The Influence of Three Delivery Positions on Pain Intensity and Feto-Maternal Outcomes During The First Stage of Labor among primi-gravidae Mothers, Comparative Study.

Document Type : Original Article

Authors

1 Assistant Professor, Faculty of Nursing, Alexandria University, Egypt Maternity and Child Health Department, College of Nursing, King Saud University, Saudi Arabia

2 Registered Specialist Midwife, Ministry of Health, Primary Health Care Center

Abstract

Background: labor pain is the result of a complex and subjective interaction of multiple physiologic and psychosocial factors on a woman’s individual interpretation of labor stimuli. Aim of study: to compare the intensity of delivery pain through different childbirth positions in the first stage of delivery among primigravidae mothers. Setting: The study was carried out at Prince Sultan Military Medical City Hospital, Riyadh. Sample: This is a clinical trial conducted on 93 primiparous pregnant women randomly selected through convenient sampling from those who were hospitalized in the hospitals of Prince Sultan Military Medical City. Women with a gestational age of 37–42 weeks, singleton pregnancy, who had passed the first labor stage through physiologic process, and with cephalic presentation were selected. The subjects were randomly allocated to be in the groups were equally divided into three matching groups (walking, setting and recumbent). An Interviewing Assessment Sheet, Partograph, Visual analogue pain intensity scale (VAS) was used. Position changes implemented during first stage of labour and intensity of pain assessed by Visual analogue pain intensity scale tool. Results: Mean score of pain severity in Latent phase was (4.33) in Semi-Recumbent position, (5.06) in Lateral position, (3.45) in Sitting position and (4.13) in walking group. In Active phase the mean was (6.67) in Semi-Recumbent position, (7.5) in Lateral position, (5.71) in Sitting position and (5.29±2.3) in walking group. However, only Active phase showed significant differences between labour position groups (P=0.009). The labour positions during first stage of labour doesn’t influence their risky for cesarean section but the walking group reported significantly less incidence of CS than the other two groups. More over ventous delivery showed high incidence in recumbent position than other. As regard to degree of laceration, Lateral or semi recumbent position, compared to sitting position or walking position, increase the risky of second degree laceration. As regard to episiotomy, the three position not reduce. Conclusion and Recommendation: Change positions during active phase of first stage of labor appeared to have a remarkable effect on labor pain intensity. In service training programs for nurses in labor units about the utilization of nonpharmacological approaches is recommended.

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