Gebe eğitim sınıfları Türkiye’nin kırsal kesiminde obstetrik sonuçları etkiler mi? prospektif-gözlemsel çalışma

Year 2020, Volume: 51 Issue: 3, 151 - 154, 30.09.2020

Erkan Şimşek Onur Karaaslan Gürcan Türkyılmaz Sevim Tuncer Hakkı Aktaş

https://doi.org/10.16948/zktipb.755797

Abstract

Amaç: Gebe eğitim sınıfları memnun edici bir gebelik ve doğum süreci geçirmeleri için gebeleri destekler. Bu çalışmamızda Türkiye’nin az gelişmiş bir bölgesinde dinoprostone ile doğum indüksiyonu uyguladığımız gebelerde gebe eğitim sınıfının gebelik sonuçlarına etkisini araştırdık.
Materyel-metod: Bu prospektif çalışma Ağustos 2019-Mart 2020 tarihleri arasında Tunceli Devlet Hastanesi, Kadın Hastalıkları ve Doğum kliniğinde yapıldı. 18-40 yaş arası, tekil gebeliği olan, kronik hastalığı bulunmayan ve sezaryen öyküsü olmayan hastalar çalışmaya dahil edildi. Gebe eğitim sınıflarında sertifikalı ebeler görevlendirildi. Eğitimler ilk trimesterde başladı ve gebeliğin son haftalarına dek devam etti. Tüm katılımcılar toplam 12 ders aldı.
Bulgular: 82 (%48) eğitim sınıfına katılan ve 89 (%52) (kontrol grubu) katılmayan toplam 171 gebe çalışmaya dahil edildi. Kontrol grubunda hastaların %69,5’I vajinal, %30,5’I sezaryen ile doğum yaptı. Gebe eğitim sınıfındaki hastaların %83.1 vajinal doğum yaparken %16,9’u sezaryen ile doğum yaptı ve bu oran istatistiksel olarak anlamlıydı (p: 0,03). Neonatal sonuçlar her iki grupta benzerdi.
Sonuç: Gebe eğitim sınıfları maternal ve neonatal sonuçları iyileştirmenin ucuz bir yoludur. Sezaryen oranlarını azaltmada yararlı olabilir ve tüm ülkede yaygın olarak erişilebilmelidir.

Keywords

destek, doğum, eğitim

Does childbirth education classes influence obstetric outcomes in a rural region of Turkey: a prospective case-control study

Abstract

Aim: Childbirth education classes support women to achieve a pleasing pregnancy and delivery. We aimed to determine the effects of CEC on obstetric outcomes in women who underwent labor induction with dinoprostone in an underdeveloped region of our country in this study.
Material-methods: Prospective study was conducted in Tunceli State Hospital, Department of Obstetrics and Gynecology, between August 2019 and March 2020. Age between 18-40, singleton pregnancy, no presence of chronic disease, and no history of cesarean section was included. CEC was provided by midwives who had certified. It started in the first trimester of pregnancy and continued until the last weeks of pregnancy. All participants received a total of 12 lessons.
Results: 171 patients recruited, including 82 (48%) of cases continued CEC, and 89 (52%) patients had no admission to CEC. 69.5% of patients delivered vaginally, and we performed a cesarean section in 30.5% of cases in control groups. 83.1% of cases achieved vaginal delivery, and 16.9% underwent cesarean section in the CEC group. The vaginal birth rate was significantly higher in the CEC group than controls (p: 0.03). Neonatal outcomes were similar between the two groups.
Conclusion: CEC is an inexpensive option to promote maternal and neonatal health. It can be a useful tool to reduce cesarean birth rates and should be used widely all over the country.

Keywords

childbirth, delivery, education, pregnancy

References

• 1. Madhavanprabhakaran, Girija & Dsouza, Melba & Nairy, Subrahmanya. Effectiveness of Childbirth Education on Nulliparous Women's Knowledge of Childbirth Preparation, Pregnancy Anxiety, and Pregnancy Outcomes. Nursing and Midwifery Studies. 2016; 6. 10.5812/nmsjournal.32526. 2. Türkiye Halk Sağlığı Kurumu (THKS) Kadın ve Üreme Sağlığı Daire Başkanlığı. Gebe Bilgilendirme Sınıfı 2014 (In Turkish) 3. Kingston, D, Chalmers B. Prenatal information. In What mothers say: The Canadian maternity care experience survey. Ottowa, Canada: Public Health Agency of Canada 2009 4. Nichols F, Humenick S. Childbirth education: Practice, research, and theory (2nd ed).Philadelphia, PA: W.B.Saunders 2000 5. Gagnon AJ, Sandall J. Individual or group antenatal education for childbirth or parenthood or both. Cochrane Database Syst Rev 2007;3 CD002869 6. Chen I, Opiyo N, Tavender E, et al. Non-clinical interventions for reducing unnecessary cesarean section. Cochrane Database Syst Rev. 2018;9(9):CD005528. 7. Brixval CJ, Axelsen SF, Laumoller SG, Andersen SK, Due P, Koushede V. The effect of antenatal education in small classes on obstetric and psycho-social outcomes-a systematic review. Systematic Reviews 2015; 4:20-26 8. Citak Bilgin N, Ak B, Ayhan F, Kocyigit F, Yorgun S, Topcuoglu MA. Effect of childbirth education on the perceptions of childbirth and breastfeeding self-efficacy and the obstetric outcomes of nulliparous women. Health Care Women Int. 2020;41(2):188‐204. 9. Akca A, Corbacioglu Esmer A, Ozyurek ES, et al. The influence of the systematic birth preparation program on childbirth satisfaction. Arch Gynecol Obstet. 2017;295(5):1127‐1133. 10. Pinar G, Avsar F, Aslantekin F. Evaluation of the Impact of Childbirth Education Classes in Turkey on Adaptation to Pregnancy Process, Concerns About Birth, Rate of Vaginal Birth, and Adaptation to Maternity: A Case-Control Study. Clin Nurs Res. 2018;27(3):315‐342. 11. Rasouli M, AtashSokhan G, Keramat A, Khosravi A, Fooladi E, Mousavi SA. The impact of motivational interviewing on participation in childbirth preparation classes and having a natural delivery: a randomized trial. BJOG. 2017;124(4):631‐639. 12. Conesa Ferrer MB, Canteras Jordana M, Ballesteros Meseguer C, Carrillo García C, Martínez Roche ME. A comparative study analyzing women's childbirth satisfaction and obstetric outcomes across two different models of maternity care. BMJ Open. 2016;6(8):e011362. 13. Stoll KH, Hall W. Childbirth education, and obstetric interventions among low-risk Canadian women: is there a connection? J Perinat Educ. 2012;21(4):229‐237. 14. Ucar T, Golbasi Z. Effect of an educational program based on cognitive-behavioral techniques on fear of childbirth and the birth process. J Psychosom Obstet Gynaecol. 2019;40(2):146‐155 15. American College of Obstetricians and Gynecologists. Obstetric care consensus no.1: Safe prevention of the primary cesarean delivery. Obstetrics and Gynecology. 2014; 123(3):693–711