Effect of Pronurturance Plus on Labor Outcomes of Women at Risk to Postpartum Hemorrhage

Abstract

Background: Postpartum hemorrhage is still the leading cause of death of birthing mothers in the world today. Pronurturance plus evidence-based practice which includes early skin-to-skin contact and breastfeeding has a significant positive effect to improve the labor outcomes and decrease the occurrence of postpartum hemorrhage. Aim: was to study the effect of pronurturance plus on labor outcomes of women at risk to postpartum hemorrhage. A Quasi-experimental research study carried out at the Delivery Room and Postpartum Department in one of the Hospital that affiliated to the Ministry of Health, Fayoum, Egypt. Sample: A purposive sample of 90 laboring women at risk for postpartum hemorrhage was divided into the study and control groups (45 for each). The control group received routine hospital care and the study group received the pronurturance plus practice. Seven women were excluded from the study group due to that some babies failed to initiate breastfeeding after delivery and some mothers didn‟t complete the duration of skin to skin contact. Finally, the sample size reached 45 & 38 women in the control and study groups respectively. Four tools were used: 1) Laboring women‟s‟ demographic data assessment tool,2)Risk factors‟ to postpartum hemorrhage assessment tool 3) Labor outcomes assessment tool, and 4) Women‟s‟ satisfaction assessment tool. The results: There were statistically significant differences between the study and the control groups with regard to the labor outcomes in third and fourth stage of labor. The study group exhibited less duration of 3 rd stage of labor, efficient uterine contraction, less amount of blood loss, less occurrence of primary postpartum hemorrhage, and high satisfaction level regarding to the apply of pronurturance plus. Conclusion: The pronurturance plus practice had a positive effect in improving labor outcomes and reducing the occurrence of primary postpartum hemorrhage among women at risk to postpartum hemorrhage. Recommendations: The practice of pronurturance plus should be a part of routine 3 rd and 4 th stage care for all birthing women regardless of their level of risk.