INTRODUCTION:

Birthing is a routine physiological process, but it can also have a profound impact on a woman's life. Treatment given to women during labour may have both physical and psychological consequences on them; in the same way, short- and long-term labour and delivery management are the most common medical issues that healthcare professionals address. Inappropriate handling of this critical occasion may result in prolonged or obstructed labor, which can cause puerperal infection, uterine rupture, postpartum haemorrhage, and fatigue in the mother.

The treatment of labour pain is still a major concern for pregnant women, their families, and medical professionals. For women who are in labour, the use of analgesics and anaesthetic medicines may not be the first choice due to the possible negative effects on mothers and foetuses. Rather, health care professionals want to minimize or completely avoid using pharmaceutical painkillers during labour (Gibbins and Thomson, 2001, Fenwick et al., 2005).

OBJECTIVES:

1. To assess the effectiveness of birth ball sitting on labour outcomes among primi gravida mothers in control and experimental group.

2. To find the association between labour outcomes such as pain, cervical dilatation, duration of first stage, mode of delivery, perineal muscle tear and selected demographic variables in experimental and control group.

HYPOTHESIS:

H₁: To assess the effectiveness of birth ball sitting on labour outcomes among primi gravida mothers in control and experimental group.

H2: To find the association between labour outcomes such as pain, cervical dilatation, duration of first stage, mode of delivery, perineal muscle tear and selected demographic variables in experimental and control group.

MATERIAL AND METHODS:

Quantitative approach, Quasi Experimental research post-test only design was adapted for this study. A non-probability purposive sampling technique was used to select the 60 samples. The inclusion criteria for this study were Primi mothers who were between the ages of 20 and 35, not have any co-morbid diseases, and who are at the first stage of labour. Labour outcomes measured by (using a pain scale, modified partograph, and experts suggested check lists). Patient anonymity and confidentiality were maintained throughout the research; no physical or psychological damage to patients was noted.

RESULT AND DISCUSSION:

The results showed that the control group's mean score and SD were 1.2 ± 0.99. In contrast, the experimental group's mean score and standard deviation are 2.57 ±0.72 and the z value is -4.910 at the p level of P<0.001***(HS), indicating statistically significant significance.

Results of cervical dilatation in the control and experimental groups showed that the control group had a mean score and SD of 1.8.3± 1.05. On the other hand, the experimental group's mean score and standard deviation are 2.57 ±0.82, the mean difference is 0.733, and the z value is -2.856 at a p-value of P<0.001***(HS), indicating statistically significant significance.

The duration of the first stage of labour was different for the experimental and control groups. The results showed that the control group's mean score and SD were 1 ± 0.37. On the other hand, the experimental group's mean score and standard deviation are 1.6 ±0.72, the mean difference is 0.600, and the z value is -3.975 at the p level of P<0.001***(HS), indicating statistical significance.

Regarding the delivery method used in the experimental and control groups, The results showed that the control group's mean score and SD were 0.57 ± 0.67. On the other hand, the experimental group's mean score and standard deviation are 1.57 ±0.73, with a mean difference of 4.538 at the p-value of P<0.001***(HS), indicating statistical significance.

Concerning the perineal tears in the experimental and control groups. The results showed that the control group's mean score and SD were 2.03 ± 1.61. In contrast, the experimental group's mean score and standard deviation are 3.5 ±0.90, with a mean difference of 1.47 and a z value of -3.693 at the p level of P<0.001***(HS), indicating statistical significance.

A significant association was identified between the mode of delivery among primi mothers and their occupation (χ2 = 14.76, p = 0.029).

Table 1: Mean, standard deviation, mean difference, and z-test value of labour outcomes before and after the birth ball sitting for the experimental and control groups. n = 60

Labour Outcomes	Control group Post test		Experimental group Post test		Mean difference	‘z’- Value	P -value
Labour Outcomes	Mean	SD	Mean	SD
Level of Pain	1.2	0.99	2.57	0.72	1.367	-4.910	P<0.001(HS)*
Cervical dilatation	1.83	1.05	2.57	0.82	0.733	-2.856	P<0.001(HS)*
Duration of first stage	1	0.37	1.6	0.72	0.600	-3.975	P<0.001(HS)*
Mode of delivery	0.57	0.67	1.57	0.73	1	-4.538	P<0.001(HS)*
Perineal tear	2.03	1.61	3.5	0.90	1.47	-3.693	P<0.001(HS)*

*-P<0.05, significant and **-P<0.01 &***-P<0.001, Highly significant

SUMMARY AND RECOMMENDATIONS:

The study was conducted to assess the effectiveness of birth ball sitting on labour outcomes among primi mother at a selected hospital. The results of the study demonstrated that the birth ball was useful in enhancing cervical dilation, the delivery method, reducing discomfort during labour, reducing the perineal muscle tear and length of the first stage of labour. Thus, for primi mothers, this birth ball sitting technique is a useful way to influence the labour process in a positive way.

REFERENCES:

1. Mirzakani, Kobra, et al, The effect of birth ball exercise during pregnancy on mode delivery in primiparous women. Journal of Midwivery and Reproductive Health, 2014

2. Aktaş D, Kolsuz S, Ertuğrul M, Beşirli EG, Gündoğan FR. Effect of birth ball exercising for the management of childbirth pain in Turkish women. Bezmialem Science. 2021; 9(1): 46-52. DOI: 10.14235/bas.galenos.2020.3898

3. Zwelling E. Overcoming the challenges: maternal movement and positioning to facilitate labor progress. MCN: The American Journal of Maternal/Child Nursing. 2010;35(2):72- 78. DOI: 10.1097/NMC.0b013e3181caeab3

4. Grenvik, J. M., Rosenthal, E., Wey, S., Saccone, G., De Vivo, V., De Prisco LCP, A., and Berghella, V. Birthing ball for reducing labor pain: a systematic review and meta-analysis of randomized controlled trials. The Journal of Maternal-Fetal & Neonatal Medicine. 2022; 35(25): 5184-5193.

5. Wai-Lei, H. A. U., TSANG, S. L., Winny, K. W. A. N., MAN, L. S. K., Kit-Yee, L. A. M., Lai-Fong, H. O. and Sin, W. H. The use of birth ball as a method of pain management in labour. Hong Kong Journal of Gynaecology, Obstetrics and Midwifery. 2012; 12(1).

6. Feni O, Anni S, Rukmaini R. The effect of the birthing ball on duration of the first stage of labour in primigravida at Utama Barokah Clinic, Bandung City in 2021. Muhammadiyah Medical Journal. 2021; 2(2): 55-61. DOI:10.24853/mmj.2.2.55-61

7. Taavoni, S., Sheikhan, F., Abdolahian, S., and Ghavi, F. Birth ball or heat therapy? A randomized controlled trial to compare the effectiveness of birth ball usage with sacrum-perineal heat therapy in labor pain management. Complementary Therapies in Clinical Practice. 2016; 24: 99-102.

8. James, S., & Hudek, M. Experiences of South African multiparous labouring women using the birthing ball to encourage vaginal births. Health SA Gesondheid. 2017; 22: 36-42.

9. Suraci, N., Carr, C., Peck, J., Hoyos, J., and Rosen, G. Improving labour progression among women with epidural anesthesia following use of a birthing ball: a review of recent literature. Journal of Obstetrics and Gynaecology. 2020; 40(4): 491-494.

Received on 01.06.2024 Modified on 08.07.2024

Int. J. Nur. Edu. and Research. 2024; 12(3):209-211.

DOI: 10.52711/2454-2660.2024.00044