Effect of Applying Spontaneous Pushing Technique During Second Stage of Labor on Women''''s Early Postpartum Fatigue

Abstract

The aim of this study was to evaluate the effect of applying of spontaneous pushing technique during second Stage of labor in early postpartum fatigue. Methods: A quasiexperimental research design was used to carry out this study at the Labor and delivery unit of Mansoura University Hospital on 100 primigravida women at ≤37 gestational weeks, who were selected by purposive sampling technique. They were free from any medical and obstetric problems, can read and write. They were assigned either to the control or intervention group (n= 50 per each group). The intervention group: had received spontaneous pushing during second stage of labor, while the control group had received the routine pushing technique. Three tools for data collection were used; an interviewing questionnaire schedule, Visual analogue scale for fatigue and women's satisfaction questionnaire. Results: The study showed significant different between the two groups regarding the duration of second stage ,newborn health status &Apger score(7.8 ±1 versus 4 ±1.4 respectively, 0<0.001).Women expressed greater satisfaction with spontaneous pushing (98% versus 44% respectively, p<0.001).Conclusion spontaneous pushing technique is an effecting method in reducing women's fatigue. Recommendation Educating women about the spontaneous pushing technique in the first stage of labor and providing support for spontaneous pushing in the second stage for decrees postpartum fatigue.

Effectiveness of Spontaneous Pushing versus Valsalva Pushing in the Second Stage of Labor on Maternal and Neonatal Outcomes: A Systematic Review and Meta-analysis

“…Time duration of the second stage of labor: Two studies reported that spontaneous pushing gave a shorter time duration in the second stage of labor compared to Valsalva pushing. 21,23 In contrast, a third study reported that Valsalva pushing produced a shorter duration. 22 The combined effect sizes of the three studies [21][22][23] showed a high level of heterogeneity (I 2 = 98%).…”

“…21,23 In contrast, a third study reported that Valsalva pushing produced a shorter duration. 22 The combined effect sizes of the three studies [21][22][23] showed a high level of heterogeneity (I 2 = 98%). The summary effect size from the random effects model was not statistically significant, thus not supporting the benefit of spontaneous pushing in reducing the duration of labor [overall effect size = -0.89 (95% CI = -3.39, 1.28, p = .376)].…”

“…Two randomized controlled trials (RCTs) 21,22 and two quasi-experimental research 18,23 were included with participants from three countries. The four studies compared spontaneous pushing versus Valsalva pushing in the second stage of labor among primiparous women in secondary and tertiary-level hospitals.…”

“…The four studies compared spontaneous pushing versus Valsalva pushing in the second stage of labor among primiparous women in secondary and tertiary-level hospitals. Two studies were conducted in Thailand, 18,21 one in Egypt, 23 and one in Turkey. 22 Appendix, Table 2 presents the four studies' countries/settings, patient characteristics, sample sizes of intervention and control groups, outcomes measured, and main results.…”

Effect of Spontaneous Pushing Technique during Second Stage of Labor on Labor Outcomes among Primiparas

“… Parturient women during second stage of labor and fulfilled the criteria of vaginal delivery without contraindications. It was designed by researcher after reviewing related literatures regarding the study(Elzihiri et al, 2016), it included the following two parts: First part Socio-demographic data, it included (age, education level, occupation and residence).  Second part concerning with current pregnancy and labor data as (gestational age, antenatal care received, onset of antenatal care, number of antenatal care visits, duration of labor pain until the time of admission, frequency of uterine contraction, bladder condition and enema performed).Tool II: Physical assessment and observation sheet during labor:-This tool was adopted from (Mohamed, 2013) and was used to assess maternal and newborn conditions, which included general examination on admission (maternal vital signs, anthropometric measurements, vaginal examination, condition of membrane, amniotic fluid color and uterine contractions) and general examination during second stage of labor (vital signs , fetal heart rate (FHR), oxytocin use of augmentation, increase in oxytocin dose during the second stage of labor, station of fetal head at initiation of pushing, uterine contractions, duration of uterine contraction, number and duration of pushing during each contraction) Tool III: Visual Analogue Scale (VAS): It was used to assess the level of pain.…”