The Effect of Selected Antenatal Exercises in Reduction of Labor Pain among Primigravid Women: Implication for Practice

Abstract

Purpose: Labor is a physiological event, but it is a painful event.The agony and stress a woman suffers are beyond description. Primigravid women must be prepared during the antenatal period itself for safe and natural childbirth. The purpose of this study was to determine the effect of antenatal exercise in pain management during labor. Materials and methods:A quasi-experimental study was conducted with 600 primigravid women. Education on antenatal exercises provided with the help of three-dimensional (3D) animation and the practice was monitored. Visual analog scale (VAS) was used to assess the perception of the pain of these primigravid women during labor. Results:The primigravid women performed exercise for a minimum of 15 to a maximum of 34 days. In the experimental group, 74% of the primigravid women had moderate pain, and only 26% of them had severe pain. Whereas in the control group, 95.7% of the primigravid women had severe pain and only 4.4% of women had mild to moderate pain. Experimental group women had better pain bearing capacity due to exercise as compared to control group. Conclusion:Nurses and childbirth educators must be willing to provide sensitive, continuous care that is a collaborative effort with the woman to assist her in coping with pain and mastering the experience of childbirth. Greater attention needs to be paid to promote and implement the antenatal exercise program from the onset of pregnancy in the absence of any medical and obstetrical complications. Healthcare providers should appreciate and strongly recommend the exercise program as nonpharmacological pain relief measure during labor.

The effectiveness of skilled breathing and relaxation techniques during antenatal education on maternal and neonatal outcomes: a systematic review

“…Of these, nine were RCTs and one was a quasi-experimental study. Two studies were conducted in the USA [ 19 , 20 ], two in India [ 21 , 22 ], one in Taiwan [ 23 ], one in New Zealand [ 24 ], one in Australia [ 25 ], one in Brazil [ 26 ], one in Iran [ 17 , 18 ], and one in Sweden [ 27 ].…”

“…Participants received a guide with the exercises to be performed daily at home, consisting of pelvic floor muscle training (PFMT) including rapid (30 times) and sustained maximal contractions (20 times holding for 10 s), stretching exercises to reduce back pain and exercises to improve venous return in the lower limbs Information about breathing exercises for birth. Relaxation at home: Training of breathing techniques for contraction control during labour, Training of breathing techniques for contraction control during labour; progressive relaxation techniques; massage; mentalisation monthly from 18–24 weeks until 30 weeks’ gestation; fortnightly till 36 weeks; Duration 50 min 18–24 weeks’ gestation Duration of labour, Memory of labour pain (VAS), Mode of birth 1 st min and 5 th min Apgar score > 7, Birthweight > 2500 g Secondary outcome = 78 Secondary outcome = 71 Pan, 2019 [ 23 ] RCT 35 39 • Adaptation of MBCP by Nancy Bardack • Transformative experience of pregnancy, childbirth, and postpartum-related adjustments in self-awareness training • Listen to programme-related audio recordings at home six times a week for 30 min each Three-minute breathing space 8 weeks; Series of nine three-hour classes held once per week and one seven-hour day of silent-meditation practice After recruitment between 13 and 28 weeks’ gestation Childbirth self-efficacy (CBSEI) Prince, 2015 [ 22 ] Quasi-experimental 300 300 • Antenatal exercises by video training (animated and easily understandable) • Antenatal techniques included breathing exercises, relaxation exercises and pelvic floor muscle exercises • Information about pregnancy and labour, benefits of selected antenatal exercise, types of exercises, selected exercises during pregnancy and labour • Each primigravid women was given a record sheet to record the exercises performed at home with relevant instructions and a compact disk (CD) was provided for their practice NI 34 weeks up to birth; Once (45 min), practice at home (< 200 up to > = 400 h) NI Memory of labour pain (VAS) Timm, 1979 [ 20 ] RCT ...…”

“…Of the ten included studies, five studies evaluated the maternal outcomes childbirth experience and self-efficacy [ 17 , 19 , 23 , 24 , 27 ] and four studies examined memory of labour pain [ 18 , 22 , 26 , 27 ]. The use of pain medication [ 19 , 25 , 27 ] and the mode of birth were investigated in three studies [ 25 – 27 ].…”

“…Inclusion criteria for participants in selected studies were comparable: (1) primiparous or multiparous women, (2) low risk pregnancies with no to low fear of childbirth, (3) second or third trimester and (4) planning a vaginal birth. Six studies included primiparous women only [ 17 – 19 , 22 , 23 , 25 , 27 ]. One study examined both primiparous and multiparous women [ 21 ] and three studies did not report on parity [ 20 , 24 , 26 ].…”

Antenatal Education in India: An Appraisal Abstract

“…This study proved that knowledge level of primigravid women in the experimental group showed significant improvement on selected antenatal exercises after video assisted teaching programme. Antenatal education program on selected antenatal exercises should be a routine activity and a service to be delivered by nurses and midwives in the antenatal, outpatient department and in the in labor unit [1][2][3][4][5].…”