Çömelme pozisyonunun doğum süresi ve ağrı algılama düzeyine etkisi

Yıl 2023, Cilt: 4 Sayı: 3, 112 - 118, 31.12.2023

Türkan Pasinlioğlu Zehra Demet Üst Taşğın

https://doi.org/10.29228/anatoljhr.71307

Öz

Amaç: Bu araştırma, gebelerde çömelme pozisyonu kullanmanın doğum eylemi süresi ve ağrı algılama düzeyine etkisini araştırmak amacıyla yapılmıştır.
Yöntem: Son test ve kontrol gruplu müdahale araştırması, Doğu Anadolu'da bir ilde bulunan kadın doğum hastanesindeki 82 gebe ile yürütülmüştür. Veriler anket formu, Partograf ve Görsel Ağrı Skalası kullanılarak toplanmıştır. Verilerin analizinde yüzdelik dağılım, ortalama, ki-kare ve bağımsız gruplarda t testi kullanılmıştır.
Bulgular: Girişim grubundaki gebelerde doğumun ilk evresinin daha kısa, ağrı algılama düzeylerinin daha düşük olduğu belirlenmiştir. Doğum eyleminin ilk evresinin toplam süresi müdahale grubundaki gebelerde 211.00±108.24 dakika, kontrol grubundaki gebelerde 295.23±95.47 olduğu bulunmuştur. Ayrıca geçiş fazındaki ağrı algılama düzeyinin müdahale grubundaki gebelerde 8.70±1.30, kontrol grubundaki gebelerde 9.42±0.85 olduğu belirlenmiştir.
Sonuçlar: Çömelme pozisyonunun doğum ağrısı algılama düzeyini azalttığı ve doğumun ilk evresini kısalttığı bulunmuştur.

Anahtar Kelimeler

ağrı, ağrı algısı, doğum

The effect of the squatting position on the duration of labor and level of pain perception

Öz

Aim: This research was carried out to investigate the effect of using the squatting position in pregnant women on labor duration and pain perception level.
Methods: This intervention research that using post-test and control group was conducted with 82 pregnant women at a gynecology hospital in a province in eastern Anatolia, Türkiye. The data were gathered using a questionnaire form, Partograph, and the Visual Analog Scale. The data were analyzed using percentage distributions, means, Chi-square, and independent samples t-test.
Results: Pregnant women in the intervention group had shorter first phase labor durations, and it was also shown that their level of pain perception were lower in this group. The total duration of the first stage of labor was determined as 211.00±108.24 minutes in the intervention group and 295.23±95.47 minutes in the control group. In addition, the pain perception level in the transition period was determined as 8.70±1.30 in the pregnant women in the intervention group and 9.42±0.85 in the pregnant women in the control group.
Conclusion: It was found that the squatting position reduces perception of labor pain while also shortening the first phase of labor.

Anahtar Kelimeler

labor, pain, pain perception

Kaynakça

• Arıkan, C. D. (2014). Clinical Course of Normal Delivery. Demir, C., Güleç, K.Ü. (Ed.) Labor & Birth (pp. 119-140). Ankara: Akademisyen Medical Bookstore.
• Arslan, H. (2012). Birth. Coşkun, A. (Ed). Handbook of women's health and diseases nursing (pp. 195-205). İstanbul: Koç University Publications.
• Bond, M., & Pilowsky, I. (1966). Subjective assessment of pain and its relation to the administration of analgesics in cancer patients. Journal of Psychosomatic Research, 10, 203-208. https://doi.org/10.1016/0022-3999(66)90064-x
• Capogna, G., Camorcia, M., Stirparo, S., Valentini, G., Garassino, A., & Farcomeni, A. (2010). Multidimensional evaluation of pain during early and late labor: A comparison of nulliparous and multiparous women. International Journal of Obstetric Anesthesia, 19(2), 167-170. https://doi.org/10.1016/j.ijoa.2009.05.013
• Coşar, F. (2015). Positions that facilitate childbirth. Journal of e-Health Midwifery, 1, 44-51.
• Dani, A., Badhwar, V. R., Sawant, G., & Salian, S. C. (2015). Comparative study of squatting position vs dorsal recumbent position during second stage of labour. Journal of Evidence Based Medicine and Healthcare, 2(54), 8769-8773. https://doi.org/https://doi.org/10.18410/jebmh/2015/1223
• Erdine, S. (2007). Pain. Istanbul: Nobel Medical Bookstore.
• Gönenç, I. M., & Terzioglu, F. (2020). Effects of massage and acupressure on relieving labor pain, reducing labor time, and increasing delivery satisfaction. Journal of Nursing Research, 28(1), 68. https://doi.org/10.1097/jnr.0000000000000344
• Gupta, J. K., Sood, A., Hofmeyr, G. J., & Vogel, J. P. (2017). Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database of Systematic Reviews, 5. https://doi.org/10.1002/14651858.CD002006.pub4
• Hodnett, E. D. (2002). Pain and women's satisfaction with the experience of childbirth: A systematic review. American Journal of Obstetrics and Gynecology, 186, 160-172. https://doi.org/10.1067/mob.[phone]
• Ishola, F., Owolabi, O., & Filippi, V. (2017). Disrespect and abuse of women during childbirth in Nigeria: A systematic review. PLoS One, 12(3), e0174084. https://doi.org/https://doi.org/10.1371/journal.pone.0174084
• Jyoti, R., Sharma, M., & Pareek, S. (2022). The effects and outcomes of different maternal positions on the second stage of labor. MRIMS Journal of Health Sciences, 10(2), 21. https://doi.org/10.4103/mjhs.mjhs_49_21
• Kibuka, M., Price, A., Onakpoya, I., Tierney, S., & Clarke, M. (2021). Evaluating the effects of maternal positions in childbirth: An overview of Cochrane Systematic Reviews. European Journal of Midwifery, 5. https://doi.org/10.18332/ejm/142781
• Kömürcü, N., & Ergin, A.B. (2008). Birth Pain and Management. İstanbul: Bedray Press Publishing Ltd. Sti.
• Lawrence, A., Lewis, L., Hofmeyr, G. J., & Styles, C. (2013). Maternal positions and mobility during first stage labour. Cochrane Database of Systematic Reviews, 8. https://doi.org/10.1002/14651858.CD003934.pub2
• Leung, R. W. C., Li, J.F.P., Leung, M. K. M., Fung, B. K. Y, Fung, L. C. W., … & Leung, W. C. (2013). Efficacy of birth ball exercises on labour pain management. Hong Kong Medical Journal, 19(5), 393-399. https://doi.org/10.12809/hkmj133921
• Lin, Y. C., Gau, M. L., Kao, G. H., & Lee H. C. (2018). Efficacy of an ergonomic ankle support aid for squatting position in improving pushing skills and birth outcomes during the second stage of labor: A randomized controlled trial. Journal of Nursing Research, 26(6), 376e84.
• Lothian, J. E. (2009). Safe, healthy birth: What every pregnant woman needs to know. Journal of Perinatal Education, 18, 48-54. http://dx.doi.org/10.1624/105812409X461225
• Lowdermilk, D. L., Perry, S. E., & Bobak, I. M. (2000). Maternity women’s health care. London: Mosby Inc.
• Manzoni, S. R., & Carvalho, E. C. D. (2008). Dor de parto: considerações históricas e conceituais. Revista Dor, 9(1), 1176-1182.
• Mazúchová, L., Kelčíková, S., Štofaníková, L., & Malinovská, N. (2020). Women's control and participation in decision-making during childbirth in relation to satisfaction. Central European Journal of Nursing & Midwifery, 11(3), 136-142. https://doi.org/10.15452/CEJNM.2020.11.0021
• Moraloglu, O., Kansu-Celik, H., Tasci, Y., Karakaya, B. K., Yılmaz, Y., & Cakır, E. (2017). The influence of different maternal pushing positions on birth outcomes at the second stage of labor in nulliparous women. Journal of Maternal-Fetal & Neonatal Medicine, 30(2), 245e9. https://doi.org/10.3109/14767058.2016.1169525
• Özdamar, K. (2015). Biostatistics with SPSS. Ankara: Nisan Bookstore.
• Özveren, H., & Uçar, H. (2009). The knowledge of student nurses on some non-pharmacological methods used in the pain control. Hacettepe University Faculty of Health Sciences Nursing Journal, 1, 59-72.
• Rathfisch, G., & Güngör, İ. (2015). Relationship with Pain at Birth. Beji, N.K. (Ed). Women's health and diseases (pp. 88-95). Istanbul: Nobel Medical Bookstores.
• Sauls, D. (2004). Adolescents' perception of support during labor. Journal of Perinatal Education, 13, 36-42. https://doi.org/10.1624/105812404X6216
• Sayıner, D. F., & Özerdoğan, N. (2009). Natural births. Journal of Nursing Science and Art, Maltepe University, 2, 143-147.
• Simkin, P., & Bolding, A. (2004). Update on non pharmacologic approaches to relieve labor pain and prevent suffering. Journal of Midwifery and Women’s Health, 49, 489-504. https://doi.org/10.1016/j.jmwh.2004.07.007
• Sönmez, T., & Apay, S. E. (2023). Effect of different birth balls used at the first stage of labor on birth outcomes and maternal satisfaction: a randomized controlled trial. Clinical and Experimental Health Sciences, 13(3), 600-607. https://doi.org/10.33808/clinexphealthsci.1164952
• Takehara, K., Noguchi, M., Shimane, T., & Misago, C. (2014). A longitudinal study of women’s memories of their childbirth experiences at five years postpartum. BMC Pregnancy and Childbirth, 14, 1-7.
• Taşkın, L. (2016). Labor and women's health nursing. Ankara: Akademisyen Medical Bookstores.
• Thies-Lagergren, L., Kvist, L. J., Sandin-Bojö, A. K., Christensson, K., & Hildingsson, I. (2013). Labour augmentation and fetal outcomes in relation to birth positions: A secondary analysis of an RCT evaluating birth seat births. Midwifery, 29(4), 344-350. https://doi.org/10.1016/j.midw.2011.12.014
• TR. Ministry of Health. (2023). Quality Standards in Health (Partograph example). https://shgmkalitedb.saglik.gov.tr/TR-94678/partograf-ornegi.html Accessed: 24.07.2023
• Türkeli, G., Öz, M., Kuşçu, E., & Uğur, M. (2016). Effect of maternal position on labor progress and obstetric outcomes: a randomized controlled study. Journal of Clinical Obstetrics & Gynecology, 26(1), 7-12. https://doi.org/10.5336/gynobstet.2015-45849
• Üstünöz, A., Güngör, S. (2005). Prenatal Education of yesterday and today. Kadayıfcı, O. (Ed.). Preparation for childbirth with the Lamaze Method and birth. (pp. 7-20) Ankara: Nobel Medical Bookstore.
• Valiani, M., Rezaie, M., & Shahshahan, Z. (2016). Comparative study on the influence of three delivery positions on pain intensity during the second stage of labor. Iranian Journal of Nursing and Midwifery Research, 21(4), 372. https://doi.org/10.4103/1735-9066.185578
• Waldenstrom, U., Hildingsson, I., Rubertsson, C., & Rådestad, I. (2004). A negative birth experience: Prevalence and risk factors in a national sample. Birth, 31(1), 17-26. https://doi.org/10.1111/j.0730-7659.2004.0270.x
• World Health Organization (2018). WHO recommendations Intrapartum care for a positive childbirth experience. https://iris.who.int/bitstream/handle/10665/260178/9789241550215-%20eng.pdf?sequence=1 Accessed: 07.06.2023.
• World Medical Association (2022). WMA Declaration of Helsinki-Ethical Principles for Medical Research Involving Human Subjects. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/ Accessed: 07.06.2023.
• Yıldırım, G., & Şahin, N.H. (2003). Nursing approach in controlling labor pain. Journal of Cumhuriyet University School of Nursing, 7, 14-20.