بررسی تأثیر کلاس‌های آمادگی دوران بارداری بر شدت درد زایمان و میزان رضایت مادر از تجربه زایمان و برخی پیامدهای زایمان طبیعی در زنان نخست‌زا

نوع مقاله : اصیل پژوهشی

نویسندگان

1 دانشجوی Ph.D روانشناسی سلامت، پردیس بین‌الملل ارس دانشگاه تهران، جلفا، ایران.

2 مربی گروه مامایی، دانشکده پزشکی، دانشگاه آزاد اسلامی، اردبیل، ایران.

3 دانشیار گروه روان‌شناسی، دانشکده روان‌شناسی، دانشگاه تهران، تهران، ایران.

4 کارشناس ارشد حقوق جزا، دانشکده علوم انسانی، دانشگاه آزاد اسلامی واحد اردبیل، اردبیل، ایران.

چکیده

مقدمه: بارداری و زایمان، از پدیده­ های شگرف طبیعت می­باشد که باید با روند طبیعی و بدون مداخله انجام پذیرد. مطالعه حاضر با هدف تعیین در تأثیر کلاس ­های آمادگی دوران بارداری بر شدت درد و میزان رضایت مادر از تجربه زایمان و برخی پیامدهای زایمان­ طبیعی در زنان نخست­ زا انجام شد.
روش‌کار: این مطالعه نیمه‌تجربی مداخله­ای در سال 1402-1401 بر روی 100 نفر از زنان نخست‌زایی که جهت مراقبت دوران بارداری و زایمان به بیمارستان سبلان شهرستان اردبیل مراجعه کرده بودند، انجام شد. نمونه­ ها در دو گروه 50 نفره دریافت کننده آموزش و کنترل قرار گرفتند. ابزار گردآوری داده ­ها پرسشنامه بود. افراد گروه دریافت کننده آموزش، در کلاس ­های آموزشی شرکت کردند و در گروه کنترل، زنان مراقبت معمول بارداری را دریافت کردند. در هر دو گروه بعد از شروع دردهای زایمانی و در پایان مرحله اول زایمان، شدت درد زایمان و در مرحله دوم زایمان، نیاز به اپی­ زیاتومی و پارگی پرینه و در طول زایمان، نیاز به اکسی‌توسین ثبت گردید. همچنین بلافاصله بعد از زایمان، نمرة آپگار دقیقه اوّل و میزان رضایت مادر از تجربه زایمان و در نهایت یک‌ساعت بعد از زایمان، زمان شروع شیردهی توسط پژوهشگر بررسی و ثبت شد. تجزیه و تحلیل داده­ ها با استفاده از نرم‌افزار آماری SPSS (نسخه 26) و آزمون­ های کای اسکوئر، تی تست، یو من ویتنی و فیشر انجام شد. میزان p کمتر از 05/0 معنی­دار در نظر گرفته شد.
یافته ­ها: آموزش ­های دوران بارداری به‌طور معناداری سبب کاهش شدت درد زایمان، نیاز به اپی‌زیاتومی، پارگی پرینه و نیاز به ایجاد انقباضات مؤثر زایمان با اکسی‌توسین (001/0>p) و همچنین باعث افزایش میزان رضایت مادر از تجربه زایمان، آپگار دقیقه اوّل نوزاد و شروع زودتر شیردهی توسط مادر گردید (001/0>p).
نتیجه ­گیری: کلاس­ های آمادگی دوران بارداری دارای نتایج مثبت زیادی می‌باشد، بنابراین پیشنهاد می‌گردد در همه مراکز مراقبت­ های بارداری و زایمان به‌طور جدی­تر و گسترده‌تری استفاده شود. 

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

The effect of prenatal preparation classes on labor pain intensity, mother's satisfaction of delivery experience and some outcomes of normal vaginal delivery in nulliparous women

نویسندگان [English]

  • Yalda Mahfouzi 1
  • Sima Khavandizadeh Aghdam 2
  • Manizheh Firoozi 3
  • Hasan Hadisi 4
1 PhD student in Health Psychology, Aras International Campus, University of Tehran, Jolfa, Iran.
2 Instructor, Department of Midwifery, Faculty of Medicine, Islamic Azad University, Ardabil Branch, Ardabil, Iran.
3 Associate professor, Department of Psychology, School of Psychology, University of Tehran, Tehran, Iran.
4 M.Sc. of Science in Criminal law, School of Humanity, Islamic Azad University, Ardabil Branch, Ardabil, Iran.
چکیده [English]

Introduction: Pregnancy and delivery are of nature wonderful phenomenon that should be done with natural process without intervention. This study was performed with aim to evaluate the effects of prenatal preparation classes on labor pain intensity, mother's satisfaction of delivery experience, and some outcomes of normal vaginal delivery in nulliparous women.
Methods: This quasi-experimental interventional study was done in 2022-2023 on 100 nulliparous women who were admitted in Sabalan hospital of Ardabil city for prenatal care and delivery from January to April of 2023. The samples were placed in two groups of receiving training and control (n=50 per group). Data collection tool was questionnaire. The group receiving training participated in prenatal preparation classes and the control group received pregnancy usual care. Then labor pain intensity after start of labor pain and at the end of first stage of labor, and at the end of second stage, need for episiotomy and prineal laceration, and need for oxytocin during labor were recorded. Immediately after delivery, first minute Apgar score and mother's satisfaction of delivery, and ultimately one hour after delivery, initiation of breast feeding were investigated and recorded by the researcher. The data were analyzed by SPSS software (version 26), Chi-square, t-test, Mann-Whitney U and Fisher tests. P<0.05 was considered statistically significant.
Results: Prenatal educations significantly reduced labor pain intensity, need for episiotomy, prineal laceration, need for augmentation with oxyto­cin (P<0.001) and also increased mother's satisfaction of delivery experience, first minute Apgar score and early onset of breast feeding (P<0.001).
Conclusion: The prenatal preparation classes have many positive outcomes; therefore, it is suggested to be used more seriously and widely in all pregnancy and childbirth care centers.

کلیدواژه‌ها [English]

  • Labor pain intensity
  • Mother's satisfaction
  • Prenatal preparation classes
  • Primiparous women

مراجع

  1. Samavati S, kazemi F, Aghababaei S, Soltani F. The effect of yoga on fear of childbirth and childbirth self-efficacy in primigravid women: a randomized controlled trial. Iran J Obstet Gynecol Infertil 2022; 25(3):75-85.
  2. Van der Riet P, Francis L, Rees A. Exploring the impacts of mindfulness and yoga upon childbirth outcomes and maternal health: an integrative review. Scandinavian journal of caring sciences 2020; 34(3):552-65.
  3. Monfarednia A, Ahangar A. Effectiveness of Muscle Relaxation Besides Mental on Perceived Stress and Resilience in Pregnant Women with Inclination to Have Natural Childbirth. Journal of Analytical Cognitive Psychology 2021; 12(44):1-11.
  4. Hamzekhani M, Hamidzadeh A, Vasegh RS, Montazeri A. Effect of computerized educational program on self-efficacy of pregnant women to cope with childbirth. Journal of knowledge & health shahroud university of Medical sciences 2014; 9(1):12-20.
  5. Safdari Dehcheshmeh F, Delaram M, Salehian T, Moradi MT, Rahimi-Madiseh M. Relief of labor pain by ice massage of the hand. Zahedan Journal of Research in Medical Sciences 2009; 11(1).
  6. Najafpour S, Salehi N, Khavandzade Aghdam S. The effect of prenatal education classes on choosing natural childbirth outcomes and reduce caesarean statistics in nulliparous women referred to hospital Sabalan Ardabil province in 2017 (Doctoral dissertation, Master Thesis]. Ardabil, Iran: Islamic Azad university Ardabil Branch faculty of Medicine); 2017.
  7. Mehrabadi M, Masoudifar M, Parvizi A, Rakhshani MH, Mortazavi F. Effects of childbirth preparation classes program based on national guideline on fear of childbirth in pregnant women: a randomized clinical trial. Iran J Obstet Gynecol Infertil 2020; 23(1):58-68.
  8. Nilsson C, Hessman E, Sjöblom H, Dencker A, Jangsten E, Mollberg M, et al. Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC pregnancy and childbirth 2018; 18:1-5.
  9. Najafpour S, Salehi N, Khavandzade Aghdam S. The effect of prenatal education classes on choosing natural childbirth outcomes and reduce caesarean statistics in nulliparous women referred to hospital Sabalan Ardabil province in 2017 (Doctoral dissertation, Master Thesis]. Ardabil, Iran: Islamic Azad university Ardabil Branch faculty of Medicine); 2017.
  10. Khavandizadeh Aghdam S, Mahfouzi Y, Kazemzadeh R. Effect of prenatal preparation classes on the duration of labor and delivery type in primiparous women. The Iranian Journal of Obstetrics, Gynecology and Infertility 2019; 21(11):37-43.
  11. Hildingsson I, Rubertsson C, Karlström A, Haines H. A known midwife can make a difference for women with fear of childbirth-birth outcome and women’s experiences of intrapartum care. Sexual & Reproductive Healthcare 2019; 21:33-8.
  12. Mohyadin E, Ghorashi Z, Molamomanaei Z. The effect of practicing yoga during pregnancy on labor stages length, anxiety and pain: a randomized controlled trial. Journal of Complementary and Integrative Medicine 2020; 18(2):413-7.
  13. Rastegari L, Mohebbi P, Mazlomzadeh S. The effect of childbirth preparation training classes on perceived self-efficacy in delivery of pregnant women. Journal of Advances in Medical and Biomedical Research 2013; 21(86):105-15.
  14. Khalili Shomia S, Khodabandeh F, Borzoee F, Bahrami Vazir E, Navipour E, Koushki B. The effect of presence of midwife (Doula) on anxiety and fear of natural childbirth in pregnant women: Randomized Clinical Trial. Iran J Obstet Gynecol Infertil 2022; 25(4):60-9.
  15. Rahimikian F, Mirmohamadali M, Mehran A, Aboozari K, Barough S. Effect of Education Designed based on Health Belief Model on Choosing Delivery Mode. Hayat 2008; 14.
  16. Vakilian K, Khoursandi M,Torabi Goudarzi M, Abdi M. Childbirth preparation using behavioral-cognitive skill in childbirth outcomes of primiparous women. Journal of Babol University of Medical Sciences 2013; 15(4):76-80.

 

 

  1. Jafari E, Mohebbi P, Rastegari L, Mazloomzadeh S. The comparison of physiologic and routine method of delivery in mother’s satisfaction level in Ayatollah Mosavai Hospital, Zanjan, Iran, 2012. Iran J Obstet Gynecol Infertil 2013; 16(73):9-18.
  2. Gao LL, Ip WY, Sun K. Validation of the short form of the Chinese childbirth self‐efficacy inventory in Mainland China. Research in nursing & health 2011; 34(1):49-59.
  3. Modares M, Maleki S, Shadmehr A, Haghani S. The effect of foot reflexology on postpartum fatigue in primiparous women. Iran J Obstet Gynecol Infertil 2021; 24(5):19-30.
  4. Niaki MT, Behmanesh F, Mashmuli F, Azimi H. The Effect of Prenatal Group Education on Knowledge, Attitude and Selection of Delivery Type in Primiparous Women. Iranian Journal of Medical Education 2010; 10(2).
  5. Sanavi FS, Navidian A, Rakhshani F, Ansari-Moghaddam A. The effect of education on base the Theory of Planned Behavior toward normal delivery in pregnant women with intention elective cesarean. Bimonthly Journal of Hormozgan University of Medical Sciences 2014; 17(6):531-9.
  6. Delaram M, Soltan F. The effect of counseling in third trimester on anxiety of nulliparous women at the time of admission for labor. Zahedan Journal of Research in Medical Sciences 2012; 14(2):61-65.
  7. Khorsandi M, Ghofanipour F, Hidarnia A, Faghihzadeh S. Effects of childbirth education classes on selfefficacy of nulliparous women in coping with labor pain. Bio Info Bank Library 2008; 5(4):56-65.
  8. Andaroon N, Kordi M, Ghasemi M, Mazlom R. The validity and reliability of the Wijma delivery expectancy/experience questionnaire (Version a) in primiparous women in Mashhad, Iran. Iranian Journal of Medical Sciences 2020; 45(2):110-7.
  9. Jamilian M, Mobasseri SH, Wakilian K, Jamilian HR. Effect of childbirth preparation classes on the duration of admission and satisfaction of mothers. Scientific Journal of Ilam university of Medical Sciences 2013; 21 (2): 1-7.
  10. Sydsjö G, Bladh M, Lilliecreutz C, Persson AM, Vyöni H, Josefsson A. Obstetric outcomes for nulliparous women who received routine individualized treatment for severe fear of childbirth-a retrospective case control study. BMC pregnancy and childbirth 2014; 14(1):1-7.
  11. Jahdi F, Sheikhan F, Haghani H, Sharifi B, Ghaseminejad A, Khodarahmian M, et al. Yoga during pregnancy: The effects on labor pain and delivery outcomes (A randomized controlled trial). Complementary therapies in clinical practice 2017; 27:1-4.
  12. Nisa SM, Qadrijati I, Murti B. Psychosocial factors associated with anxiety and delivery pain. Journal of Maternal and Child Health 2018; 3(1):44-58.
  13. Jahani Shourab N, Mirteimouri M, Latifnejad Roudsari R. A case series of severe perineal lacerations during normal childbirth. Iran J Obstet Gynecol Infertil 2018; 21(8):103-14.
مجله زنان، مامایی و نازایی ایران
دوره 26، شماره 9
آذر 1402
صفحه 40-50

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