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 Table of Contents  
ORIGINAL ARTICLE
Year : 2016  |  Volume : 7  |  Issue : 1  |  Page : 13-16

Effectiveness of PTP on childbirth preparation regarding childbirth practice during labor among primigravid women


Department of Obstetrics and Gynecological Nursing, Father Muller College of Nursing, Mangalore, Karnataka, India

Date of Web Publication21-Jan-2016

Correspondence Address:
Precilla D'Silva
Department of Obstetrics and Gynecological Nursing, Father Muller College of Nursing, Mangalore, Karnataka
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0975-9727.174606

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  Abstract 

Context:Childbirth is a natural and universal phenomenon. Although labor is often thought of as one of the most painful events in human experience, supportive care is intended to ease a woman's anxiety and discomfort. A wide variety of pain relief measures, pharmacological and nonpharmacological, are available for women in labor. Aim: To assess the practices adopted during labor among the primigravid women in the experimental and control group, to compare the practices adopted during labor among the primigravid women in control and experimental group, and to find the association between selected baseline variables and childbirth practices. Settings and Design: Father Muller Medical College Hospital, Mangalore, Quasi-experimental design. Materials and Methods: Observational checklist to assess the childbirth practices. Statistical Analysis: Frequency, mean, standard deviation (SD), mean percentage, Spearman's rank correlation coefficient, chi-square for association. Result:The mean practice scores are higher among the experimental group compared to the control group, which indicates that the Planned teaching Programme has helped to adopt the practices during labor among primigravid women specially in the experimental group. No association was found between demographic variables and childbirth practices. Conclusion: Planned Teaching Programme is a simple and cost-effective method that can be initiated by nurses who are to be used by mothers during labor.

Keywords: Childbirth preparation, childbirth education, PTP


How to cite this article:
D'Silva P, Mathias A. Effectiveness of PTP on childbirth preparation regarding childbirth practice during labor among primigravid women. Muller J Med Sci Res 2016;7:13-6

How to cite this URL:
D'Silva P, Mathias A. Effectiveness of PTP on childbirth preparation regarding childbirth practice during labor among primigravid women. Muller J Med Sci Res [serial online] 2016 [cited 2020 Jun 1];7:13-6. Available from: http://www.mjmsr.net/text.asp?2016/7/1/13/174606


  Introduction Top


Pregnant women become more focused about labor and birth of a child as they approach the final phase of pregnancy. Midwives and maternity nurses play a vital role in helping pregnant women to overcome their fear and anxieties about labor and childbirth. Various educational programs and methods have been designed to help pregnant women and both the parents, in general, to know the different aspects of labor and delivery. Formal and informal antenatal education has a long history. In early times, women were prepared informally for childbearing and child-rearing by core siding with extended family members such as aunts and grandmothers. Formal antenatal education began in the Western countries in a response to a need to improve antenatal care and maternal infant outcomes in the twentieth century (Zwelling 1996). Much research has been undertaken worldwide to evaluate antenatal education programs resulting in a range of findings measured from a range of perspectives. Recent research has attempted to assess the effectiveness of antenatal education in preparing women for pregnancy, childbirth, and childcare, but the evidence has been inconclusive. Research has been focused on evaluating antenatal education in terms of maternal satisfaction using measures such as increased knowledge and reducing anxiety or measuring obstetric outcome.

Objectives of the study

  1. To assess the practices adopted during labor among the primigravid women in the experimental group
  2. To assess the practices adopted during labor among the primigravid women in the control group
  3. To compare the practices adopted during labor among the primigravid women in the control and experimental groups
  4. To find the association between selected variables and childbirth practices



  Materials and Methods Top


A Quasi-experimental design was used to assess the effectiveness of planned teaching program on childbirth preparation regarding childbirth practice during labor among primigravid women. Purposive sampling technique is used. The study was conducted at Father Muller Hospital in Mangaluru. The tool was developed after intensive review of literature, consultation, and discussion with experts and also with the personal experience of the researcher. A blueprint was prepared, which showed the distribution of items according to the content areas. The final tool consisted of the following two parts: Part I: Baseline pro forma and Part II: Observation checklist to assess the childbirth practice of primigravid women during labor. The items in the observation checklist were divided into three phases that included the childbirth practices during the early labor phase, late labor phase, and the bearing-down period. One observation was made during each phase and childbirth practice was assessed (i.e. whether the participants are practicing or not?) Scores assigned were 3 for self-done, 2 for done with motivation, and 1 for not done with motivation. The maximum possible score was 33 and minimum was 0. Ethical clearance was obtained from the concerned institution. The investigator conducted the pilot study from 24 September to 29 September 2012 on 10 primigravid mothers who satisfied the inclusion and exclusion criteria. The main study was done on 50 primigravid mothers from 17 November 2012 to 15 December 2012. Informed consent was taken from the subjects and confidentiality was assured. The inclusion criteria included was as follows: Primigravida mothers with 36-40 weeks of gestation and who are undergoing normal vaginal delivery.


  Results Top


The analysis of data was done using Statistical Package for the Social Sciences (SPSS) version 20 (SPSS Inc., Chicago, USA). Majority had prior information on childbirth preparation (56% from control and 48% of the experimental).

[Table 1] shows the area-wise mean, standard deviation (SD), and mean percentage of childbirth practices of the control group. The mean practice scores observed during labor among the control group are 5.04, 5.96, and 5.88, respectively.
Table 1: Area wise mean, mean percentage, standard deviation of childbirth practices of control group

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[Table 2] depicts the area-wise mean, SD, and mean percentage of childbirth practices of experimental group. The mean percentage of practice score is highest in the area 1 (early labor phase) i.e. 91.5%, whereas in the area 3 (Bearing down technique phase) the score is 74.3%. The mean percentage of total practice score is 79.5% in the experimental group, which indicates adaptation of childbirth practices during labor.
Table 2: Area wise mean, mean percentage, standard deviation of practices during childbirth of the experimental group

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Data presented in [Table 3] shows that the overall mean childbirth practice scores is lower (16.88) in the control group than in the experimental group (26.24). The computed t-value (9.75) is more than the tabled value (t48 = 1.6772); hence, the null hypothesis is rejected (H 0 ) and the research hypothesis (H 1 ) is accepted. This shows that the planned teaching program was effective in terms of childbirth practice.
Table 3: Overall mean, mean difference, standard deviation and t value of childbirth practices of control and experimental group

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Sample characteristics

Out of 50 primigravid mothers, 72% of the subjects belonged to the age group of 21-25 years and maximum subjects had only primary schooling as their basic education. Majority of the women in the experimental (56%) and control (48%) groups had prior information on childbirth and 48% of the subjects had their mother as their source of information.


  Discussion Top


Overall childbirth practices of experimental group according to the area

The mean practice scores observed during labor among the experimental group are 8.24, 9.0, and 8.92 according to the area. A quasi-experimental design on effectiveness of video-based Lamaze method (childbirth preparation classes) on prenatal mother's knowledge, attitude, and practices was conducted at Kaohsiung Military Hospital. Women in labor with gestation of 32 weeks or more were divided into four study groups, including two experimental groups (E1) issued with traditional nursing guidelines and instructed in video-based Lamaze method (E2). This study showed that the video-based Lamaze method is likely to promote more effectively than traditional guidelines on the knowledge, attitudes, and practice of prenatal mothers in relation to giving birth.

Comparison of childbirth practices of the control and experimental groups

The mean practice scores is higher among the experimental group (26.24) than the control group (16.88), which indicates that the planned teaching program has helped to adopt the practices during labor among the primigravid women specially in the experimental group.

Childbirth practice score of respondents of the experimental group ranged from 27 to 33 (maximum score = 33) and that of the control group ranged from 14 to 20 (maximum score = 33). The mean percentage of childbirth practice scores of experimental group was 79.5% and control group was 51.1%. Effectiveness of individual instructional planned teaching program (IITP) on behavioral outcome during labor among primigravida mothers at a selected hospital in Mangalore was conducted in the year 2007 by Ms. Ruby M. Raj. Quasi-experimental posttest only design was used for the study. The study consisted of 40 primigravida mothers (N = 25 each group) who met the inclusion criteria.

The mean behavioral outcome score (70.4) of primigravida mothers in the experimental group was higher than the mean behavioral outcome score (36.9) of primigravida mothers of the control group. The computed "t" value (t48 = 1.6772) showed a significant difference in the behavioral outcome between the experimental and control groups. There was no significant association between behavioral outcome of primigravid mothers and selected variables, such as age and education, in the experimental group (P = 0.17, P = 0.17, P < 0.05) and in the control group (P = 0.06, P = 0.3, P < 0.05).

Effectiveness of PTP on childbirth practice

The findings revealed that the childbirth practice score of experimental group had significantly improved after planned teaching programme (PTP) than the mean childbirth practice scores of the control group. The findings of the study suggest that PTP was an effective method to improve the behavioral outcome of primigravid women during labor. The statistical analysis demonstrated a highly significant improvement in the childbirth practice scores of the primigravid women in the experimental group after the intervention of PTP (t = 9.75).

Pre-experimental one-group pre- and posttest were conducted to assess the effectiveness of the structured teaching program on the knowledge regarding prevention of postnatal and neonatal infections among the primipara mothers at RSRM hospital, Chennai. Forty-five primipara mothers participated in the study. The results revealed that, the overall mean percentage in pretest was 51.28% whereas in posttest 79.9% and t-value was 10.94 at 0.001 level. Forty-five primipara mothers participated in the study. The results revealed that, the overall mean percentage in pretest was 51.28% whereas in posttest was 79.9% and t-value was 10.94 at 0.001 level. Study findings showed that primipara mothers had inadequate knowledge about prevention of postnatal and neonatal infections, and structured teaching program was effective in improving their knowledge. A Quasi-experimental study using pretest and posttest design was conducted to evaluate the effectiveness of a planned teaching program on selected aspects of reproductive health among the rural adolescent girls in Belgaum. A purposive sample of 86 rural adolescent girls participated in the study. A structured questionnaire was used to collect the data. The results showed that the girls had significantly higher score on reproductive health in the posttest (34.35) compared to the pretest mean (21.81), and the t-value (31.30) that was statistically significant. The study concluded that PTP is an effective method to increase the knowledge about reproductive health among the rural adolescent girls.

Similar findings were seen in other research studies where teaching had been identified as an effective modality in improving the childbirth practices.

Association of childbirth practices and demographic variables

Chi-square test was used to identify the association between childbirth practices and demographic variables. Calculated P-value was greater than 0.05, which indicated that there is no association between childbirth practices and demographic variables.

A quasi-experimental study using pretest and posttest design was conducted to evaluate the effectiveness of a planned teaching program on selected aspects of reproductive health among the rural adolescent girls in Belgaum. A purposive sample of 86 rural adolescent girls participated in the study. A structured questionnaire was used to collect the data. The results showed that the girls had significantly higher score on reproductive health in the posttest (34.35) compared to the pretest mean (21.81), and the t-value (31.30) was statistically significant. The study concluded that PTP is an effective method to `increase the knowledge about reproductive health among rural adolescent girls.

Similar findings were seen in other research studies where teaching had been identified as an effective modality in improving the childbirth practices.

Acknowledgment

Father Muller College of Nursing is gratefully acknowledged for permitting to conduct this study.

The Principal and the teaching faculty of Father Muller College of Nursing, especially the Department of Obstetrics and Gynecological Nursing, are also acknowledged for material help and general support.

The participants of the study are thanked for their whole-hearted participation.

Financial Support and Sponsorship

Nil.

Conflicts of Interest

There are no conflicts of interest.


  Bibliography Top


Rao K. Textbook of Midwifery and Obstetrics for Nurses. New Delhi: Elsevier; 2011. p. 75-6.

Ho I, Holroyd E. Chinese women's perceptions of the effectiveness of antenatal education in the preparation for motherhood. J Adv Nurs 2002;38:74-85.

Dickread G. Childbirth without Fear: The Principles and Practice of Natural Childbirth. London: Harper & Brothers Publishers; 2004. http://www.goodreads.com/book/show/187652.Childbirth_without_Fear.

Lawrence A, Lewis L, Hofmeyr GJ, Dowswell T, Styles C. Maternal positions and mobility during first stage labour. Cochrane Database Syst Rev 2009;CD003934. Available on onlinelibrary.wiley.com/doi/10.1002/14651858.CD0039.pub4/abstract.

Evron S, Dimitrochencko V, Khazin V, Sherman A, Sadan O, Boaz M, et al. The effect of intermittent versus continuous bladder catheterization on labor duration and postpartum urinary retention and infection: A randomized trial. J Clin Anesth 2008;20:567-72. Availbale on



 
 
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[Table 1], [Table 2], [Table 3]



 

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