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Effectiveness of Ambulation during First Stage of Labour, on the Outcome of Labour among Primigravid Women in Selected Hospitals of Palakkad District, Kerala
Abstract
Many women desire mobility during labour, which helps to enhance their physiological and psychological wellbeing. The purpose of the study was to determine the effectiveness of ambulation during first stage of labour, on the outcome of labour. Quasi experimental, post test only control group design was used in 60 samples. Statistical analysis of data revealed that ambulation during first stage of labour was effective in reducing duration of labour (t value = -2.27 and p value <0.05) also in bringing positive behavioural response (Mann-Whitney U test, p value< 0.05).
... Na sua maioria os estudos incluíram parturientes nulíparas17,18,19,20,21,22,23,24,25,27 , de baixo risco17,18,20,21,22,24,25,27 , com gravidez de termo18,20,21,22,23,24 e com feto único18,20,21,22,23,24,25 .Nos artigos analisados, as posições reclinadas/deitadas consideradas foram a posição supina17,23,24,25 , semi-reclinada na cama 17, 23, 25 e posição de decúbito lateral23,25 . No que respeita às posições verticais/mobilidade consideraram-se a posição de pé20,23,24,25,27 , sentada19,20,21,23,24,25,27 (cama, cadeira, bola de parto), ajoelhada20, 23, 24 , agachada 20, 23, 24, 25 , em quatro apoios 25 , a deambulação 17, 18, 19, 27 e o movimento de balanço pélvico 20, 21, 22 . ...
... Na sua maioria os estudos incluíram parturientes nulíparas17,18,19,20,21,22,23,24,25,27 , de baixo risco17,18,20,21,22,24,25,27 , com gravidez de termo18,20,21,22,23,24 e com feto único18,20,21,22,23,24,25 .Nos artigos analisados, as posições reclinadas/deitadas consideradas foram a posição supina17,23,24,25 , semi-reclinada na cama 17, 23, 25 e posição de decúbito lateral23,25 . No que respeita às posições verticais/mobilidade consideraram-se a posição de pé20,23,24,25,27 , sentada19,20,21,23,24,25,27 (cama, cadeira, bola de parto), ajoelhada20, 23, 24 , agachada 20, 23, 24, 25 , em quatro apoios 25 , a deambulação 17, 18, 19, 27 e o movimento de balanço pélvico 20, 21, 22 . ...
... Na sua maioria os estudos incluíram parturientes nulíparas17,18,19,20,21,22,23,24,25,27 , de baixo risco17,18,20,21,22,24,25,27 , com gravidez de termo18,20,21,22,23,24 e com feto único18,20,21,22,23,24,25 .Nos artigos analisados, as posições reclinadas/deitadas consideradas foram a posição supina17,23,24,25 , semi-reclinada na cama 17, 23, 25 e posição de decúbito lateral23,25 . No que respeita às posições verticais/mobilidade consideraram-se a posição de pé20,23,24,25,27 , sentada19,20,21,23,24,25,27 (cama, cadeira, bola de parto), ajoelhada20, 23, 24 , agachada 20, 23, 24, 25 , em quatro apoios 25 , a deambulação 17, 18, 19, 27 e o movimento de balanço pélvico 20, 21, 22 . ...
Enquadramento: O trabalho de parto é um processo inimitável, único e emocionante para a mulher que o experiencia. Vários organismos nacionais e internacionais recomendam a mobilidade e adoção de posturas verticais, como práticas benéficas na dinâmica do primeiro estádio do trabalho de parto. Objetivo: Identificar a evidencia científica sobre a influência da mobilidade e adoção de posturas verticais na duração do 1º estádio do trabalho de parto. Método: Realizou-se uma revisão integrativa da literatura, através da pesquisa em bases de dados bibliográficas online. Dois revisores independentes avaliaram a relevância dos artigos, a extração e síntese dos dados. Resultados: Da pesquisa (337 artigos) obtiveram-se doze artigos para análise, a qual demonstrou quase com unanimidade que a mobilidade materna e a adoção de posturas verticais durante o primeiro estádio do trabalho de parto encurtam a duração desse estádio. Conclusão: Apesar do consenso encontrado, a heterogeneidade dos estudos analisados quanto ao número de participantes e tipo de intervenções, requer atenção na interpretação dos resultados e aponta para a necessidade de mais estudos sobre a temática.
... respectively; p = 0.002), maternal and neonatal outcome data not available in this study. 8 8) Prabakar et al 2015 Effectiveness of ambulation during the rst stage of labor-on-labor outcome. Quasi experimental posttest only 60 samples, duration of labor was effective (t value -2.27 and p value <0.05) brought positive behavioral response (Man -Whitney U test p value <0.05) nding are supported by systematic review which include 21 studies total 3706 women on mobility duration on rst stage. ...
This systematic review is the product of 10 top published journals. The search engines adopted in this study were PubMed, Medline, Cochrane Library, Google Scholar, and Research gate. The inclusion criteria were:1. Papers published between 2004-2020, 2. Top tier journal articles (High quality), 3. Term Mobility and rst stage of labor, duration of labor, Maternal and neonatal outcome. The present highlight is that the active phase of labor enhances the effect of gravity that helps the fetus to descend comfortably as there is adequate space to move downwards as the diameter of the pelvis expands to its maximum. The pressure on the nerve in the spine during labor is reduced and thus reducing and relieving pain. If the membranes are intact, the woman is allowed to walk about. This attitude prevents vena cava compression and encourages descent of the head. Ambulation can reduce the duration of labor, need for analgesia and improve maternal comfort. Mobilization improves frequency, strength and length of contractions, decreases the use of oxytocin to augment labor and improves oxygen supply to the fetus. It improves alignment of pelvic bones and the shape and capacity of pelvis, and optimizes the good t between fetus and pelvis. This paper shows the research gaps from different studies in the review of the literature. In this present study of systematic review, 10 recent multiple interventions based on RCTs and Non RCTs studies between 2004 to 2020 were systematically reviewed using the keywords search method. The ndings are discussed and research gaps are listed accordingly Systematic review on Mobility/Ambulation during the First Stage of Labor:
... If the membranes are intact and the women is allowed to walk about, this attitude prevents compression and encourages descend of head 4. Duration of the first stage is shortened in 25% and cephalic moulding is not increased, the incidence of forceps delivery diminished in the ambulant group. 5 When allowed the freedom to ambulate and change position during labor and birth, many women up to choose this as it has become a more effective form of pain relief. 6 A prospective study was conducted among antenatal mothers in France on ambulatory epidural anesthesia and duration of labor. ...
Introduction: The birthing women experiences, many demanding sensation and discomfort during labour and child birth. The childbearing women commonly tensed about childbirth and delivery. Ambulation during first stage of labour eases the process and it became a popular measure during this phase. Ambulation has also been found to increase foeto-maternal circulation which in turn increases the well-being of the new-born as well. Through the literature review, movement in labour to facilitates the progress of labour and enhance child birth satisfaction. This consciousness made the researcher to supply or issue the method of ambulation during the first stage of labour. With this aim, the study was conducted to assess the effectiveness of ambulation on maternal parameters in first stage of labor among the primi mother. Materials and Methods: A quasi experimental posttest only control group design was adopted to evaluate the efficacy of ambulation during first stage of labor on maternal parameters among primi mothers. Non probability purposive sampling technique was used to recruit 40 primi mothers who are in first stage of labor and were assigned into experimental group and control group. A structured questionnaire was used to collect the demographic variable; Numerical pain rating scale was used to assess the intensity of pain, Tool to assess the frequency and duration of uterine contraction, Stethoscope to assess the foetal heart rate and opinionnaire on ambulation was used to assess the maternal parameters. Tool was administered for 20 minutes at different time interval for experimental group only. Mothers in the control group underwent routine treatment. The data obtained was analyzed and interpreted using descriptive and inferential statistics. Results: The study findings showed that there is significant difference in the pain level in both groups. The mean and standard deviation in 2nd post intervention in experimental group is 3.35+0.48 and in control group 2.95+ 0.22. There was significant difference and comparison of cervical dilatation among both the groups. The mean and standard deviation in 2nd post intervention in experimental group is 2.20 +0.41 and in control group 2.10 + 0.30. The comparison of frequency of contraction among both the groups is significant. In this mean and standard deviation in 2nd post intervention in experimental group is 2.20 + 0.41 and in control group 2.10 + 0.00. The comparison of duration of contraction among both the groups is significant. In this mean and standard deviation in 2nd post intervention in experimental group is 2.05 + 0.68 and in control group 2.00 + 0.00 was statistically significant. The comparison of FHR among both the groups is significant. In this mean and standard deviation in 2nd post intervention in experimental group is 3.80 + 0.41 and in control group 3.75 + 0.63. There is no significant difference in control group. There was no significant association between the selected demographic variables with maternal parameters such as pain, cervical dilatation, frequency of contraction, duration of contraction in experimental and control group. There is a significant association between age and fetal heart rate in experimental group. Conclusion: The study concluded that the ambulation technique is effective to reduce the duration of labor in first stage among primi mothers. The mothers in the experimental group who were administered ambulation technique experienced reduction in the duration of labor.
... It seems that there are some potential mechanisms in this regard. According to some evidence, the implementation of pelvic movements by the mother in an upright position and freedom of movement during the labor will assist the gravity power, facilitate the descent of presenting part, strengthen the uterine contractions, and reduce the length of labor (24). The reduction of labor length can also be related to the mitigation of the labor pain. ...
Background & aim: Recently, the use of birth ball in childbirth has been widely considered. This review study aimed to critically evaluate the evidence regarding the effect of using the birth ball on the mode of delivery and length of labor.
Methods: For the purpose of the study, the articles related to the subject of interest and published up to August 5th, 2018 were searched in several scientific databases, including Cochrane library, CENTRAL, and PubMed. This review included all randomized control trials evaluating the use of birth ball for giving birth. Two study outcomes were considered in the present study, namely the type of delivery and length of labor stages. Finally, five studies were entered into the systematic review and meta-analysis. The risk of bias was calculated by means of the Cochrane’s tool.
Results: The included studies had a different range of quality, mostly lower than the standard level. The results of the reviewed articles revealed that the group who used birth ball had shorter active labor phase, as compared to the control group (P=0.048). However, the use of birth had no statistically significant effect on the length of the second stage of labor (P=0.128). In addition, using birth ball did not increase the chance of vaginal delivery (P=0.922).
Conclusion: Given the findings of the present study, it is essential to perform further high-quality studies with more scientific design to provide clinical evidence on the use of birth ball as a maternity service.
... Moreover, nearly three quarters in upright group were preferred to assume the upright position in the next labor compared to more than one quarter in recumbent group who anticipated to assume recumbent position in the next labor. These findings are in the same line with Prabhakar et al. [26] who studied the effectiveness of ambulation during first stage of labor, on the outcome of labor among primigravida women and found that mothers were stay in bed and not walk around experienced lower satisfaction with childbirth than mothers that were walk around or move from one position to another. Also these findings supported by Hodnett et al. [10] who found that women who encouraged to assuming upright position were satisfied and more comfortable. ...
Objective: The aim of this study was to assess the effect of upright versus recumbent position during the active phase of first stage of labor among primipara women on labor outcomes in term of progress, duration of labor, method of delivery, neonatal outcome and maternal satisfaction with assumed position.Methods: Quasi experimental design was used. The study was conducted in the labor unit in obstetric department at Benha University Hospital. A purposive sample of 100 parturient women in 1st stage of labor were recruited in the study, they divided into two groups; upright group (50) and recumbent group (50). Data were collected through four main tools: Structured Interviewing questionnaire sheet, Structured Observational Checklist include (Partograph and Apgar score), Visual analogue pain intensity scale and maternal satisfaction with assumed position questionnaire.Results: It revealed that high statistical significant difference between the upright and recumbent groups in term of decreases interval and increases duration, frequency and intensity of uterine contraction, cervical dilatation and fetal head descent/fifth among the upright group. While the recumbent group showed less progress. Moreover, the recumbent group expressed more pain score, consume longer duration of 1st, 2nd, 3rd stage of labor than the upright group and statistical significant difference in Apgar score of the neonate during both first and fifth minute. In addition, the upright group had higher satisfaction scores compared to those assumed recumbent positions (p < .001).Conclusions: Upright position had positive effect on progress of labor, decreased duration of the three stages of labor, better neonatal outcomes and improving parturient women's satisfaction with assumed position. The study recommended that all parturient women in low-risk labor should be informed about the benefits of assuming upright positions during first stage of labor, and be encouraged and supported to use them.
Background: Labor is a physiologic process and consideration of labor pain and relief that is among the major components of maternal care. Application of some labor positions can lay the fetus better in the pelvic canal direction. Aim of the study: to evaluate the pain intensity in the sitting position versus the walking position during the first stage of labor and investigate their effects on labor outcomes among primiparous women. Research design Quasi-experimental research design was utilized to fulfill the aim of this study. Setting: The study was carried out in the labor unit in the obstetric department at Mansoura University Hospital. Sample: Included 100 primiparous women in 1 st stage of labor were recruited in the study, they were divided into two equal groups; a sitting group (50) and a walking group (50) randomly selected through convenient sampling from those who were hospitalized in the previously selected setting with a gestational age of 37–42 weeks, singleton pregnancy, and with cephalic presentation. Tools: Structured Interviewing questionnaire sheet, Structured Observational Checklist including (Partograph and Apgar score), and Visual analogue pain intensity scale (VAS) were used.
EFFECTIVENESS OF AMBULATION DURING THE FIRST STAGE OF LABOR ON INTENSITY OF LABOUR PAIN AND DURATION OF FIRST STAGE OF LABOUR AMONG THE PRIMIGRAVIDA MOTHERS
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