Perceptions of paternal involvement and labour pain management in Chinese couples during childbirth: A qualitative study

Birth plan and fathers: A scoping review

BACKGROUND

With increasing paternal involvement in maternal and infant care, expectant fathers, who are often present during the labour process have been seen to use birth plans to express their wishes during childbirth. Despite their involvement, existing literature mainly focuses on maternal outcomes, highlighting the need to explore paternal involvement with birth plans.

AIMS

To explore and consolidate the available literature on the involvement of fathers in the birth plan process, their perspectives toward birth plans, and how it has influenced their overall childbirth experience.

METHODS

This scoping review was conducted based on Arksey and O'Malley's five-stage framework. Seven databases were searched from 1980 till March 2024: PubMed, Cochrane Library, Embase, Scopus, Web of Science, CINAHL, and Google Scholar. Data were screened, extracted, and cross-checked between two independent reviewers. A thematic analysis was conducted to summarise the data.

RESULTS

BASED ON THE FINDINGS FROM THE 33 INCLUDED STUDIES, ONE OVERARCHING THEME WAS IDENTIFIED: : 'Factors promoting and restricting fathers' participation in birth plan'; supported by two main themes 1) Motivations behind paternal engagement in the birth plan process and 2) Roadblocks to paternal involvement in the birth plan.

CONCLUSION

The findings of this review provided insights to guide future practice to engage fathers during childbirth by enhancing their involvement in birth plans. The findings on the motivating factors for fathers to be involved in the birth plan process and barriers affecting their participation also provided directions for future research by highlighting the gaps in the current evidence.

The Chinese version of rating scale of pain expression during childbirth (ESVADOPA): reliability and validity assessment

BACKGROUND

Childbirth pain is a physiological phenomenon during the delivery process, the intense pain of childbirth could bring harmful effects to pregnant women and their babies. Assessment of childbirth pain is the first step in childbirth pain intervention. Some pain assessment scales have shortcomings such as interfering in the birthing process and affecting pain perception during delivery, while the Rating Scale of Pain Expression during Childbirth (ESVADOPA) could be used as an auxiliary scale to compensate for these shortcomings. The purpose of this study was to introduce the ESVADOPA and adapt it among Chinese pregnant women to check on the psychometric properties of the translated version of ESVADOPA.

METHODS

A new translation model based on Brislin's classical back translation model was used to translate and cross-cultural adapt the ESVADOPA. During June 2021 and June 2022, pregnant women at Shandong Provincial Hospital Affiliated to Shandong First Medical University were invited. In the stage of translation and cross-culturally adaptation, 18 midwives and 30 pregnant women were invited to participate in the first round of pre-experiment. And in the second round of pre-experiment, 15 midwives and 20 pregnant women were invited to participate. The Chinese version of ESVADOPA was tested on a group of pregnant women (N = 487). Construct validity was evaluated by exploratory factor analysis, confirmatory factor analysis and criterion-related validity. Reliability was assessed by Cronbach's α coefficient, McDonald Omega, Spearman-Brown split-half reliability and Guttman split-half reliability.

RESULTS

The item statistical analysis and construct validity resulted in six items and one factor that explained 61.064% of the total variance. Confirmatory factor analysis showed that the data fit the one-factor structure. Criterion-related validity indicated that the scale is significantly and positively correlated with the Numeric Rating Scale (NRS). Cronbach's α coefficient, McDonald Omega, Spearman-Brown split-half reliability, and Guttman split-half reliability of the Chinese version of ESVADOPA were 0.868, 0.896, 0.845, 0.842, respectively.

CONCLUSION

The Chinese version of the ESVADOPA with good reliability and validity data could be used to assess the pain rating of pregnant women during childbirth without interfering in the birthing process.

Effectiveness of mind-body interventions in labour pain management during normal delivery: A systematic review and meta-analysis

BACKGROUND

Labour pain is a common experience among women and poses risks to both the mother and neonate. Mind-body interventions have demonstrated effectiveness in diverse contexts, but their effectiveness in labour pain management remains controversial.

OBJECTIVE

To identify the effects of each category of mind-body interventions on labour pain management, particularly pain intensity; the use of pharmacological pain relief medications; and the consequent outcomes, including the rate of caesarean section, duration of labour, and fear of childbirth.

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic search for related articles was conducted in 10 databases. Randomised controlled trials focusing on the effectiveness of mind-body interventions in labour pain management were included. Two researchers independently conducted methodological quality assessments, data extraction and grading the evidence. Meta-analyses were conducted when studies measured the same outcomes. Standardised mean differences were calculated for continuous variables, whilst risk ratios were calculated for dichotomous variables. All analyses were performed using RevMan version 5.3.

RESULTS

A total of 25 studies from 24 trials were included, and six categories of mind-body interventions, namely hypnosis, mindfulness, breathing skills, muscle relaxation techniques, guided imagery, and therapeutic touch, were identified. Specifically, hypnosis and mindfulness might be effective in relieving labour pain intensity, with large effect sizes (SMD: -1.45, 95 % confidence interval [CI] -2.34, -0.55, I2 = 91 %; SMD: -1.22, 95 % CI -2.07, -0.37, I2 = 93 %, respectively), but could not reduce the use of epidural analgesia. Mindfulness, in particular, yielded statistically significant reductions in the rate of caesarean section, with a small effect size (RR: 0.46, 95 % CI 0.21, 0.97, I2 = 49 %), and in fear of childbirth, with a medium effect size (SMD: -0.63, 95 % CI -1.09, -0.17, I2 = 65 %). Additionally, all categories of mind-body interventions were associated with a significantly decreased duration of labour compared with the control conditions.

CONCLUSIONS

Mind-body interventions may have potential benefits in terms of decreasing labour pain intensity, the rate of caesarean section, the duration of labour, and fear of childbirth, with small-to-large effect sizes. Particularly, hypnosis and mindfulness exhibited significant positive effects in terms of relieving labour pain intensity, with large effect sizes. These interventions could serve as complementary or alternative methods for labour pain management in clinical practice. Nevertheless, further rigorous randomised controlled trials are warranted to confirm our results.

REGISTRATION

CRD42024498600 (PROSPERO, January 15, 2024).

Determination of mothers' thoughts and adaptation behaviors regarding the infant: A descriptive study

BACKGROUND

With motherhood, women focus on their new baby. They begin to develop new adaptation behaviors to provide the best care for the infant. The study aims to describe the adaptive behaviors and concerned thoughts of first-time and repeat mothers.

METHODS

The study was designed in descriptive and cross-sectional type. Data were collected from mothers using a questionnaire and "The scale of being the mother of a baby." The study was completed with 112 mothers who were reached by snowball sampling method and agreed to participate. The data were analyzed at the 95% confidence interval at the p˂.05 significance level.

RESULTS

66.1% of the mothers had a baby for the first time, and 73.2% of the mothers received information/education about baby care. It was determined that they wanted to receive information on topics such as maternal and infant nutrition, diseases, and immunization. A statistically significant difference was found between the age of pacifier use (p = .032). It was determined that mothers got 130.7 points in total from the scale, 88.3 points from the evaluation of motherhood sub-dimension, and 42.3 points from the life change sub-dimension. A statistically significant difference was found between the baby care knowledge/training status and the scale scores.

CONCLUSION

The importance and continuity of education during and after pregnancy has emerged. Nurses are competent people with a key role in this regard, and it is recommended to use individualized care protocols for the training provided.