A study to assess the effectiveness of antenatal Exercises in reduction of labour pain among primi mothers in selected hospital, Erode.

Ms. K. Vijayalakshmi¹, Dr. P. Padmavathi²

¹Vice Principal, SPMIHS, Palayakottai, Tirupur District.

²Research guide and Principal, Dhanvantri College of Nursing,

Ganapathypuram, Pallakkapalayam, Namakkal District – 637303.

*Corresponding Author E-mail: rishiyazhu2010@gmail.com

ABSTRACT:

Giving birth is a life-changing event, and the care that a woman receives during labour has the potential to affect her both physically and emotionally the short and longer term. Therefore, improving the quality of maternity care in both developed and developing countries is an important part of attempts made to decrease maternal and neonatal mortality and morbidity. In obstetric care, many interventions are complex, containing a number of different components which may have an effect on the impact of the interventions in healthcare settings. Objective: To determine the effectiveness of antenatal exercises in reduction of labour pain among primi gravida mothers in both the groups. Methodology: A quantitative approach and evaluate in nature and true experimental design where post test only with control group design. The study population were Primi mothers, 30(15 control and 15 experimental group) mothers attending antenatal OPD in private maternity Hospital, Erode District. Visual analog scale was used to assess the level of pain. Result: The findings revealed that after the antenatal exercise the visual analog pain scale score was reduced in experimental group compared to the control group among primi mothers. In control group there was no significant association between the level of labour pain and demographic variables. In experimental group there was no significant association between the level of pain and demographic variables such as age, family, living area, habit of regular exercise and previous source of information and highly significant association in education, occupation and income. Conclusion: The antenatal exercise was more effective in reduction pain during labour among the primi mothers in experimental group.

KEYWORDS: Maternal and Neonatal Mortality and Morbidity, Demographic Variables.

INTRODUCTION:

Safe motherhood and reproductive health are a global issue in today’s world. Women’s preferences for health related outcomes are playing an important role in modern healthcare practice and policy.

Women’s autonomy in healthcare decision-making is extremely beneficial for better maternal, child health outcomes and as an indicator of women’s empowerment. (Spanglar SA, 2011)

Young B, Takoudes T, Lim KH, Rana S, 2010, stated that, labor is a physiological event. Pain is a common phenomenon and is an inevitable part of the childbirth process. The agony and stress a woman suffers are beyond description. Stress of pain disturbs the maternal autonomic functions and liberates catecholamine, which predisposes to dysfunctional labor and compromise fetal oxygenation.6 Continuous labor pain has effect on respiratory system, blood circulation, endocrine glands and other body activities. A recent review by Lowe8 focuses on methods for measuring pain experience and physiologic and environmental factors that influence labor pain.

The study concludes that primigravid women who received structured teaching program had better labor pain reduction as compared to those women under routine care. Therefore, it is strongly recommended that antenatal exercise program should be a routine activity and a service to be delivered by the healthcare providers in the antenatal outpatient department and in the labor unit. Greater attention should be paid to promote and implement active exercise programs among all women in general and necessarily during commence from the onset of pregnancy in the absence of any medical and obstetrical complications. (Emi John Prince, Vidya Seshan, 2015)

Exercise is a natural part of life. Physical exercises increase mood-elevating chemicals in the brain and thereby reduce pregnancy-related blues. As the women need to exercise during pregnancy, the present study was conducted to determine the effect of antenatal exercises on labour process among primigravid mothers at selected Urban Health Centres in Coimbatore (Tamilnadu). The practise of antenatal exercises revealed a significant difference in duration of labour, nature of delivery, behaviour manifestations, and level of pain in mother and presence of asphyxia and birth injuries in new born. (A. Jaya Sudha, 2013)

Statement of the problem:

A study to assess the effectiveness of antenatal Exercises in reduction of labour pain among primi mothers in selected hospital, Erode.

OBJECTIVES:

1. To assess the level of labour pain among primi gravida mothers in control group.

2. To assess the level of labour pain among primi gravida mothers in experimental group after implementation of antenatal exercises.

3. To determine the effectiveness of antenatal exercises in reduction of labour pain among primi gravida mothers in both the groups.

4. To find out the association between post test scores of labour pain among control and experimental group of primi gravida mothers with their demographic variables.

MATERIALS AND METHODS:

A quantitative approach and evaluate in nature and true experimental design where post test only with control group design. The study population were Primi mothers,30(15 control and 15 experimental group) mothers attending antenatal OPD in private maternity Hospital, Erode District. Visual analog scale was used to assess the level of pain.

Tool for data collection:

The tool used for this study is divided into two sections, Demographic variable (which included Age, types of family, education, occupation, family income, religion, BMI, habit of regular exercise, residential area and previous source of information regarding antenatal exercise.) and Visual analog pain scale (simple descriptive pain intensity scale) scale was used to measure the level of pain perception experienced by primi gravida mothers during labour process. It consist of 1-10 score.

Method of data collection and data analysis:

The data were collected for 4 weeks, permission was sought and obtained from administrative officer. The primi mothers were selected by simple random sampling method among those who fulfilled the sampling criteria. Totally 30 mothers were selected and divide them as 15 each in group (control and experimental). From both group the personal data were collected and to the experimental group exercises (Kegel exercises, Pelvic tilt and Aerobic Exercises) taught to the primi gravid mother with the help of video. The mother will practice daily for the duration of 30 minutes from 7th months to onset of labour. Post test was conducted for both control and experimental group with visual analog pain scale while mother was admitted in labour ward with pain and assessed the level of pain. Data was analyzed using descriptive and inferential statistics. Frequency and percentage distribution was used to describe the demographic information and level of pain. Unpaired “t”-test was found to assess the effectiveness of antenatal Exercises in reduction of labour pain Chi-square test to find out association between level of pain and Selected Demographic data.

RESULT:

Demographic variable:

According to their demographic data, regarding age of the mother in control and experimental group majority 40% (6) and 46.67% (7) of them were between 24-26 years, according to their education the highest percentage in both control and experimental group 33.33% (5) and 40% (6) of them were had high school education, in occupation majority 40% (6) and 33.33% (5) of them were private employee and got the similar percentage 46.67% (7) of family monthly income of in both groups. Type of family in control group the majority 60% (9) of them were in nuclear family and majority of the mothers in experimental group were 53.33% (8) belongs to joint family. In both the groups the highest percentage 40% (6) and 53.33% (8) of the primi mothers were lived in rural areas. Highest percentage 26.67% (4) in control group of them were having the habit of regular exercise whenever getting time whereas in experimental group similar percentage 26.67% (4) of them were not doing the regular exercise and whenever getting time respectively. Source of information the highest percentage in control group 40% (6) of them got from mass media whereas in experimental group the highest percentage 40% (6) of them got the information from health professionals.

Level of pain:

Among control group in post test level of pain 12 (80%) had moderate level of pain and 3(20%) had severe pain whereas in experimental group 13(86.67%) had mild level of pain and only 2 (13.33%) of them had moderate level of pain. It was inferred that after the antenatal exercise the visual analog pain scale score was reduced in experimental group compared to the control group among primi mothers.

It infers that the effectiveness of antenatal exercise on the level of pain during labour among primi mothers in experimental group overall post test mean score was 3.4, SD of 1.24 and the mean percentage was 34%. The obtained ‘t’ value was 9.93 (p<0.001) was highly significant. Hence it was inferred that the antenatal exercise was more effective in reduction pain during labour among the primi mothers in experimental group.

Association between the Post test Level of labour pain and the Selected Demographic Variables among primi mothers in Control and Experimental Group.

Among the control group there was no significant association between the level of labour pain and demographic variables such as age (χ2 =2.50), education (χ2 =1.145), occupation (χ2 =0.104), income (χ2 =0.476), type of family (χ2 =0.069), living area (χ2 =2.29), habit of regular exercise (χ2 =6.14) and previous source of information (χ2 =3.75) at 0.05 level respectively. Whereas in experimental group there was no significant association between the level of pain and demographic variables such as age (χ2 =0.659), family (χ2 =0.01), living area (χ2 =1.66), habit of regular exercise (χ2 =2.74), and previous source of information (χ2 =1.58) at 0.05 level respectively. But there was a highly significant association between demographic variables such as education (χ2 =15.0), occupation (χ2 =15.00) and income (χ2 =15) at 0.001 level respectively.

CONCLUSION:

· The antenatal exercise was more effective in reduction pain during labour among the primi mothers in experimental group.

· In control group there was no significant association between the level of labour pain and demographic variables

· In experimental group there was no significant association between the level of pain and demographic variables such as age, family, living area, habit of regular exercise and previous source of information and highly significant association in education, occupation and income.

REFERENCES:

1. A. Jayasudha, Randomized Controlled Trial on Effect of antenatal exercises on labour outcome among primigravid mothers, Nursing Journal of India, Jan-Feb 013;104(1):10-3.

2. Young B, Takoudes T, Lim KH, Rana S. Rupture of the posterior cul-de-sac during spontaneous labour. Obstet Gynecol 2010;115(2):414-417

3. Spanglar SA. To open oneself is a poor woman’s trouble: emboided inequiality and childbirth in south-central tanzania. Medical Anthropology Quaterly 2011;25(4): 479-498

4. Dutta, D.C. (2004). Textbook of Obstetrics including Perinatology and Contraception. (6th ed.). Calcutta: New Central Book Agency.

5. AK Khatri, Suraj Sirohi, Sanjay Dixit, Shailesh Rai, Dhruvendra Pandey, Effect of Antenatal Exercise on Outcome of Labor, National Journal of Community Medicine│Volume 5│Issue 3│Apr – June 2014,342-345.

6. Sinhgad. Breathing exercise on labour pain. e-Journal of Nursing. 2011 dec 1(2):673-80.

Received on 14.08.2021 Modified on 17.09.2021

Int. J. Nur. Edu. and Research. 2022; 10(1):16-18.

DOI: 10.52711/2454-2660.2022.00004