Comparative study on the influence of three delivery positions on pain intensity during the second stage of labor

Mahboubeh Valiani, Mehri Rezaie, Zahra Shahshahan

Abstract


ABSTRACT

Background: Labor is a physiologic process, and consideration of labor pain and relieving that is among the major components of maternal care. Application of some labor position can lay the fetus better in pelvic canal direction. The present study aimed to investigate the effect of laying the mother in three labor positions on the pain severity in the second, third, and fourth stages of labor.


Materials and Methods: This is a clinical trial conducted on 96 primiparous pregnant women randomly selected through convenient sampling from those who were hospitalized in the hospitals of Isfahan and Jahrom. 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 of lithotomy, sitting, and squatting positions. Pain severity in the second, third, and fourth labor stages was measured with visual analog scale (VAS) as well as McGill present pain intensity (PPI). The data were collected through interviews and observations with the help of VAS. The data were analyzed by Chi-square and Kruskal–Wallis statistical tests.


Results: In the latent phase of the second labor stage, mean pain severity in lithotomy (2.27) and squatting positions (2.48) was significantly less than the mean pain severity in sitting (5.33) position (P = 0.001). Pain severity in the active phase of the second and third labor stages was significantly less in squatting position (6.14) group compared to the other two groups (7.59 and 7.41 in sitting and lithotomy positions, respectively) (P = 0.024). Pain severity in the fourth labor stage showed no
significant difference in all three groups.


Conclusions: Application of various labor positions as one of the non-medicational methods to reduce pain in the second and third stages of labor leads to labor pain reduction.


Key words: Childbirth pain, delivery position, labor positions, McGill numerical scale and verbal scale, pain delivery, second labor stage, the second stage of delivery


Keywords


Childbirth pain; delivery position; labor positions; McGill numerical scale and verbal scale; pain delivery; second labor stage; the second stage of delivery

Full Text:

PDF

References


Hosseini Far. Women Empowering. 2010.

Ministry of Health, Treatment and Medical Training. Health Deputy. Mother Friendly Hospital Initiative. 2006.

Ministry of Health, Treatment and Medical Training. Medical Council or Iran. Available from: http://www.jahannews.com. [Last accessed on 2011 May 11].

Lurie S. Euphemia Maclean, Agnes Sampson and pain relief during labor in 16th century Edinburgh. Anaesthesia 2004;59:834‑5.

Abbaspoor S, Farhadyfar A. Evaluation of the effect of maternal position on delivery pain intensity during the first stage of labor. Horizon Science, Faculty of Medical Sciences and Health Services Gonabad 2007;12:16‑20.

Lowdermilk P, Willson HW. Maternal Child Nursing Care. 3rd edittion: Mosby; 2006. p. 212‑380.

Khoda Karami N. International Day of the Midwife. Medical Council or Iran. Jame‑e‑Jam. 2009.

Henderson C, Macdonald S. Mayes, Midwifery: A Text Book for Midwives. 3rd ed. London: Bailliere Tindall; 2004. p. 581.

Simkin P. Ancheta R. The Labor Progress Hand Book. 2nd ed. Malden, MA: Blackwell Science; 2005. p. 192.

Moshref Abadi Dehkordi S. Psychometric medicine. 1st ed. Isfahan University of Medical Sciences and Health Services, 2007. p. 1‑15.

Simkin P, Ancheta R. The Labor Progress Hand Book. 1st ed. Malden, MA: Blackwell Science; 2000. p. 70‑85.

Shahnaz TZ. Preparation for Childbirth and Pain Reducing Methods. Tehran: Resana‑e‑Takhasosi Publication; 2009. p. 379.

Kurdi M, Mansouri A, Esmaeili H. The evaluation of pain intensity in first stage of labor: The effect of mother positioning in selective positions. Journal of Sabzevar School of Medical Sciences. Vol 14, No 1, Spring. 2007. p. 15‑20.

Romano AM, Lothian JA. Promoting, protecting and supporting normal birth: A look at the evidence. J Obstet Gynecol Neonatal Nurs 2008;37:94‑105.

Soong B, Jacobs J, Barnes M. Reducing perineal trauma: A study of midwives practices at the time of birth. Birth Issues 2001;10:5‑11.

Flynn N, Jkelly H, Chollins M. Ambulation in labor. Br Med J 1998;3:591‑3.

Calvert JP, Newcombe RG, Hibbard BM. An assessment of radiotelemetry in the monitoring of labour. Br J Obstet Gynaecol 1982;89:285‑91.

Nasir A, Korejo R, Noorani KJ. Child birth in squatting position. J Pak Med Assoc 2007;57:19‑22.

Hodnett ED, Downe S, Edwards N, Walsh D. Home‑like versus conventional institutional settings for birth. Cochrane Database Syst Rev 2005;CD000012.

Shorten A, Donsante J, Shorten B. Birth position, accoucheur, and perineal outcomes: Informing women about choices for vaginal birth. Birth 2002;29:18‑27.

Motamedi M. The effect of the selective maternal position in active stage of labor. Shahrood University of Medical Sciences and Health Services, Knowledge & Health, Vol 4, No 1, Spring 2009, p. 31‑5

Fraser M. Cooper AM, Nolt GW. Myles Text Book for Midwives. An African context, Churchill Livingstone, London Elsevier; 2006. p. 470‑520.

Bonder‑Adler B, Bodner K, Joura EA, Husslein P, Wagenbichler P, Kaider A, et al. Influence of different maternal birth positions on perineal trauma and neonatal parameters during spontaneous vaginal delivery. Geburtsh Fr 2001;61:766‑70.

Ragnar I, Altman D, Tydén T, Olsson SE. Camparison of the maternal experience and duration of labour in two upright delivery positions‑a rondomised controlled trial. BJOG 2006;113:165‑70.

Khavandi Zadeh A, Shahbaz Zadegan S, Mahfoozi B. The effect of maternal position during active phase of labor on outcome of delivery in the primigravida. JARUMS 2010;9:218‑23.

Akhlaghi F, Pou Javad M, Jafari S. The relationship between maternal position during labor and perception of labor pain intensity during active phase of labor. IJOGI 2012;14:14‑19.

Davim RM, Torres Gde V, Melo ES. Non‑pharmacological strategies on pain relief during in labor: Pretesting of an instrument. Rev Lat Am Enfermagem 2007;15:1150‑6.

Melzack R, Belanger E, Lacroix R. Labor pain: Effect of maternal position on front and back pain. J Pain Symptom Manage 1991;6:476‑80.

Renolds JL. Primitive delivery position in modern obestetrics: Were the wise women wiser wiser than we? Can Fam Physician 1991;37:356‑61.

Gohar Nejad K. The effect of standing and lying on the pain intensity during the first stage of labor. IJOGI 1997;35‑40.

Molina FJ, Solá PA, López E, Pires C. Pain in the first stage of labor: Relationship with the patient’s position. J Pain Symptom Manage 1997;13:98‑103.

McManus TJ, Calder AA. Upright posture and the efficiency of labor. Lancet 1978;1:72‑4.

Méndez‑Bauer C, Arroyo J, García Ramos C, Menéndez A, Lavilla M, Izquierdo F, et al. Effects of standing position on spontaneous uterine contractility and other aspects of labor. J Perinat Med 1975;3:89‑100.

Andrews CM, Chrzanowski M. Maternal position, labor, and comfort. Appl Nurs Res 1990;3:7‑13.


Refbacks

  • There are currently no refbacks.