimental groups. The opinion of experimental group mothers on ambulation revealed that half of the mothers (50%) agreed for recommending the ambulation for their neighbors and friends and less than half (35%) of them have agreed for comfort during first stage of labor and 40% of them have agreed for ambulation should be made as a routine in labor room. In the experimental group, mean pain score (6.8) is less than the control group (7.5). The calculated Mann-Whitney Z-value (2.045) is greater than the Z α-value of 1.960 at 0.05 level of significance. In the experimental group, the mean duration of first stage of labor score (3.95) is significantly higher than the control group mean score (3.00). The mean outcome of labor in experimental group (13.95) is greater than the control group. Conclusion There was a significant difference in the duration of first stage of labor between the experimental and control groups. But, there was no significant difference in the overall outcome of labor between experimental and control groups. There was no significant association between intensity of labor pain with selected demographic variables. This may be because of small sample size. How to cite this article Savitha V, Nayak S, Paul S. Effect of Ambulation during First Stage of Labor on Labor Pain and Outcome of Labor among the Primigravida Mothers in a Selected Hospital, Mangalore. J South Asian Feder Obst Gynae 2013;5(1):1-3.

Mobility as an Effective Non-pharmacological Method for Parturition: A Pilot Study

“…The study finding is in concurrence where 40% of women who adopted mobility during labour and expressed that mobility should be adopted as a protocol in labour room and 50% recommended the same to family and friends as there was less pain and discomfort during the first stage of labour. 4 A positive birthing experience and maternal satisfaction enhance confidence and mental well-being for future pregnancies and a stronger bond with mother and child.…”

“…3 Mobility of the mother during labour has been recognised as an important non-pharmacological intervention by various research studies. [4][5][6][7][8] One notable reference to mobility during childbirth comes from the work of Grantly Dick-Read, a British obstetrician who published 'Childbirth Without Fear' in 1933. 9 His ideas laid the foundation for future research and practices related to childbirth.…”

“…However, as the natural childbirth movement gained momentum in the 1960s and 1970s, researchers began to investigate the benefits of mobility and various birthing positions, and a number of studies have recognised the pivotal role of maternal mobility during labour in shaping parturition, maternal satisfaction and foetal outcomes. [4][5][6][7][8] Maternal mobility during labour enhances foetal and maternal outcomes through several physiological mechanisms. Upright positions, walking and, most importantly, movement encourage the foetus's descent due to gravity, thereby shortening the duration of labour.…”

“…3 Mobility of the mother during labour has been recognised as an important non-pharmacological intervention by various research studies. 4–8…”

“…However, as the natural childbirth movement gained momentum in the 1960s and 1970s, researchers began to investigate the benefits of mobility and various birthing positions, and a number of studies have recognised the pivotal role of maternal mobility during labour in shaping parturition, maternal satisfaction and foetal outcomes. 4–8…”