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Alizadeh-Dibazari Z, Abdolalipour S, Mirghafourvand M. The effect of prenatal education on fear of childbirth, pain intensity during labour and childbirth experience: a scoping review using systematic approach and meta-analysis. BMC Pregnancy Childbirth 2023; 23:541. [PMID: 37501120 PMCID: PMC10373291 DOI: 10.1186/s12884-023-05867-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 07/22/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Antenatal education provides parents with strategies for pregnancy, childbirth, and parenthood. There is not enough evidence of the positive effect of prenatal education on childbirth and maternal outcomes. The present scoping review using a systematic approach, evaluates the effectiveness of prenatal education on fear of childbirth, pain intensity during labour, childbirth experience, and postpartum psychological health. METHODS We used Google Scholar and systematically reviewed databases such as PubMed, Web of Science, Cochrane, Scopus, and SID (Scientific Information Database). Randomized controlled and quasi-experimental trials examining the effect of structured antenatal education and routine prenatal care compared to routine prenatal care were reviewed. The participants included pregnant women preferring a normal vaginal delivery and had no history of maternal or foetal problems. The outcomes considered in this study included fear of childbirth, pain intensity during labour, childbirth experience (as primary outcomes) and postpartum psychological health (as secondary outcomes). The grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of evidence. RESULTS Overall, 3242 studies were examined, of which 18 were qualified for the final analysis. The meta-analysis showed that providing prenatal education and routine care compared to only routine care may decrease the fear of childbirth, postpartum depression, and pain intensity during labour. However, we found no study examining the outcome of the childbirth experience. In addition, the inconsistency of included studies prevented conducting a meta-analysis on the rest of the outcomes. CONCLUSIONS Our investigations showed that there are very few or no studies on the effect of prenatal education on outcomes such as childbirth experience, postpartum anxiety, and maternal attachment, and the existing studies on the effect of prenatal education on outcomes such as the fear of childbirth, postpartum depression, and pain intensity during labour lack sufficient quality to make definitive conclusions. Therefore, high-quality, randomized trials with a more extensive sample size are suggested to provide clear reports to make definitive decisions. PROSPERO ID CRD42022376895.
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Affiliation(s)
- Zohreh Alizadeh-Dibazari
- Midwifery Department, Faculty of Nursing and Midwifery, Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somayeh Abdolalipour
- Midwifery Department, Faculty of Nursing and Midwifery, Students' Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
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Pietrzak J, Mędrzycka-Dąbrowska W, Wróbel A, Grzybowska ME. Women's Knowledge about Pharmacological and Non-Pharmacological Methods of Pain Relief in Labor. Healthcare (Basel) 2023; 11:1882. [PMID: 37444716 DOI: 10.3390/healthcare11131882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 06/13/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
This study aimed to assess knowledge about non-pharmacological pain-relief methods in labor among women who have given birth at least once. This cross-sectional study was conducted using an online survey among 466 adult women. The minimum sample size was estimated based on the number of labor admissions in the year before the study in Poland. The survey included questions about respondents' sociodemographics and knowledge of pain-relief methods. The knowledge score was calculated using the sum of correct answers. Non-parametric Spearman's correlation, Kruskal-Wallis and Wilcoxon variance tests were used. Antenatal classes (313/68.9%) and the Internet (248/54.6%) were the most common sources of knowledge. The most popular pharmacological pain-relief methods included epidural anesthesia (386/85.0%) and nitrous oxide (301/66.3%). Massage and breathing techniques were the most commonly known non-pharmacological methods (405/89.2% and 400/88.1%, respectively). The knowledge score about non-pharmacological methods was significantly higher as compared to the pharmacological methods score (rc = 0.85; p < 0.001). Respondents' age correlated with knowledge about non-pharmacological methods (rs = -0.10,p = 0.026) but did not correlate with knowledge about pharmacological methods. Educational level correlated with knowledge about pharmacological (rs = -0.13,p = 0.007) and non-pharmacological (rs = 0.14, p = 0.003) methods concerning pain relief in labor. No correlation was found between respondents' knowledge and gravidity, number of vaginal or cesarean deliveries, and hospital referral levels for previous deliveries. Our findings support the need to implement educational programs to increase evidence-based knowledge about pain-relief methods during labor in women.
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Affiliation(s)
- Jakub Pietrzak
- Department of Obstetrics and Gynecological Nursing, Medical University of Gdansk, Dębinki 7, 80-211 Gdańsk, Poland
| | - Wioletta Mędrzycka-Dąbrowska
- Department of Anesthesiology Nursing & Intensive Care, Medical University of Gdansk, Dębinki 7, 80-211 Gdańsk, Poland
| | - Andrzej Wróbel
- Second Department of Gynecology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland
| | - Magdalena Emilia Grzybowska
- Department of Gynecology, Obstetrics and Neonatology, Medical University of Gdansk, Smoluchowskiego 17, 80-214 Gdańsk, Poland
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Berčan T, Kovačević N, Cilenšek I, Podbregar I. Association of Maternal Antenatal Education with Quality of Life after Childbirth in the Slovenian Population before and during the COVID-19 Pandemic. Healthcare (Basel) 2023; 11:healthcare11111568. [PMID: 37297709 DOI: 10.3390/healthcare11111568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 05/24/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023] Open
Abstract
Pregnancy and childbirth have a crucial impact on a woman's quality of life. In Slovenia, antenatal classes are the main educational tool used to prepare expectant mothers for their new role. The aim of our study was to assess the relationship between the duration of antenatal classes and the mothers' quality of life after childbirth. A self-administered, previously validated and tested questionnaire regarding the quality of life after childbirth was completed by Slovenian women. Based on an online survey, data were collected for two groups of mothers. The first group (n = 1091) gave birth before the COVID-19 pandemic, and the second group (n = 1163) gave birth during the pandemic. Group differences were analyzed using the Mann-Whitney U test. Linear regression and correlation coefficients were calculated for the association between quality of life and the duration of antenatal classes. Our study showed a significant decrease in the duration of antenatal classes and a decrease in quality of life after birth during the COVID-19 pandemic. We also showed that more antenatal education was associated with a higher quality of life. Despite the influence of multiple factors during the COVID-19 pandemic, we defined the correlation between the duration of antenatal classes and postpartum quality of life in a sample of Slovenian mothers. The duration of the antenatal classes is an important factor influencing the quality of life after childbirth.
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Affiliation(s)
- Tina Berčan
- Emergency Medical Dispatch Service, Emergency Medical Dispatch Centre Ljubljana, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Nina Kovačević
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Institute of Oncology Ljubljana, 1000 Ljubljana, Slovenia
| | - Ines Cilenšek
- Institute of Histology and Embryology, Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Iztok Podbregar
- Faculty of Organizational Sciences, University of Maribor, 4000 Kranj, Slovenia
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Dagla C, Antoniou E, Sarantaki A, Iliadou M, Mrvoljak-Theodoropoulou I, Andersson E, Dagla M. The Effect of Antenatal Education on Expectant Fathers' Attitudes toward Breastfeeding and Attachment to the Fetus. NURSING REPORTS 2023; 13:243-254. [PMID: 36810274 PMCID: PMC9944450 DOI: 10.3390/nursrep13010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND This study explores the effect of antenatal education on fathers' attitudes toward: (i) breastfeeding and (ii) attachment to the fetus. A secondary aim is to explore the relationship of fathers' demographic and the psycho-emotional characteristics that come with breastfeeding and attachment. METHODS This is a longitudinal study involving a group of 216 Greek expectant fathers who participated with their partners in an antenatal educational program performed by midwives in Athens, Greece (September 2020-November 2021). The Iowa Infant Feeding Attitudes Scale (IIFAS) and Paternal Antenatal Attachment Scale (PAAS) were administered at two time points: (a) 24th-28th gestation week and (b) 34th-38th gestation week. The T-test and Univariate Analyses of Variance (ANOVA) were performed. RESULTS The expectant fathers' scores show that breastfeeding intention/exclusivity and prenatal attachment to the fetus were higher after their participation in the antenatal education program, but the difference was not statistically insignificant. Expectant fathers with a cohabitation agreement (p = 0.026), who felt very much supported by their partners (p = 0.001) and had no relationship difficulties with their partners (p < 0.001), as well as those who reported being very happy during pregnancy (p < 0.001), showed greater paternal antenatal attachment to the fetus. CONCLUSIONS Although the difference was statistically insignificant, antenatal education appears to have an impact on paternal breastfeeding attitudes and antenatal attachment to the fetus. Additionally, several paternal characteristics were associated with greater antenatal attachment. Future research should be directed toward the investigation of additional factors that impact antenatal-paternal attachment and breastfeeding attitudes so that effective education programs can be designed.
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Affiliation(s)
- Calliope Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
- Correspondence: ; Tel.: +30-6984493365
| | - Evangelia Antoniou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Antigoni Sarantaki
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | - Maria Iliadou
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
| | | | - Ewa Andersson
- Department of Women’s and Children’s Health, Division of Reproductive Health, Karolinska Institutet, 17177 Stockholm, Sweden
| | - Maria Dagla
- Department of Midwifery, School of Health & Care Sciences, University of West Attica, 12243 Athens, Greece
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Sutcliffe KL, Dahlen HG, Newnham E, Levett K. "You are either with me on this or not": A meta-ethnography of the influence birth partners and care-providers have on coping strategies learned in childbirth education and used by women during labour. Women Birth 2023:S1871-5192(23)00020-3. [PMID: 36774285 DOI: 10.1016/j.wombi.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/29/2023] [Accepted: 02/01/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Childbirth education, which includes providing information and practical techniques to help manage childbirth, aims to support women and their birth partners. It is unknown how birth partners and care providers influence the utilisation of childbirth education information and techniques during women's labour and birth. AIM To explore the literature that investigates the influence that birth partners and care-providers have on the application of childbirth education information and techniques used by women during childbirth. METHODS A meta-ethnography was performed using a systematic synthesis of reciprocal translation and refutational investigation. There were 22 papers included in the final synthesis. Quality appraisal was undertaken using the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBIQARI) quality appraisal tool for qualitative studies. FINDINGS An over-arching theme of 'you are either with me on this or not' emerged from the data, which expressed the positive and negative influences on the use of childbirth education information and techniques during labour and birth. The influence of birth partners was captured in the themes 'stepping up to their full potential' and 'a spare part'. The themes 'in alignment with the woman' and 'managed by another' were conceptualised from the data in relation to care-providers' influence. A theme, 'the right fit', described organisational and contextual influences. CONCLUSION Birth partners and care-providers who are present during a woman's labour have significant potential to influence her use of childbirth education strategies in labour, which provides important insights for translation of evidence into practice.
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Affiliation(s)
- Kerry L Sutcliffe
- School of Medicine, University of Notre Dame Australia, NSW, Australia.
| | - Hannah G Dahlen
- School of Nursing & Midwifery, Western Sydney University, NSW, Australia
| | - Elizabeth Newnham
- School of Nursing & Midwifery, University of Newcastle, NSW, Australia
| | - Kate Levett
- School of Medicine, University of Notre Dame Australia, NSW, Australia; Adjunct Fellow, NICM Health Research Institute, and THRI, Western Sydney University, Australia; Honorary Fellow, Centre for Midwifery, Child and Family Health, University of Technology Sydney, Australia
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Heim MA, Makuch MY. Breathing Techniques During Labor: A Multinational Narrative Review of Efficacy. J Perinat Educ 2023; 32:23-34. [PMID: 36632511 PMCID: PMC9822559 DOI: 10.1891/jpe-2021-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
We conducted a narrative review to assess the use and effectiveness of breathing techniques for pain control as the only non-pharmacological resource during labor and childbirth. A search was conducted using PubMed, PEDro, SciELO, and Scopus with publications between January 2005 and September 2021 in English, Portuguese, or Spanish. Seven publications were selected. Most of the articles reported on the use of slow and deep breathing during contractions in the first stage of labor and breathing associated with pushing-down efforts in the second stage. The information regarding the moment when guidance on the use of the techniques was provided varied across studies. According to the reviewed papers, breathing techniques offer benefits for women in labor without adverse effects on newborns.
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Uludağ E, Serçekuş P, Vardar O, Özkan S, Alataş SE. Effects of online antenatal education on worries about labour, fear of childbirth, preparedness for labour and fear of covid-19 during the covid-19 pandemic: A single-blind randomised controlled study. Midwifery 2022; 115:103484. [PMID: 36155390 PMCID: PMC9461235 DOI: 10.1016/j.midw.2022.103484] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 06/01/2022] [Accepted: 09/08/2022] [Indexed: 11/19/2022]
Abstract
Objective To examine the effects of online antenatal education on worries about labour, fear of childbirth, preparedness for labour and fear of COVID-19 during the COVID-19 pandemic. Design A single-blind randomised controlled trial comparing two groups: an antenatal education group and a control group. Participants The sample consisted of 44 pregnant women. Measurements A demographic data form, The Oxford Worries on Labour Scale, The Fear of Birth Scale, The Prenatal Self Evaluation Questionnaire and The Fear of COVID-19 Scale were used for data collection. Findings Online antenatal education decreased worries about labour, fear of childbirth and fear of COVID-19 and improved preparedness for labour. Key conclusions Online antenatal education offered during the COVID-19 pandemic is effective in preparedness for labour. Implications for practice As an alternative, online antenatal education should be offered to pregnant women unable to attend face to face education programs due to fear of transmission of infection.
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Affiliation(s)
- Elif Uludağ
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey
| | - Pınar Serçekuş
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
| | - Okan Vardar
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey
| | - Sevgi Özkan
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey
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Leister N, Teixeira TT, Mascarenhas VHA, Gouveia LMR, Caroci-Becker A, Riesco ML. Complementary and Integrative Health Practices in a Brazilian Freestanding Birth Center: A Cross-Sectional Study. Holist Nurs Pract 2022; Publish Ahead of Print:00004650-990000000-00011. [PMID: 35947420 DOI: 10.1097/hnp.0000000000000535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The study aimed to analyze the use of complementary and integrative health practices (CIHPs) during labor and birth in a freestanding birth center. A total of 28 different CIHPs were applied with or used by laboring women. The most adopted CIHPs were mind-body practices (99.9%) and natural products (35.5%), mostly used by primiparous women (P <.05). Adopting CIHPs can increase care quality, increase positive experiences during childbirth, and promote evidence-based choices.
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Affiliation(s)
- Nathalie Leister
- Centre for Maternal & Child Health Research, School of Health Sciences, City University of London, London, England (Dr Leister); School of Nursing, University of São Paulo, São Paulo, Brazil (Ms Teixeira and Drs Gouveia and Riesco); and Department of Midwifery, School of Arts, Sciences and Humanities, University of São Paulo, São Paulo, Brazil (Mr Mascarenhas and Dr Caroci-Becker)
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Shorey S, Loh DNL, Chan V, Chua C, Choolani MA. Parents' perceptions of antenatal educational programs: A meta-synthesis. Midwifery 2022; 113:103432. [PMID: 35907268 DOI: 10.1016/j.midw.2022.103432] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 06/17/2022] [Accepted: 07/12/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Contents and mode of delivery of antenatal educational programs differed considerably. Yet there is a lack of high-level evidence about the delivery of these programs. OBJECTIVE We aimed to understand the experiences and needs of parents who have attended antenatal educational programs. DESIGN Six databases were searched from each database. Included studies were appraised using the Critical Appraisal Skills Program tool. Qualitative data were meta-summarized and meta-synthesized. FINDINGS Seventeen studies were included, and three themes were developed: (1) Contradicting views on antenatal educational programs, (2) Feeling 'well prepared' after attending the antenatal educational programs, and (3) Parents' expectations and way forward for the antenatal educational programs. DISCUSSION Findings revealed that the description of contents of antenatal educational programs needed to be more specific. Mindfulness strategies were well-received by parents in the included studies. Educators should take into account inclusivity and increase educational resources related to individual, cultural and community needs. Learning needs can be assessed before and after classes. Parents with specific needs that were not addressed should be identified and referred to the relevant professionals for continued support. More deliberate actions were needed during the programs to foster social and professional networks for attendees to support them throughout antenatal and postnatal periods. CONCLUSION We consolidated the experiences and needs of parents who have attended antenatal educational programs. Findings can help refine policies related to antenatal care to improve pregnancy, birth and parenthood experiences for both mothers and fathers.
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Affiliation(s)
- Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore.
| | - Doris Ngiuk Lan Loh
- Obstetrics and Gynecology Department, National University of Singapore, 5 Lower Kent Ridge Rd, 119074, Singapore
| | - Valerie Chan
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore
| | - Crystal Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive, 117597, Singapore
| | - Mahesh A Choolani
- Obstetrics and Gynecology Department, National University Hospital, 5 Lower Kent Ridge Rd, 119074, Singapore
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Kucab A, Barnaś E, Błajda J. Assessment of the Postpartum Emotional Wellbeing among Women Participating and Not Participating in Antenatal Classes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084476. [PMID: 35457343 PMCID: PMC9028235 DOI: 10.3390/ijerph19084476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 04/02/2022] [Accepted: 04/04/2022] [Indexed: 11/16/2022]
Abstract
The perinatal period is associated with an increased risk of emotional disorders. Exposure to stress impacts the functioning of the maternal brain, also shaping the developmental processes of the child's brain. To assess the emotional wellbeing of women participating and not participating in antenatal classes. The study involved a group of 200 women divided into two groups: the study group, participants of the antenatal classes (N = 100), and the control group, not participating in the antenatal classes (N = 100). The Edinburgh Postnatal Depression Scale (EPDS) and Mini-COPE inventory were used. EPDS was administered at two time points: on the 2nd day of puerperium and 6 weeks after the delivery, while Mini-COPE inventory was applied once during pregnancy. Severe symptoms of depression on the 2nd day after childbirth concerned 16.0% of the women (N = 15) participating in the antenatal classes and 11.0% of the controls (N = 11). Intensification of depressive symptoms 6 weeks after the delivery occurred in 19.5% of the females attending antenatal classes (N = 17) and 18.8% of the controls (N = 18). Severe symptoms of depression 6 weeks after the delivery in the group of women participating in antenatal classes were significantly related to adopting helplessness to cope with stress and a sense of being accepted by the husband/partner, family, and society. In the case of women not participating in antenatal classes, the severity of symptoms of depression 6 weeks after the delivery was slightly related to the sense of acceptance by the husband/partner, family, and society. Apart from identifying risk factors for emotional disorders in pregnancy, it is worth taking into account whether a woman participated in antenatal classes when planning the care in the perinatal period. This factor can be a potential protective factor in preventing emotional problems after childbirth.
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Perception of Traumatic Childbirth of Women and Factors Affecting. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1001319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Bay H, Erkal Aksoy Y, Dereli Yılmaz S. Factors Affecting Primiparous Pregnant Women's Prenatal Attachment Levels, Childbirth Self-Efficacy Beliefs, and Labor Worry Levels. Clin Nurs Res 2022; 31:952-959. [PMID: 35291834 DOI: 10.1177/10547738221078900] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
This study aimed to identify the factors affecting primiparous pregnant women's prenatal attachment levels, childbirth self-efficacy beliefs, and labor worry levels. This cross-sectional study was conducted with 351 pregnant women. The data were collected by using a Personal Information Form, the Prenatal Attachment Inventory, the Oxford Worries about Labour Scale, and the Childbirth Self-Efficacy Inventory. The mean Prenatal Attachment Inventory, Oxford Worries About Labour Scale and Childbirth Self-Efficacy Inventory scores of the participants were 40.53 ± 10.32, 21.82 ± 6.8, and 201.35 ± 23.21, respectively. The data obtained in the study showed that the care offered in the preconception period affected the participating pregnant women's prenatal attachment, labor worry, and childbirth self-efficacy levels. With individualized preconception care provided by health personnel, not only will awareness be increased but also women will be able to have a more positive pregnancy and labor experience.
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Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Perceptions of primiparous women about the effect of childbirth preparation classes on their childbirth experience: A qualitative study. Midwifery 2021; 103:103154. [PMID: 34627102 DOI: 10.1016/j.midw.2021.103154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 09/07/2021] [Accepted: 09/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE to evaluate the perceptions of primiparous women about the effect of childbirth preparation classes on their childbirth experience. DESIGN descriptive qualitative study. PARTICIPANTS AND SETTING 13 Iranian women who participated in childbirth preparation classes and had a vaginal delivery were interviewed. MEASUREMENTS semi-structured interviews were used to collect data. FINDINGS six main themes were extracted from the data analysis: incentive and learning about pregnancy and childbirth; active participation in labour; sense of self-control; use of non- medical pain relief methods during labour; preferring vaginal birth to caesarean section; and positive childbirth experience. KEY CONCLUSIONS women reported that participation in childbirth preparation classes prepared them well for a vaginal birth, and these classes were perceived to be associated with a positive childbirth experience. IMPLICATIONS FOR PRACTICE attendance at childbirth preparation classes is perceived to have a positive effect on vaginal birth. Therefore, encouraging and supporting women to attend the full course of classes has the potential to increase women's preference towards vaginal birth, resulting in a reduction in the caesarean section rate.
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Affiliation(s)
- Robab Hassanzadeh
- Department of Midwifery, Bonab Branch, Islamic Azad University, Bonab, Iran
| | - Fatemeh Abbas-Alizadeh
- Reproductive Health Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- Member of South Asia Infant Feeding Research Network, School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mojgan Mirghafourvand
- Social Determinants of Health Research Centre, Nursing and Midwifery Faculty, Tabriz University of Medical Sciences, Tabriz, Iran.
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Uslu Yuvaci H, Cinar N, Yalnizoglu Caka S, Topal S, Peksen S, Saglam N, Cevrioglu AS. Effects of antepartum education on worries about labor and mode of delivery. J Psychosom Obstet Gynaecol 2021; 42:228-234. [PMID: 32050831 DOI: 10.1080/0167482x.2020.1725465] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
AIM This study evaluated the effects of antenatal education, which was provided in a pregnancy education class, on pregnant women's concerns about labor and the mode of delivery. MATERIALS AND METHODS Primigravid pregnant women (n = 144) were enrolled into the study between May 2017 and November 2018. Pregnant women received standard education on nutrition during pregnancy, exercise, methods of coping with pain, and breastfeeding. The participants completed the "Introductory Information Form" and "Oxford Worries about Labour Scale" to collect data. RESULTS A statistically significant difference was found between the participants' pain, distress, uncertainty, and interventions in the pre-education, post-education, and postpartum periods and mean total score on the Oxford scale (p<.05). However, education had no significant effect on the mode of delivery (p>.05). CONCLUSION Education provided during pregnancy significantly decreased women's worries about labor, but it did not lead to a significant difference in the modes of delivery.
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Affiliation(s)
- Hilal Uslu Yuvaci
- Department of Obstetrics and Gynecology, University of Sakarya School of Medicine, Sakarya, Turkey
| | - Nursan Cinar
- School of Health Sciences, Sakarya University, Sakarya, Turkey
| | | | - Sumeyra Topal
- School of Health Sciences, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Sultan Peksen
- Department of Obstetrics and Gynecology, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Nuran Saglam
- Department of Obstetrics and Gynecology, Sakarya Training and Research Hospital, Sakarya, Turkey
| | - Arif Serhan Cevrioglu
- Department of Obstetrics and Gynecology, University of Sakarya School of Medicine, Sakarya, Turkey
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Biana CB, Cecagno D, Porto AR, Cecagno S, Marques VDA, Soares MC. Non-pharmacological therapies applied in pregnancy and labor: an integrative review. Rev Esc Enferm USP 2021; 55:e03681. [PMID: 33886910 DOI: 10.1590/s1980-220x2019019703681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 08/22/2020] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To identify non-pharmacological therapies applied during pregnancy and labor. METHOD Integrative review conducted in the databases: PubMed, ScieLO and PEDro, searching for articles from 2008 in English, Spanish and Portuguese. The descriptors used were: pregnancy, childbirth, physiotherapy, alternative and complementary medicine, alternative therapy, non-pharmacological therapy, biomechanical therapy. RESULTS Forty-one articles were analyzed and subdivided into ten categories of nonpharmacological therapies: massage, perineal massage, hot bath, supportive care, childbirth preparation group, breathing techniques, pelvic floor exercises, transcutaneous electrostimulation, Swiss ball and spontaneous pushing. Six articles (60%) showed a positive outcome for reduction of pain in labor and all of them had a positive outcome for different variables of labor, such as reduction of time, anxiety and pelvic floor laceration rates. CONCLUSION The use of non-pharmacological therapies was efficient to reduce the effects of labor and childbirth, such as pain, duration of labor, anxiety, laceration and episiotomy.
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Affiliation(s)
- Camilla Benigno Biana
- Universidade Federal de Pelotas, Faculdade de Enfermagem, Departamento de Enfermagem, Pelotas, RS, Brazil
| | - Diana Cecagno
- Universidade Federal de Pelotas, Faculdade de Enfermagem, Departamento de Enfermagem, Pelotas, RS, Brazil
| | - Adrize Rutz Porto
- Universidade Federal de Pelotas, Faculdade de Enfermagem, Departamento de Enfermagem, Pelotas, RS, Brazil
| | - Susana Cecagno
- Universidade Federal de Pelotas, Faculdade de Enfermagem, Departamento de Enfermagem, Pelotas, RS, Brazil
| | - Vanessa de Araujo Marques
- Universidade Federal de Pelotas, Faculdade de Enfermagem, Departamento de Enfermagem, Pelotas, RS, Brazil
| | - Marilu Correa Soares
- Universidade Federal de Pelotas, Faculdade de Enfermagem, Departamento de Enfermagem, Pelotas, RS, Brazil
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Actis Danna V, Bedwell C, Wakasiaka S, Lavender T. Utility of the three-delays model and its potential for supporting a solution-based approach to accessing intrapartum care in low- and middle-income countries. A qualitative evidence synthesis. Glob Health Action 2020; 13:1819052. [PMID: 33040697 PMCID: PMC7580724 DOI: 10.1080/16549716.2020.1819052] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/28/2020] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The 3-Delays Model has helped in the identification of access barriers to obstetric care in low and middle-income countries by highlighting the responsibilities at household, community and health system levels. Critiques of the Model include its one-dimensionality and its limited utility in triggering preventative interventions. Such limitations have prompted a review of the evidence to establish the usefulness of the Model in optimising timely access to intrapartum care. OBJECTIVE To determine the current utility of the 3-Delays Model and its potential for supporting a solution-based approach to accessing intrapartum care. METHODS We conducted a qualitative evidence synthesis across several databases and included qualitative findings from stand-alone studies, mixed-methods research and literature reviews using the Model to present their findings. Papers published between 1994 and 2019 were included with no language restrictions. Twenty-seven studies were quality appraised. Qualitative accounts were analysed using the 'best-fit framework approach'. RESULTS This synthesis included twenty-five studies conducted in Africa, Asia, Latin America and the Caribbean. Five studies adhered to the original 3-Delays Model's structure by identifying the same factors responsible for the delays. The remaining studies proposed modifications to the Model including alterations of the delay's definition, adding of new factors explaining the delays, and inclusion of a fourth delay. Only two studies reported women's individual contributions to the delays. All studies applied the Model retrospectively, thus adopting a problem-identification approach. CONCLUSION This synthesis unveils the need for an individual perspective, for prospective identification of potential issues. This has resulted in the development of a new framework, the Women's Health Empowerment Model, incorporating the 3 delays. As a basis for discussion at every pregnancy, this framework promotes a solution-based approach to childbirth, which could prevent delays and support women's empowerment during pregnancy and childbirth.
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Affiliation(s)
- Valentina Actis Danna
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Carol Bedwell
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
| | - Sabina Wakasiaka
- College of Health Science, School of Nursing, University of Nairobi, Nairobi, Kenya
| | - Tina Lavender
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, UK
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Hassanzadeh R, Abbas-Alizadeh F, Meedya S, Mohammad-Alizadeh-Charandabi S, Mirghafourvand M. Comparison of childbirth experiences and postpartum depression among primiparous women based on their attendance in childbirth preparation classes. J Matern Fetal Neonatal Med 2020; 35:3612-3619. [PMID: 33076724 DOI: 10.1080/14767058.2020.1834531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Assessment of women's childbirth experience is an important indicator in maternity services. Positive childbirth experiences improve mothers' health, whereas negative childbirth experiences can cause psychological stresses and, in extreme cases, may lead to postpartum depression. METHODS In this cohort study, 204 women at 35-37 weeks of gestation were selected using cluster sampling from the health centers of Tabriz, Iran. Women were divided into three groups (68 women in each group) based on their attendance in childbirth preparation classes: (a) non-attenders (did not attend any sessions), (b) irregular attenders (attended 1-3 sessions), and (c) regular attendants (attended 4-8 sessions). Interviews were conducted at one month postpartum to complete the Childbirth Experience Questionnaire (CEQ) and Edinburgh Postnatal Depression Scale (EPDS). The general linear model (GLM) was used to identify associations between women's attendance to the classes and either their childbirth experience or postpartum depression scores. RESULTS Based on the GLM, the mean score of childbirth experience among the regular attenders was significantly higher than women who were irregular attenders (p = .032) or non-attenders (p < .001). In addition, the mean score of postpartum depression scale was significantly lower among regular attenders compared with non-attenders (p < .001). However, there was no significant difference in postpartum depression score among regular and irregular attenders (p = .257). CONCLUSIONS Attending prenatal classes was associated with positive childbirth experience and low postpartum depression score.
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Affiliation(s)
- Robab Hassanzadeh
- Midwifery Department, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Abbas-Alizadeh
- Reproductive Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Shahla Meedya
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | | | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Prieto Bocanegra BM, Gil Sosa JC, Madrid Simbaqueba DC. Terapias complementarias durante la gestación y parto. Revisión integrativa. REVISTA CUIDARTE 2020. [DOI: 10.15649/cuidarte.1056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Introducción: La gestación y el parto son experiencias significativas, que dejan huella en cada mujer que realiza éste tránsito, por tanto, la aplicación de estrategias complementarias contribuye a un cuidado más humano. Objetivo: Describir las terapias complementarias que se pueden aplicar en forma efectiva y segura en mujeres gestantes, para contribuir a un mayor bienestar durante el embarazo y parto. Materiales y métodos: Se realizó una revisión integrativa de la literatura, en diferentes bases de datos: Science Direct, Medline, Scielo, Scopus y Ovid; en inglés, portugués y español, durante el segundo semestre de 2018 y primero del 2019. Resultados: Se analizaron diferentes terapias alternativas que se usan con mujeres gestantes: la masoterapia, hidroterapia, termoterapia, libertad de movimientos, uso de pelotas, visualización de imágenes, musicoterapia; las cuales dieron seguridad en su aplicación, con resultados benéficos en el binomio madre-hijo. Discusión: las terapias complementarias, son una oportunidad que tiene el profesional de enfermería para poder aplicarlas en los diferentes contextos en donde se cuida la gestante, si bien existe diversa literatura que señalan los beneficios tanto para la madre como para el feto, es necesario que los profesionales las reconozcan y pongan en práctica en los diferentes escenarios de cuidado. Conclusiones: El uso de las terapias complementarias, durante el embarazo y parto de bajo riesgo, son útiles para disminuir las diferentes molestias presentadas durante estas etapas y mejorar así la experiencia de gestar y parir.
Como citar este artículo: Prieto Bocanegra Brigitte Migdolia, Gil Sosa Johana Carolina, Madrid Simbaqueba Diana Carolina. Terapias complementarias durante la gestación y parto. revisión integrativa. Revista Cuidarte. 2020; 11(2): e1056. http://dx.doi.org/10.15649/cuidarte.1056
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Midwife-led integrated pre-birth training and its impact on the fear of childbirth. A qualitative interview study. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 25:100512. [PMID: 32305869 DOI: 10.1016/j.srhc.2020.100512] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 03/24/2020] [Accepted: 04/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Although most expectant women with severe fear of childbirth take pre-birth training sessions, the available literature does not provide substantial emphirical data on its impacts, especially in developing countries like Kenya. AIM The study aimed at exploring women's experience from midwife-led integrated pre-birth training and its impact on the fear of childbirth. METHOD A qualitative interview was conducted using a thematic analysis. Thirty-three women who had experienced high and severe fear of childbirth, and had completed midwife-led integrated pre-birth training were interviewed one month after giving birth. The interviews were conducted in a maternal and child health clinic in Samburu, Kenya from December 2019 to January 2020. Collected data was analysed based on thematic analysis. RESULTS The general theme 'midwife-led integrated pre-birth training promoted constructive disposition and enhanced trust in the process of giving birth' was validated by the interviewed participants. Their contributions covered three themes: 'the significance of midwife-led pre-birth training', 'the role of efficient communication during pregnancy,' and 'adaptation to procedures for improved childbirth experience'. CONCLUSIONS In this study 85% (n = 29) of the participants revealed that midwife-led integrated pre-birth training enhanced their expectations for birth processes. They demonstrated readiness and preparedness for this process, which would lead to improved childbirth outcomes.
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Deng Y, Li H, Dai Y, Yang H, Morse AN, Liang H, Lin Y. Are there differences in pain intensity between two consecutive vaginal childbirths? A retrospective cohort study. Int J Nurs Stud 2020; 105:103549. [PMID: 32199151 DOI: 10.1016/j.ijnurstu.2020.103549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 02/01/2020] [Accepted: 02/07/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Pain assessment is crucial for in-labour pain management. Even though women's self-rated pain intensity is the standard for pain relief or analgesic administration, multiparas appear to receive worse in-labour pain management than primiparas do. The discrepancy in pain perception between primiparas and multiparas remains unclear. Healthcare providers tend to think that multiparas endure the pain and report less pain because they have experienced childbirth. OBJECTIVE To retrospectively analyse the intensity of in-labour pain during first and second vaginal childbirth within the same group of women and explore whether parity may be an influential factor in labour pain intensity. DESIGN Retrospective cohort study. SETTING Labour and delivery in a large academic specialized hospital in Guangzhou, China. PARTICIPANTS Women were included if they had two consecutive vaginal childbirths with singleton cephalic presentations and cervical dilation ≤ 3 cm for the first childbirth and ≤ 2 cm for the second childbirth. The final study sample consisted of 417 women. METHODS All childbirth case records between January 2015 and August 2018 were scanned using a structured electronic medical system. Maternal and neonatal demographics as well as obstetric and neonatal outcomes were extracted. The in-labour pain for each childbirth was compared between first and second births. Paired t-tests, McNemar's chi-square tests and mixed-effects modelling were applied to compare the differences in labour pain intensity between the two vaginal childbirths and explore the factors that influenced maximum labour pain scores during the second childbirth. RESULTS Four hundred seventeen women were included, with an average birth interval of 1.7 years. The average maximum labour pain score during the latent phase was 6 (5,6) for the first childbirth and 5 (4,6) for the second childbirth (paired t =-6.13, P <0.001). Pain scores decreased in 28.1% (117/417) of women and increased in 13.7% (57/417) of women from the first to the second childbirth. More than half of the women in our study experienced the same maximum labour pain score during the first and second labour. Mixed-effects modelling revealed that parity, education and pregnancy complications were independently associated with maximum labour pain scores. CONCLUSIONS From a clinical point of view, in-labour pain is not clinically different for women when comparing their first and second labours. Health care professionals may underestimate in-labour pain in primiparas when comparing them with nulliparas. More studies are warranted to explore options for achieving better pain management for women with more childbirths.
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Affiliation(s)
- Yongfang Deng
- Dlivery and Labor Room, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, No.9 Jinsui Rd, Tianhe District, Guangzhou 510623, China
| | - Huixian Li
- Statistician, Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Ying Dai
- Department of Pediatric Surgery, Guangzhou Women and Children's Medical Center Guangzhou, Guangzhou Medical University, Guangzhou, China
| | - Hongmei Yang
- Department of Pediatric operation room, Guangzhou Women and Children's Medical Center Guangzhou, Guangzhou Medical University, Guangzhou, China
| | - Abraham N Morse
- Department of Urogynecology, Guangzhou Women and Children's Medical Center Guangzhou, Guangzhou Medical University, Guangzhou, China.
| | - Huiying Liang
- Institute of Pediatrics, Guangzhou Women and Children's Medical Center Guangzhou, Guangzhou Medical University, Guangzhou, China
| | - Yan Lin
- Department of Nursing Administrative Office, Guangzhou Women and Children's Medical Center Guangzhou, Guangzhou Medical University, No.9 Jinsui Rd, Tianhe District, Guangzhou 510623, China.
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Mselle LT, Eustace L. Why do women assume a supine position when giving birth? The perceptions and experiences of postnatal mothers and nurse-midwives in Tanzania. BMC Pregnancy Childbirth 2020; 20:36. [PMID: 31931780 PMCID: PMC6958681 DOI: 10.1186/s12884-020-2726-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/07/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Before the advent of Western medicine in Tanzania, women gave birth in an upright position either by sitting, squatting or kneeling. Birthing women would hold ropes or trees as a way of gaining strength and stability in order to push the baby with sufficient force. Despite the evidence supporting the upright position as beneficial to the woman and her unborn child, healthcare facilities consistently promote the use of the supine position. The purpose of this study was to explore the perceptions and experiences of mothers and nurse-midwives regarding the use of the supine position during labour and delivery. METHODS We used a descriptive qualitative design. We conducted seven semi-structured interviews with nurse-midwives and two focus group discussions with postnatal mothers who were purposively recruited for the study. Qualitative content analysis guided the analysis. RESULTS Four themes emerged from mothers' and midwives' description of their experiences and perceptions of using supine position during childbirth. These were: women adopted the supine position as instructed by midwives; women experience of using alternative birthing positions; midwives commonly decide birthing positions for labouring women and supine position is the best-known birthing position. CONCLUSION Women use the supine position during childbirth because they are instructed to do so by the nurse-midwives. Nurse-midwives believe that the supine position is the universally known and practised birthing position, and prefer it because it provides flexibility for them to continuously monitor the progress of labour and assist delivery most efficiently. Mothers in this study had no other choice than to labour and deliver their babies in the supine position as instructed because they trusted midwives as skilled professionals who knew what was best given the condition of the mother and her baby.
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Affiliation(s)
- Lilian Teddy Mselle
- Department of Clinical Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lucia Eustace
- Department of Nursing and Midwifery, Missenyi District Council, Bukoba, Kagera Tanzania
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Thomson G, Feeley C, Moran VH, Downe S, Oladapo OT. Women's experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review. Reprod Health 2019; 16:71. [PMID: 31146759 PMCID: PMC6543627 DOI: 10.1186/s12978-019-0735-4] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 05/08/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many women use pharmacological or non-pharmacological pain relief during childbirth. Evidence from Cochrane reviews shows that effective pain relief is not always associated with high maternal satisfaction scores. However, understanding women's views is important for good quality maternity care provision. We undertook a qualitative evidence synthesis of women's views and experiences of pharmacological (epidural, opioid analgesia) and non-pharmacological (relaxation, massage techniques) pain relief options, to understand what affects women's decisions and choices and to inform guidelines, policy, and practice. METHODS We searched seven electronic databases (MEDLINE, CINAHL, PsycINFO, AMED, EMBASE, Global Index Medicus, AJOL), tracked citations and checked references. We used thematic and meta-ethnographic techniques for analysis purposes, and GRADE-CERQual tool to assess confidence in review findings. We developed review findings for each method. We then re-analysed the review findings thematically to highlight similarities and differences in women's accounts of different pain relief methods. RESULTS From 11,782 hits, we screened full 58 papers. Twenty-four studies provided findings for the synthesis: epidural (n = 12), opioids (n = 3), relaxation (n = 8) and massage (n = 4) - all conducted in upper-middle and high-income countries (HMICs). Re-analysis of the review findings produced five key themes. 'Desires for pain relief' illuminates different reasons for using pharmacological or non-pharmacological pain relief. 'Impact on pain' describes varying levels of effectiveness of the methods used. 'Influence and experience of support' highlights women's positive or negative experiences of support from professionals and/or birth companions. 'Influence on focus and capabilities' illustrates that all pain relief methods can facilitate maternal control, but some found non-pharmacological techniques less effective than anticipated, and others reported complications associated with medication use. Finally, 'impact on wellbeing and health' reports that whilst some women were satisfied with their pain relief method, medication was associated with negative self-reprisals, whereas women taught relaxation techniques often continued to use these methods with beneficial outcomes. CONCLUSION Women report mixed experiences of different pain relief methods. Pharmacological methods can reduce pain but have negative side-effects. Non-pharmacological methods may not reduce labour pain but can facilitate bonding with professionals and birth supporters. Women need information on risks and benefits of all available pain relief methods.
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Affiliation(s)
- Gill Thomson
- School of Community Health & Midwifery, University of Central Lancashire, Preston, Lancashire, PR1 2HE, UK.
| | - Claire Feeley
- School of Community Health & Midwifery, University of Central Lancashire, Preston, Lancashire, PR1 2HE, UK
| | - Victoria Hall Moran
- School of Community Health & Midwifery, University of Central Lancashire, Preston, Lancashire, PR1 2HE, UK
| | - Soo Downe
- School of Community Health & Midwifery, University of Central Lancashire, Preston, Lancashire, PR1 2HE, UK
| | - Olufemi T Oladapo
- Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, 20 Avenue Appia, 1211, Geneva, Switzerland
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Donate-Manzanares M, Rodríguez-Cano T, Gómez-Salgado J, Rodríguez-Almagro J, Hernández-Martínez A, Barrilero-Fernández E, Beato-Fernández L. Quality of Childbirth Care in Women undergoing Labour: Satisfaction with Care Received and How It Changes over Time. J Clin Med 2019; 8:jcm8040434. [PMID: 30934940 PMCID: PMC6518019 DOI: 10.3390/jcm8040434] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 12/31/2022] Open
Abstract
(1) Background: To evaluate women’s satisfaction with the care received during childbirth undergoing labour and how this changes over time. (2) Methods: An observational, multicentre and longitudinal study in two public hospitals of Spain with a convenience sample of 248 women during the post-partum period. Satisfaction was evaluated using the Intrapartal-Specific Quality from the Patient’s Perspective questionnaire. Socio-demographic and clinical variables were considered. A bivariate analysis evaluated the relationship between satisfaction and the recorded variables to compare the hypotheses, and also to know if there were any significant differences between the scores obtained at the various evaluated time points (three days, 15 days, one year postpartum). The multivariate analysis by binary logistic regression helped complete the study about the variables related to the level of satisfaction; (3) Results: The mean scores for satisfaction at each time point were high, and they lowered with time. The bivariate analysis showed an association between satisfaction and the following variables: ‘mother’s place of birth’, ‘level of education’, ‘type of labour onset’, ‘type of birth’ and ‘type of perineal trauma’. For the multivariate analysis, women who gave birth vaginally, began labour spontaneously and had an epidural were more satisfied than those who did not; (4) Conclusions: Women seemed to obtain good levels of satisfaction with the care they received. Even so, based on continuously improved quality, we proposed some improvement measures, particularly regarding the physical environment and the information offered to patients. It is important to know at what time experience while giving birth should be evaluated as scores can lower with time as part of its normal evolution.
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Affiliation(s)
| | | | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, University of Huelva, 21071 Huelva, Spain.
- Safety and Health Posgrade Program, Universidad Espíritu Santo, Guayaquil 091650, Ecuador.
| | | | | | | | - Luis Beato-Fernández
- Department of Psychiatry, Hospital General Universitario, 13005 Ciudad Real, Spain.
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Heim MA, Miquelutti MA, Makuch MY. Perspective of pregnant women regarding antenatal preparation: A qualitative study. Women Birth 2018; 32:558-563. [PMID: 30528818 DOI: 10.1016/j.wombi.2018.11.016] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/24/2018] [Accepted: 11/27/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Antenatal Education programs have been recommended for pregnant women to help them during gestation, childbirth and development of parenthood. Evidence on the perspectives and expectations of pregnant women regarding antenatal education in hospital settings, specifically in developing countries is still scarce. In-depth understanding is a key issue to organize interventions. AIM Identify experiences, needs and expectations of a group of pregnant women regarding antenatal education. METHODS A qualitative study was conducted. Data were collected through semi-structured interviews at the antenatal clinic of a public maternity teaching hospital in the southeastern region of Brazil. The interviews were recorded, transcribed verbatim and thematic analysis was performed. Twenty-two pregnant women were recruited following the logic of purposive sampling. FINDINGS All the participants reported they would like to receive guidance on non-pharmacological techniques for pain management during labor. The participants reported barriers to performed physical exercise; however, they also said that if they were encouraged by healthcare professionals they would exercise. According to the majority, the exercises should be of low intensity, and the improvement of general wellbeing was the most commented benefit. Also participants said that antenatal education meetings should be linked to antenatal consultations to facilitate participation. According to some participants, knowledge about antenatal education was acquired in conversations with other women, from lay media, and some reported a lack of guidance during antenatal consultation. CONCLUSION The participants of our study reported they would like to participate in antenatal education groups to receive guidance on non-pharmacological techniques to use during labor and childbirth.
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Affiliation(s)
- Maria Augusta Heim
- University of Campinas Medical School (UNICAMP), Departament of Obstetrics and Gynecology, Brazil
| | - Maria Amelia Miquelutti
- University of Campinas Medical School (UNICAMP), Departament of Obstetrics and Gynecology, Brazil
| | - Maria Y Makuch
- University of Campinas Medical School (UNICAMP), Departament of Obstetrics and Gynecology, Brazil.
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Miquelutti MA, Silveira C, Cecatti JG. Kinesiologic tape for labor pain control: Randomized controlled trial. Physiother Theory Pract 2018; 35:614-621. [PMID: 29608125 DOI: 10.1080/09593985.2018.1457117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Background: Kinesiologic taping has been studied for managing diverse types of dysfunctions and pain, but not for managing pain during labor. Objective: This study evaluated the effectiveness and safety of using kinesiologic tape (KT) during labor relative to pain, maternal satisfaction, and obstetric and neonatal outcomes. Method: The study was a single-blind randomized controlled trial composed of 60 pregnant women divided into two groups. In the kinesiologic tape group (KTG), the tape was applied to the region of spinal nerves T10-L1 and S2-S4; in the control group (CG), the tape was applied to the region of spinal nerves T1-T4. Study participants were low-risk pregnant women with spontaneous onset of labor and no previous Cesarean section. Outcomes evaluated were pain, duration of labor, type of delivery, uterotonic and anesthetic requirement, neonatal vitality, and satisfaction with delivery and tape use. Intention-to-treat analysis was performed, and risk ratios with a 95% CI were estimated. Results: After the first hour of tape use, a significant increase in pain was observed in the CG (p = 0.002). However, there were no differences between groups relative to the remaining outcomes assessed. In the KTG, 59% of participants reported satisfaction with tape use, whereas in the CG, 44% reported satisfaction with tape use. Conclusion: Despite its safety, the KT technique did not prove to effectively control labor pain.
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Affiliation(s)
- Maria Amelia Miquelutti
- a Department of Obstetrics and Gynecology, School of Medical Sciences , University of Campinas (UNICAMP) , Campinas , São Paulo , Brazil
| | - Carla Silveira
- a Department of Obstetrics and Gynecology, School of Medical Sciences , University of Campinas (UNICAMP) , Campinas , São Paulo , Brazil
| | - José Guilherme Cecatti
- a Department of Obstetrics and Gynecology, School of Medical Sciences , University of Campinas (UNICAMP) , Campinas , São Paulo , Brazil
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Sarpkaya Güder D, Yalvaç M, Vural G. The effect of pregnancy Pilates-assisted childbirth preparation training on childbirth fear and neonatal outcomes: a quasi-experimental/quantitative research. ACTA ACUST UNITED AC 2018. [DOI: 10.1007/s11135-018-0682-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Donate-Manzanares M, Rodríguez-Almagro J, Rodríguez-Cano T, Hernández-Martínez A, Barrilero-Fernández E, Santos-Hernández G, Beato-Fernández L. Cross-cultural adaptation and validation of the psychometric properties of the Quality from the Patient's Perspective I Questionnaire translated into Spanish. Midwifery 2017; 55:75-82. [DOI: 10.1016/j.midw.2017.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 09/07/2017] [Accepted: 09/10/2017] [Indexed: 11/27/2022]
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Akca A, Corbacioglu Esmer A, Ozyurek ES, Aydin A, Korkmaz N, Gorgen H, Akbayir O. The influence of the systematic birth preparation program on childbirth satisfaction. Arch Gynecol Obstet 2017; 295:1127-1133. [DOI: 10.1007/s00404-017-4345-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 03/07/2017] [Indexed: 12/01/2022]
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Miquelutti MA, Cecatti JG. Kinesio Taping for pain control during labor: Protocol of a randomized, controlled trial. Nurs Health Sci 2017; 19:95-99. [PMID: 28220582 DOI: 10.1111/nhs.12321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 09/14/2016] [Accepted: 11/02/2016] [Indexed: 12/16/2022]
Abstract
This study protocol will evaluate the effectiveness and safety during labor and delivery of the Kinesio Taping bandage for pain sensation, satisfaction of patients, and obstetric and neonatal outcomes. A randomized controlled trial with 60 participants divided into two groups will be conducted. The intervention group will receive bandage application on the vertebral regions corresponding to uterine dermatomes - from T10 to L1 and from S2 to S4. The control group will receive bandage application away from uterine dermatomes, from T1 to T4. The primary endpoint is pain during labor. Secondary endpoints are perinatal outcomes and patient satisfaction with the bandage and with her labor. Pain levels will be evaluated on an hourly basis during labor, and intention-to-treat analysis will be performed. Risk ratios and 95% confidence intervals will be calculated. Findings on effectiveness of pain control with no adverse effects to both the mother and neonate are the first step in evaluating the systematic use of Kinesio Taping during labor. Since self-control may affect birthing experience satisfaction, discovering new alternatives for pain control may allow for a better experience.
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Affiliation(s)
- Maria Amelia Miquelutti
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - José Guilherme Cecatti
- Department of Obstetrics and Gynecology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
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Rasouli M, AtashSokhan G, Keramat A, Khosravi A, Fooladi E, Mousavi SA. The impact of motivational interviewing on participation in childbirth preparation classes and having a natural delivery: a randomised trial. BJOG 2016; 124:631-639. [DOI: 10.1111/1471-0528.14397] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2016] [Indexed: 11/27/2022]
Affiliation(s)
- M Rasouli
- Department of Midwifery; School of Nursing and Midwifery; Shahroud University of Medical Sciences; Shahroud Iran
| | - G AtashSokhan
- Department of Midwifery; School of Nursing and Midwifery; Shahroud University of Medical Sciences; Shahroud Iran
| | - A Keramat
- Department of Reproductive Health; School of Nursing and Midwifery; Shahroud University of Medical Sciences; Shahroud Iran
| | - A Khosravi
- Centre for Health Related Social and Behavioural Sciences Research; Shahroud University of Medical Sciences; Shahroud Iran
| | - E Fooladi
- Department of Reproductive Health; School of Nursing and Midwifery; Mazandaran University of Medical Sciences; Sari Iran
| | - SA Mousavi
- Golestan Research Centre of Psychiatry; Golestan University of Medical Sciences; Gorgan Iran
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Gökçe İsbir G, İnci F, Önal H, Yıldız PD. The effects of antenatal education on fear of childbirth, maternal self-efficacy and post-traumatic stress disorder (PTSD) symptoms following childbirth: an experimental study. Appl Nurs Res 2016; 32:227-232. [DOI: 10.1016/j.apnr.2016.07.013] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2016] [Revised: 07/17/2016] [Accepted: 07/26/2016] [Indexed: 11/15/2022]
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Serçekuş P, Başkale H. Effects of antenatal education on fear of childbirth, maternal self-efficacy and parental attachment. Midwifery 2015; 34:166-172. [PMID: 26656473 DOI: 10.1016/j.midw.2015.11.016] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/29/2015] [Accepted: 11/19/2015] [Indexed: 11/24/2022]
Abstract
OBJECTIVE to examine the effects of antenatal education on fear of childbirth, maternal self-efficacy, and maternal and paternal attachment. DESIGN quasi-experimental study, comparing an antenatal education group and a control group. PARTICIPANTS 63 pregnant women and their husbands. MEASUREMENTS demographic data forms, the Wijma Delivery Expectancy/Experience Questionnaire, the Childbirth Self-Efficacy Inventory, the Maternal Attachment Inventory and the Postnatal Paternal-Infant Attachment Questionnaire were used for data collection. FINDINGS antenatal education was found to reduce the fear of childbirth and to increase childbirth-related maternal self-efficacy. However, antenatal education was found to have no effect on parental attachment. KEY CONCLUSIONS it is recommended that widespread antenatal education programmes should be provided in developing countries, and the content of the education programme about parental attachment should be increased. IMPLICATIONS FOR PRACTICE this study found that antenatal education has no influence on maternal and paternal attachment. As such, there is a need to increase the content of the education programme about parental attachment.
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Affiliation(s)
- Pınar Serçekuş
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
| | - Hatice Başkale
- Pamukkale University, Faculty of Health Sciences, Denizli, Turkey.
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Olfati F, Asefzadeh S, Changizi N, Keramat A, Yunesian M. Patient Involvement in Safe Delivery: A Qualitative Study. Glob J Health Sci 2015; 8:33-40. [PMID: 26755469 PMCID: PMC4954900 DOI: 10.5539/gjhs.v8n6p33] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 08/24/2015] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Patient involvement in safe delivery planning is considered important yet not widely practiced. The present study aimed at identifythe factors that affect patient involvementin safe delivery, as recommended by parturient women. METHODS This study was part of a qualitative research conducted by content analysis method and purposive sampling in 2013.The data were collected through 63 semi-structured interviews in4 hospitalsand analyzed using thematic content analysis. The participants in this research were women before discharge and after delivery. Findings were analyzed using Colaizzi's method. RESULTS Four categories of factors that could affect patient involvement in safe delivery emerged from our analysis: patient-related (true and false beliefs, literacy, privacy, respect for patient), illness-related (pain, type of delivery, patient safety incidents), health care professional-relatedand task-related factors (behavior, monitoring &training), health care setting-related (financial aspects, facilities). CONCLUSION More research is needed to explore the factors affecting the participation of mothers. It is therefore, recommended to: 1) take notice of mother education, their husbands, midwives and specialists; 2) provide pregnant women with insurance coverage from the outset of pregnancy, especially during prenatal period; 3) form a labor pain committee consisting of midwives, obstetricians, and anesthesiologists in order to identify the preferred painless labor methods based on the existing facilities and conditions, 4) carry out research on observing patients' privacy and dignity; 5) pay more attention on the factors affecting cesarean.
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Miquelutti MA, Cecatti JG, Makuch MY. Developing strategies to be added to the protocol for antenatal care: an exercise and birth preparation program. Clinics (Sao Paulo) 2015; 70:231-6. [PMID: 26017787 PMCID: PMC4418303 DOI: 10.6061/clinics/2015(04)02] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 01/07/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To describe the implementation process of a birth preparation program, the activities in the protocol for physical and birth preparation exercises, and the educational activities that have been evaluated regarding effectiveness and women's satisfaction. The birth preparation program described was developed with the following objectives: to prevent lumbopelvic pain, urinary incontinence and anxiety; to encourage the practice of physical activity during pregnancy and of positions and exercises for non-pharmacological pain relief during labor; and to discuss information that would help women to have autonomy during labor. METHODS The program comprised the following activities: supervised physical exercise, relaxation exercises, and educational activities (explanations of lumbopelvic pain prevention, pelvic floor function, labor and delivery, and which non-pharmacological pain relief to use during labor) provided regularly after prenatal consultations. These activities were held monthly, starting when the women joined the program at 18-24 weeks of pregnancy and continuing until 30 weeks of pregnancy, fortnightly thereafter from 31 to 36 weeks of pregnancy, and then weekly from the 37th week until delivery. Information and printed materials regarding the physical exercises to be performed at home were provided. Clinicaltrials.gov: NCT01155804. RESULTS The program was an innovative type of intervention that systematized birth preparation activities that were organized to encompass aspects related both to pregnancy and to labor and that included physical, educational and home-based activities. CONCLUSIONS The detailed description of the protocol used may serve as a basis for further studies and also for the implementation of birth preparation programs within the healthcare system in different settings.
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Affiliation(s)
- Maria Amélia Miquelutti
- Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil
| | - José Guilherme Cecatti
- Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil
| | - Maria Yolanda Makuch
- Department of Obstetrics and Gynecology, School of Medical Sciences, Universidade de Campinas, Campinas, SP, Brazil
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