Combination pelvic rocking exercises with belly dance to reduce labor pain

Background: Labor pain will get more substantial along with the increase in cervical dilatation and can affect the mother's psychological condition and the welfare of the fetus. Pelvic rocking exercises help reduce pain during labor, but the combined pelvic rocking exercises with belly dance for birth have not been studied. In this study, combining pelvic rocking exercises with belly dance for birth as physical preparation and exercise, especially in the pelvic area, can reduce pain effectively and efficiently so that mothers can give birth vaginally.Purpose: Analyze the effect of intervention combination of pelvic rocking exercises with belly dance for birth to pain intensity of first stage the active phase in mother birth.Methods: This is Quasy experimental research with pretest and posttest with control group design. Respondents were primigravida mothers during the first stage of the active phase. Determination of respondents by accidental sampling obtained the treatment group (n=17) and control group (n=17). The intervention was given for 20 minutes every 1 hour during the first stage of the active phase.Result: The combined intervention of pelvic rocking exercises with belly dance for birth was effective in reducing pain intensity as seen from the average decrease in pain intensity every hour, at the 1st hour of 4.0, the 2nd hour of 3.0, the 3rd hour of 2.7, and the 4th hour of 2.6 (p<0.001)Conclusion: The combination of pelvic rocking exercises with belly dance for birth is effective to pain intensity of the first stage, the active phase in women giving birth.

Electroencephalogram-derived pain index for evaluating pain during labor

Background The discriminative ability of a point-of-care electroencephalogram (EEG)-derived pain index (Pi) for objectively assessing pain has been validated in chronic pain patients. The current study aimed to determine its feasibility in assessing labor pain in an obstetric setting. Methods Parturients were enrolled from the delivery room at the department of obstetrics in a tertiary hospital between February and June of 2018. Pi values and relevant numerical rating scale (NRS) scores were collected at different stages of labor in the presence or absence of epidural analgesia. The correlation between Pi values and NRS scores was analyzed using the Pearson correlation analysis. The receiver operating characteristic (ROC) curve was plotted to estimate the discriminative capability of Pi to detect labor pain in parturients. Results Eighty paturients were eligible for inclusion. The Pearson correlation analysis exhibited a positive correlation between Pi values and NRS scores in parturients (r = 0.768, P < 0.001). The ROC analysis revealed a cut-off Pi value of 18.37 to discriminate between mild and moderate-to-severe labor pain in parturients. Further analysis indicated that Pi values had the best diagnostic accuracy reflected by the highest area under the curve (AUC) of 0.857, with a sensitivity and specificity of 0.767 and 0.833, respectively, and a Youden index of 0.6. Subgroup analyses further substantiated the correlations between Pi values and NRS scores, especially in parturients with higher pain intensity. Conclusion This study indicates that Pi values derived from EEGs significantly correlate with the NRS scores, and can serve as a way to quantitatively and objectively evaluate labor pain in parturients.

PENGARUH OLAH NAFAS BELLY BREATHING UNTUK MENGURANGI NYERI PERSALINAN KALA 1 FASE AKTIF DI KLINIK DHIAULHAQ MAGELANG

ABSTRAKLatar Belakang: Banyak ibu sangat takut mengalami rasa sakit saat persalinan melalui vagina sehingga lebih memilih persalinan Caesar. Rasa takut akan semakin mencekam ketika tanggal persalinan semakin dekat. Penelitian menunjukkan, faktor mengurangi rasa takut adalah mendapat dukungan positif dari keluarga dan memilih beberapa metode penghilang rasa sakit (Danuatmadja, 2008). Untuk mengurangi efek stres fisiologis maupun psikologis akibat nyeri persalinan dapat dilakukan melalui penanganan non farmakologi.Salah satu terapi tersebut adalah olah nafas. Tujuan: Penelitian ini bertujuan untuk mengetahui Pengaruh Olah Nafas Belly Breathing Terhadap Nyeri Persalinan Kala 1 Fase Aktif Di Klinik Dhiaulhaq Magelang Jawa Tengah. Metode: Desain penelitian ini adalah Quasy Eksperimental dengan pendekatan one group Pre-Post test Design. Populasi penelitian adalah ibu bersalin di klinik Dhiaulhaq Magelang Jawa Tengah dengan jumlah sampel 38 dan menggunakan teknik accidental sampling. Analisis menggunakan uji Wilcoxon. Hasil: Terdapat perbedaan antara nyeri sebelum diberikan terapi olah nafas dengan nyeri pasca pemberian olah nafas pada kala 1 fase aktif dengan nilai P= 0,000 < 0,05. Terdapat perbedaan rasa nyeri yang bermakan antara sebelum diterapkan dan sesudah diterapkan. Kesimpulan: Terdapat 29 responden (76,32%) setelah diterapkan olah nafas belly breathing, nyeri berkurang, 1 responden (2,63%) nyeri bertambah, dan terdapat 8 responden (21,1 %) dengan nyeri tetap.Kata Kunci : Belly Breating, Nyeri PersalinanTHE EFFECT OF BELLY BREATHING TO REDUCE LABOR PAIN DURING 1 ACTIVE PHASE AT DHIAULHAQ MAGELANG CLINICABSTRACTBackground: Many women are frightened of the pain during vaginal delivery so they prefer a caesarian delivery. The fear will be more gripping as the due date draws near. Research shows the factors that reduce fear are getting positive support from family and choosing several methods of pain relief (Danuatmadja, 2008). To reduce the effects of physiological and psychological stress due to labor pain can be done through non-pharmacological treatmen. One the therapies is breathing exercise. Objective: This study is aimed to determine the Influence of Belly Breathing to Pain of Labor Kala 1 Phase Active In Dhiaulhaq Clinic Magelang, Central Java. Methods: The design of this research is Quasy Experimental with a one group Pre- Posttest Design approach. The population of the study was maternal birth in Dhiaulhaq Clinic Magelang, Central Java with 38 samples and using accidental sampling technique. The analysis was using Wilcoxon test. Results: There is a difference between pain before brathing therapy and after having breathing therapy in kala I active phase p=0.000<0.05. There is significant difference of pain level between before and after the tharapy was applied. Conclusion: After applying the Belly Breathing exercise there were 29 respondents (76.32 %) experienced reducing pain, one respondent (2.63 %) experienced increasing pain, and 8 respondents (21.1%) increasing pain constantly.Keyword: Belly Breathing, Labor Pain

Pelatihan Terapi Relaksasi Hypnobirthing Untuk Tenaga Kesehatan Dalam Rangka Meningkatkan Pelayanan Kesehatan Ibu Dan

Background: labor pain is a real problem for maternity mothers, as many as 90% of women experience pain during childbirth. Mothers who are about to give birth expect to be able to give birth with a sense of comfort, but in reality many health workers, especially midwives, do not understand how to accompany mothers in labor and teach the correct relaxation techniques to reduce labor pain. The hypnobirthing relaxation technique is a natural pain reduction program by utilizing the subconscious mind to believe that childbirth is a natural, comfortable, and normal process that pregnant women can learn during their pregnancy. Methods: Method this study is used relaxation hypnobirthing intervention. The sample of this study were all midwives in the South Klaten Public Health Center area. The researcher demonstrated hypnobirthing relaxation and then the respondents practiced it in pairs. Results: the average value of the knowledge of the midwives before the training on hypnobirthing relaxation was only 50, after the training the knowledge increased by 90. Hypnobirthing relaxation training can increase knowledge and skills of midwives to in assisting pregnant women during their pregnancy and lead pregnant women to a comfortable, smooth, natural, and normal labor. Conclusion: Hypnobirthing relaxation training for midwives can increase their knowledge in assisting mothers in childbirth so that they can relax in the face of childbirth.

Entonox® versus Pethidine in Labor Pain Relief: A Randomized Controlled Trial

Background: Pain relief during labor is a part of standard care in modern obstetrics. Several modalities used for pain relief have their own disadvantages and benefits in terms of side effects, effectiveness, availability, and satisfaction. The objectives of this study are primarily to compare the effectiveness and patients’ satisfaction for pain relief during labor between pethidine and inhaled 50% nitrous oxide (Entonox®). Methods: Laboring women at 37–41 + 6 weeks of gestation were randomly allocated to receive pethidine (50 mg intravenously) or Entonox® for reducing labor pain. Pain scores were evaluated at 0, (baseline), 30, 60, 90, and 120 min after initiation, using the visual analog scale (VAS) and also satisfaction score after delivery using the verbal rating scale (VRS). The secondary outcomes were also assessed, including APGAR scores, labor course, side effects, and cesarean section rate. Results: A total of 136 laboring women underwent randomization into two groups, but only 58 and 65 in the pethidine group and the Entonox® group were available for analysis. The median pain scores at baseline, 30, 60, and 90 min were comparable between both groups (p-value > 0.05); however, pain score at 120 min in the pethidine group was significantly higher (p-value: 0.038). The median of satisfaction score was significantly higher in the Entonox® group (4 vs. 3; p-value 0.043). All of the secondary outcomes were comparable between the two groups. Conclusions: Both have comparable effectiveness, but Entonox® has a higher satisfaction score. Entonox® could be an alternative to pethidine for reducing labor pain, because of its efficacy, ease for self-adjustment for satisfaction, and no serious effects on the labor course and newborns.

The relationship of the application of guided imagery therapy techniques towards pain intensity of maternal post caesarian section operation in postnatal care at the maternity hospital in the city of Padang

Background: Most of the maternity mothers experience discomfort disorders due to the pain felt by the mother after caesarean section surgery. The pain causes disruption of the mother’s activities after giving birth, the mother has difficulty breastfeeding her baby, and has difficulty doing physical activities. The pain results from surgical wounds on the abdominal wall and uterine wall of the mother. The pain experienced by each mother is different, ranging from low pain levels to severe pain levels.Methods: This type of comparative analytic research with a cross sectional study approach with one group pretest and posttest design. As many as 30 samples of post caesarean section delivery mothers were taken by purposive sampling technique. Marginal homogeneity test was used for research analysis.Results: The study showed that there was a decrease in the level of post-partum labor pain before and after the intervention of guided imagery therapy. Before the intervention, most of the respondents (46.7%) had moderate pain levels (4-6), after giving the intervention some respondents (43.3%) had mild pain levels. Statistical test showed a significant relationship with a significance value of 0.000 (p value <0.05).Conclusions: Giving guided imagery therapy to post caesarean section delivery mothers is able to reduce the level of pain that the mother experiences without causing additional risk for the mother. This therapy provides a sense of comfort and relaxation for the mother through the imagination generated by the mother in her mind so that it diverts and reduces the pain that the mother is experiencing.

Evaluation of Maternal and Fetal Outcomes in Mothers with Spinal Analgesia in Comparison with the Control Group

Background: Proper reduction of labor pain has always been one of the most important goals of medicine and the patient's request for labor pain relief is a sufficient necessity for the use of pain relief methods. The aim of this study was to evaluate the maternal and fetal outcomes of mothers who underwent spinal analgesia in comparison with the control group in mothers who referred to the maternity ward of Ali Ibn Abitaleb Hospital in Zahedan in 2020. Methods: The present study was a case-control study that was performed on 200 pregnant women in 1398. Pregnant women whose criteria for admission and selection of an anesthesiologist were divided into painless (spinal) delivery groups. The control group was selected by simple random sampling from among those who met the inclusion criteria but did not want to have a painless delivery. The two groups were compared using ANOVA, Kruskal-Wallis, Linear regression, Chi-Square and Fisher's exact tests. A significance level of 0.05 was considered. Results: The length of the first and second stages of labor in the non-intervention group was significantly shorter than the painless groups. In the analgesic method used, the Apgar score of the infant had no negative effects on the type of delivery and did not lead to complications in the mother in the postpartum stage. Conclusion: Findings from this study showed that spinal analgesia had no negative effects on maternal and neonatal outcomes.

Utilization of Obstetric Analgesia for Labor Pain Management and Associated Factors among Obstetric Care Providers in Public Hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study

Background. In low-income countries, pain-free labor initiative is an emerging concept and still parturient undergoes through painful labor; this is not different in Ethiopia; despite the national direction to use analgesia for labor pain and strong demand from the women, evidence on utilization of obstetric analgesia for labor pain management in Ethiopia is scarce. The objective of this study was to assess level of obstetric analgesia utilization and associated factors among obstetric care providers in public hospitals in Addis Ababa, Ethiopia. Methods. An institution-based cross-sectional study was used. All obstetric care providers working in labor and delivery units in public hospitals in Addis Ababa were included. The data were collected using a self-administered structured questionnaire. After checking for completeness, data were entered into Epi-data 3.1 and analyzed using SPSS 20. Bivariate and multivariable logistic regressions were used to identify factors associated with utilization of obstetric analgesia. Result. Of 391 obstetric care providers included in the study, 143 (36.6%; 95% CI: 31.5–40.9%) reported providing labor analgesia. Having adequate knowledge (AOR 2.7; 95% CI: 1.37–5.23), ten and more years of work experience (AOR 4.3; 95% CI: 1.81–10.13), and availability of analgesics (AOR 3.3; 95% CI: 1.99–5.53) were significantly associated with providing labor analgesia. Conclusion. Slightly more than 3 in 10 obstetric care providers reported providing labor analgesics to women. Training of providers and ensuring adequate supply of analgesics is required to make sure that women in labor would not suffer from labor pain.