Relationship between Length of Delivery Stages and Mode of Delivery for Nulliparous Women in Labor in Two Groups of Physiological and Traditional Delivery

Document Type : Original Article

Authors

1 Lecturer of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

2 M.Sc. of Midwifery, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.

3 Assistant Professor, Department of Physiology, Women's Fertility Health Research Center, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Abstract

Introduction: If delivery stages become long, it leads to delivery harmful outcomes including increased rate of cesarean delivery, neonate's admission in NICU, postpartum infection, and increased economic impose on people and society. This study was performed to evaluate the relationship between length of delivery stages and mode of delivery in nulliparous women in two groups of physiological and traditional delivery.
Methods: This clinical blind study was performed on 370 nulliparous mothers at Talesh Shahid Noorani hospital during 2011-2012. People were randomly divided into two groups (185 member) of Physiological and Traditional Delivery. The required information was collected through observations of delivery stages, interviewing with mothers and studying the contents of their files. Data collection tool was a checklist including the characteristics of subjects, partograph form, assessment of first, second, and third stages of delivery. Data analysis was performed by SPSS software (version 13) and Chi-square, and t tests. PResults: Two groups were significantly different in terms of length of the first and the second stages of delivery (P<0.001). Length of the first and the second stages of delivery was longer in physiologic delivery group (421.23±123.48) than traditional delivery group (243.45±131.28) (P<0.001). But, length of the third stage did not show a statistically significant difference between two groups (P=0.72). In traditional delivery group, the rate of vaginal delivery with episiotomy (%44.9) and cesarean section (%35.1) was higher than vaginal delivery with episiotomy (%18.9) and cesarean section (%11.4) in physiologic delivery group (P<0.001). Vaginal delivery without episiotomy was higher in traditional delivery group (%69.7) than physiologic delivery group (%20) that two groups had statistically significant difference (P<0.001).
Conclusion: Unlike Traditional delivery, with increasing the length of delivery, the rate of cesarean delivery decreased and vaginal delivery increased.

Keywords

References

  1. Pascali-Bonaro D, Kroeger M. Continuous female companionship during childbirth: a crucial resource in times of stress or calm. J Midwifery Womens Health 2004 Jul-Aug;49(4 Suppl 1):19- 27.
  2. Trueba G, Contreras C, Velazco MT, Lara EG, Martinez HB. Alternative strategy to decrease cesarean section: support by doulas during labor. J Prenatal Educ 2000 Spring;9(2):8-13.
  3. Thomassen P, Lundwall M, Wiger E, Wollin L, Uvnas-Moberg K. [Doula--a new concept in obstetrics] [Article in Swedish]. Lakartidningen 2004 Dec 18;100(51-52):4268-71.
  4. Fahami F, Masoufar S, Davazdahemami Sh. [The effect of Lamaze practices on the outcome of pregnancy and labour in primipara women] [Article in Persian]. Iran J Nurs Midwifery Res 2007;12(3):11-4.
  5. Bonica JJ. The pain of child birth. 2nd ed. Edinburgh:Appleton and Lang;2013.
  6. Simkin P, Bolding A. Update on nonpharmacologic approaches to relieve labor pain and prevent suffering. J Midwifery Womens Health 2004 Nov-Dec;49(6):489-504.
  7. Saisto T, Salmela-Aro K, Nurmi JE, Kononen T, Halmesmaki E. A randomized controlled trial of intervention in fear of childbirth. Obstet Gynecol 2001 Nov;98(5 Pt 1):820-6.
  8. Midwifery management of pain in labor. J Nurs Midwifery 1996 Mar-Apr;43(2):77-82.
  9. Simkin PT, Klein MC. Nonphamacologic approaches to management of labor pain. BMJ [serial online] 2009;310:1387-90. Available at: http://www.uptodate.com. Accessed May 31, 2010.
  10. Kojic Z, Arsenijevic L, Scepanovic L, Popovic N. [Labor pain--physiologal basis and regulatory mechanisms] [Article in Serbian]. Srp Arh Celok Lek 2007 Mar-Apr;135(3-4):235-9.
  11. Tietze KW, Horbach L, Muller D, Heidenreich J, Schmitt W. [Data condensation in demonstration of the relationship between labor painand fetal heart rate changes during labor] [Article in German]. Klin Wochenschr 1971 Jan;49 (1):50-1.
  12. Brown ST, Douglas C, Flood LP. Woman's evaluation of intrapartum nonpharmacological pain relief methods used during labor. J Perinat Educ 2001 Summer;10(3):1-8.
  13. Robertson E, Johansson SE. Use of complementary, non-pharmacologic pain reduction methods during child birth among foreign-born and Swedish-born women. Midwifery 2008 Aug;26(4):442-9.
  14. Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Syst Rev 2007 Jul 18;(3):CD003766.
  15. Chang MY, Wang SY, Chen CH. Effect of massage on pain and anxiety during labor: a randomized controlled trial in Taiwan. J Adv Nurs 2001 Apr;38(1):68-73.
  16. Stark MA, Rudell B, Haus G. Observing position and movements in hydrotherapy: a pilot study. J Obstet Gynecol Neonatal Nurs 2008 Jan[1]Feb;37(1):116-22.
  17. Waldenstrom U, Hildingsson I, Ryding EL. Antenatal fear of child birth and its association with subsequent caesarean section and experience of childbirth. BJOG.2006 Jun;113(6):638-46.
  18. Kennel J, Klaus M, McGrath S, Robertson S, Hinkley C. Continuous emotional support during labor in a US hospital: a randomized controlled trial. JAMA 1991 Mat 1;265(17):2197-201.
  19. Klaus MH, Kennell JH, Robertson SS, Sosa R. Effect of social support during parturition on maternal and infant morbidity. Br Med J (Clin Res Ed) 1986 Sep 6;293(6547):585-7.
  20. Gentz BA. Alternative therapies for the management of pain in labor and delivery. Clin Obstet Gyneco 2001 Dec;44(4):704-32.
  21. Simkin PP, O’hara M. Nonpharmacologic relief of pain during labor: systematic reviews of five methods. Am J Obstet Gynecol 2002 May;186(5 Suppl Nature):S131-59.
  22. Gupta JK, Hofmeyr GJ. Position for women during second stage of labour. Cochrane Database Syst Rev 2004;(1):CD002006.
  23. Smith CA, Collins CT, Cyna AM, Crowther CA. Complementary and alternative therapies for pain management in labour. Cochrane Database Syst Rev 2006 Oct 18;(4):CD003521.
  24. van Gemund N, Hardeman A, Scherjon S, Kanhai H. Intervention rates after elective induction of labor compared to labor with a spontaneous onset. A matched cohort study. Gynecol Obstet Invest 2003;56(3):133-8.
  25. Danel I, Berg C, Johnson CH, Atrash H. Magnitude of maternal morbidity during labor and delivery: United States, 1993-1997. Am J Public Health 2003 Apr;93(4):631-4.
  26. Chang CY, Gau M. Develope and test of birth ball exercise during laboring phase. Available at: http://www.ntcn.edu.tw/dep/HelpBirth/English/di ssertation-e/article95-e.htm. Accessed April 5, 2010.
  27. Robertson E, Johansson SE. Use of complementary, non-pharmacological pain reduction methods during childbirth among foreign-born and Swedish-born women. Midwifery 2010 Aug;26(4):442-9.
  28. Tournaire M, Theau-Yonneau A. Complementary and alternative approaches to pain relief. Evid Based Complement Alternat Med 2007 Dec;4(4):409-17.
  29. Osmundson SS, Ou-Yang RJ, Grobman WA. Elective induction compared with expectant management in multiparous women with a favorable cervix. Obstet Gynecol 2010 Sep;116(3):601-5.

Files

Share

How to cite

Statistics