Doğum Sürecinde Yaşanan Korku ve Ağrının Yönetiminde Nonfarmakolojik Yaklaşımlar

Abstract

Doğum süreci ile ilgili korku ve ağrı kadınların sıklıkla yaşadıkları ve birbiri ile ilişkili sorunlardır. Kadınlar bu durumlarla baş etmede farmakolojik veya nonfarmakolojik yöntemler kullanabilirler. Farmakolojik yöntemler etkili yöntemlerdir, fakat nonfarmakolojik yöntemlere göre daha fazla yan etkisi vardır. Örneğin, epidural analjezi doğumda müdahale ihtimalini arttırır, yenidoğan ve emzirme üzerindeki olumsuz etkileri vardır. Nonfarmakolojik yöntemlerin ise, doğumun ilerlemesi üzerinde olumsuz bir etkisi yoktur. Bu yöntemlerin çoğu doğum korkusunu azaltmak için de kullanılır; etkisinin artması için düzenli uygulanıp, eşlerin sürece dahil olması gerekir. Doğuma yönelik yapılan nonfarmakolojik yöntemler aynı zamanda girişimsel olmayan yöntemlerdir. Kadına uygulanan girişimlerin azaltılması, kanıta dayalı uygulamaların rehber alınması ve ana-çocuk sağlığının korunması/ geliştirilmesi amacıyla 1996 yılında Doğum Servislerini Geliştirme Koalisyonu (CIMS), anne dostu bakım modelini oluşturmuştur. ACOG (American College of Obstetricians and Gynecologists) 2019 yılında doğumda müdahale sınırlamasını önermiştir. Yapılan çalışmalarda da müdahaleyi sınırlanmasının hasta memnuniyetini arttırdığı görülmüştür. Bu derlemede kadınların sıklıkla yaşadığı problemlere yönelik müdahale gerektirmeyen güncel yöntemlerin anlatılması amaçlanmıştır.

Keywords

• doğum korkusu
• doğum ağrısı
• nonfarmakolojik yöntemler

Non-pharmacological Approaches in the Management of Fear and Pain Experienced in the Birth Process

Abstract

Fear and pain related to the birth process are interconnected problems that women frequently experience. Women can use pharmacological or non-pharmacological methods to cope with these situations. They are effective results of pharmacological methods, but have more side effects than non-pharmacological methods. For instance, epidural analgesia increases the probability of using an intervention during labor and has negative effects on newborn behaviors and breastfeeding. On the other hand, non-pharmacological methods have no negative effect on the labor process. Most of these non-pharmacological methods are also utilized to reduce tokophobia, and so that their effects can be enhanced, they need to be used regularly and spouses should be included in the process. Non-pharmacological methods used in the context of labor are, at the same time, non-invasive methods. The Coalition for Improving Maternity Services (CIMS) created the mother-friendly care model in 1996 to reduce the number of interventions administered to women, take evidence-based practices as the guide, and protect/develop mother & child health. In 2019 ACOG (American College of Obstetricians and Gynecologists) recommended limiting the use of interventions in labor. Also, in previous studies, it was found that limiting the use of interventions enhanced patient satisfaction. This study aimed to present current methods not requiring the use of interventions for problems experienced frequently by women.

Keywords

• Labor pain
• tokophobi
• non-pharmacological methods

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