Labor Pain Research Articles

The Effectiveness Of Counter Pressure And Effleurage Massage On The Intensity Of Labor Pain During The Active Phase I

Latar Belakang: Nyeri dapat meningkatkan pernapasan dan denyut jantung ibu, dan jika tidak ditangani dengan cepat, bisa berakibat fatal bagi ibu dan bayi. Bidan biasanya menghabiskan lebih banyak waktu dengan pasien yang mengalami nyeri dibandingkan dengan petugas kesehatan lainnya. Peran bidan meliputi mengidentifikasi dan mengatasi penyebab nyeri serta memberikan intervensi yang tepat untuk mengurangi nyeri. Karena itu, penanganan dan pemantauan nyeri pada fase aktif persalinan sangat penting untuk menentukan apakah persalinan akan berlangsung normal atau memerlukan tindakan medis karena komplikasi yang disebabkan oleh nyeri yang sangat hebat.Tujuan: Menganalisis efektivitas counter pressure dan effleurage massage terhadap intensitas nyeri persalinan kala I fase aktif di RSUD dr. Rubini Mempawah.Metode: Penelitian ini menggunakan desain kuasi-eksperimen dengan rancangan pretest-posttest nonequivalent control group design. Populasi yang diteliti adalah ibu-ibu yang menjalani persalinan pada fase aktif selama bulan Mei dan Juni, dengan jumlah 78 orang. Sampel penelitian terdiri dari 20 orang, dibagi menjadi 10 orang untuk intervensi counter pressure dan 10 orang untuk intervensi pijat effleurage. Teknik pengambilan sampel yang digunakan adalah consecutive sampling.Hasil: Terdapat perbedaan signifikan dalam intensitas nyeri persalinan pada fase aktif sebelum dan setelah penerapan metode counter pressure dengan nilai p < 0,004. Begitu pula, terdapat perbedaan signifikan dalam intensitas nyeri sebelum dan setelah penerapan pijat effleurage, juga dengan nilai p < 0,004. Selain itu, efektivitas antara metode tekanan kontra dan pijat effleurage dalam mengurangi intensitas nyeri persalinan pada fase aktif juga berbeda secara signifikan, dengan nilai p < 0,001.Kesimpulan: Counter pressure lebih efektif daripada effleurage massage dengan nilai post-test counter pressure memiliki selisih nilai median 3 sedangkan nilai post-test effleurage massage memiliki selisih nilai median 2.Saran: Diharapkan peneliti selanjutnya dapat menerapkan terapi komplementer untuk mengurangi intensitas nyeri persalinan. Penelitian ini diharapkan dapat menjadi referensi untuk studi lebih lanjut mengenai efektivitas metode counter pressure dan pijat effleurage dalam mengurangi intensitas nyeri persalinan pada fase aktif. Kata Kunci : counter pressure, effleurage, nyeri persalinan ABSTRACT Background: Pain can increase maternal breathing and heart rate, and if not treated quickly, can be fatal for both mother and baby. Midwives usually spend more time with patients experiencing pain than other health workers. The role of midwives includes identifying and addressing the causes of pain and providing appropriate interventions to reduce pain. Therefore, pain management and monitoring in the active phase of labor are very important to determine whether labor will proceed normally or require medical intervention due to complications caused by very severe pain.Purpose: To analyze the effectiveness of counter pressure and effleurage massage on the intensity of labor pain in the first stage of the active phase at RSUD dr. Rubini Mempawah.Methods: This study used a quasi-experimental design with a pretest-posttest nonequivalent control group design. The population studied were mothers who underwent labor in the active phase during May and June, totaling 78 people. The study sample consisted of 20 people, divided into 10 people for counter pressure intervention and 10 people for effleurage massage intervention. The sampling technique used was consecutive sampling.Results: There was a significant difference in the intensity of labor pain in the active phase before and after the application of the counter pressure method with a p value <0.004. Likewise, there was a significant difference in the intensity of pain before and after the application of effleurage massage, also with a p value <0.004. In addition, the effectiveness between the counter pressure method and effleurage massage in reducing the intensity of labor pain in the active phase also differed significantly, with a p value <0.001.Conclusion: Counter pressure is more effective than effleurage massage with post-test counter pressure values having a median value difference of 3 while post-test effleurage massage values have a median value difference of 2.Suggestions; It is hoped that further researchers can apply complementary therapy to reduce the intensity of labor pain. This study is expected to be a reference for further studies on the effectiveness of the counter pressure method and effleurage massage in reducing the intensity of labor pain in the active phase. Keywords: : counter pressure, effleurage, labor pain

The effect of neurolinguistic programming on labor pain, fear, duration and maternal satisfaction: A randomized controlled trial

ObjectivesLabor pain is one of the most severe pains experienced by women. In the literature, there is no research examining the effect of Neurolinguistic Programming (NLP) on birth pain and fear. It was aimed to determine the effect of NLP on labor pain, fear, duration, and maternal satisfaction in both nulliparous, and multiparous pregnant women. DesignThis study consists of each with two arms, parallel-group randomized controlled trials, on two different samples for both nulliparous and multiparous women. Data were collected between 3 October 2023–21 January 2024. A total of 124 women (62 nulliparous and 62 multiparous women) who gave birth vaginally constituted the sample of the study. Both nulliparous and multiparous women were randomly assigned to groups. The primary outcomes were labor pain, fear, duration, and satisfaction. When the cervical span was 3–4, 5–6, and 7–8 cm, NLP was applied to the experimental group for 20 min each, the control group rested for 20 min each. ResultsAccording to the measurement times, the mean pain score of the experimental group was lower than the control group. The mean VAS pain score measured over time decreased by 90.3 % in the NLP group compared to the control group for primiparous and 64.5 % compared to the control group for multiparous. In both nulliparous and multiparous, the fear of labor of the NLP group was lower, the duration of labor was shorter, and the satisfaction with labor was higher compared to the control group (p < 0.05). ConclusionNLP reduces labor pain and fear, shortens the duration of labor, and increases maternal satisfaction in labor.

The Use of Birth Ball as A Non-Pharmacological Complementary Therapy in The Reduction of Labor Pain in Phase 1

Childbirth is the process of expelling the fetus to the placenta, the process of giving birth is identical to pain, while to reduce this pain, non-pharmacological methods are carried out, one of which is the Birth Ball method. This study aims to evaluate the effectiveness of using birth ball as a non-pharmacological complementary therapy in reducing labor pain in the first stage. The method used was a narrative literature review by searching for relevant articles on Google Scholar using keywords such as “Birth ball” and “Labor pain”. Inclusion criteria included Indonesian-language articles published between 2021-2023. Of the six studies analyzed, it was found that birth ball use significantly reduced the intensity of labor pain. These studies showed that birth balls can accelerate cervical opening and reduce anxiety of laboring mothers through movements that increase endorphin release. In conclusion, birth balls are effective as an alternative method to reduce labor pain in Stage I, providing the added benefit of increasing maternal comfort and relaxation during the labor process. This study suggests the use of birth ball as part of midwifery practice to reduce labor pain non-pharmacologically.

Effects of Warm Compresses on the Perineal Area During the Active Phase of Labor: A Quasi-Experimental Study.

Background A perineal tear refers to any injury to the female genitalia during labor, which can occur spontaneously or with the use of instruments. An episiotomy, a surgical procedure, is sometimes performed to enlarge the vaginal orifice to facilitate delivery. Ineffective management of labor pain can result in negative physiological and psychosocial outcomes. Objective This study aims to investigate the effect of warm compresses on the perineal area during active labor. Methods This quasi-experimental study utilized a convenience sample, dividing 80 mothers into intervention and control groups. Participants were randomly assigned to groups after meeting the inclusion criteria and signing consent forms. The inclusion criteria encompassed pregnant women aged 18 years or older with a healthy singleton pregnancy, a cephalic presentation, and a gestational age of 37 weeks or more. The women were in the active phase of the first stage of labor (6-7 cm cervical dilation). In Part I, a data collection tool was developed to gather sociodemographic data, obstetrical history, and initial assessment information. Part II assessed perineal pain using the Visual Analogue Scale. Part III collected data on the perineal status post-delivery, and Part IV gathered information about the newborns. The research was conducted in the labor unit at East Jeddah Hospital, with data collection occurring from November 2022 to February 2023. Results The results of this study revealed that the mean second-stage labor pain score was 9.73 for the control group and 8.68 for the intervention group. In the third stage of labor, the mean pain score was 4.52 for the control group and 2.75 for the intervention group. During the fourth stage of labor, the mean pain score for the control group was 2.90, compared to 1.50 for the intervention group. In terms of perineal outcomes, 17 participants (42.5%) in the intervention group had an intact perineum, compared to 11 participants (27.5%) in the control group. However, there was no significant difference in the episiotomy rate between the two groups. Conclusions The findings of this study indicate that applying a warm compress to the perineal area during active labor can enhance perineal intactness and significantly reduce perineal pain. Future research could explore the challenges nurses encounter when applying warm compresses to the perineum during labor.

The Effect of Breathing Exercises Using a Breathing Exercise Device and Virtual Reality Applications During Pregnancy and Labor on Labor.

The study aimed to determine the effects of breathing exercises using a breathing exercise device and virtual reality applications during pregnancy and labor on labor pain, duration, and birth satisfaction. This study was planned as a single-blind randomized controlled experimental study. The study was conducted with a total of 114 pregnant women who were randomized between September 2022 and May 2023 at a maternity hospital in Southeastern Anatolia, Turkey. The participants were divided into three groups: the breathing exercise group (39), the virtual reality group (37), and the control group (38). The data were collected by using the descriptive information form, labor observation form, visual analog scale, and Birth Satisfaction Scale. The incidence of average pain scores and labor duration were lower in the intervention groups when compared with the control group (P < .05). The average birth satisfaction scores of pregnant women in both experimental groups were determined to be higher than those in the control group (P < .05). The research results show that breathing exercises using a breathing exercise device during pregnancy and labor and virtual reality applications shorten the duration of labor, reduce labor pain, and increase birth satisfaction.

Gender roles as predictive factors on labor pain: a cross-sectional study.

Labor is a complex, subjective experience, and all factors that influence pain should be considered to ensure a comprehensive evaluation. This study aimed to determine whether gender roles were predictive of labor pain. The study has a descriptive and cross-sectional design. It was carried out in a delivery room of a city hospital in Turkey between September 2019 and September 2020. The study sample consisted of 231 primiparous women presenting for labor and delivery. Data were gathered with a descriptive characteristics form, Visual Analogue Scale and The Bem Sex-Role Inventory. Descriptive statistics and simple regression analysis were employed to analyze the obtained data. Regression analysis demonstrated that gender roles were predictive of labor pain in the latent, active, and transitional stages, but not in the second stage. Gender roles were most responsible for labor pain in the latent phase. Results of the study revealed that gender roles may be useful variables to predict women's labor pain, and contributed to the relevant literature. Nurses and midwives offering care for labor pain should consider gender roles as a factor affecting labor pain. It is also necessary to individualize the supporting care given during labor.

What is the authentic underlying reason of childbirth worries in Turkish population?: An observational study.

This study aims to determine women's childbirth worries during antenatal. The research was carried out with 532 pregnant women in the antenatal clinic in Turkey as an observational study. Sociodemographic characteristics and scores of the Oxford Worries about Labor Scale of pregnant women were evaluated quantitatively. In addition, the answers given by the pregnant women to the open-ended question were themed. Although working status and receiving antenatal education reduce the fear of childbirth, birth scenes/stories on TV or social media, birth stories in the pregnant women's friends/family, being stressed in daily life, and dysmenorrhea increase the worries about childbirth (WaC). In addition, primiparas experience more WaC than multiparas. The reasons for WaC in pregnant women were classified as birth pain, artificial pain, cesarean section/receiving anesthesia, intervention/examination, pandemic, people's thoughts/experiences, birth process/insufficiency in birth, hospital/staff, fears about the baby, complications/death, and ignorance of the birth process. The results of this study reveal that WaC is a pivotal issue for pregnant women, for which managing the labor process, labor pain and labor fear is important. The stipulation of support for pregnant women is essential to enhance labor outcomes.

Terapi Kneading Massage dan Teknik Breathing Exercise Diapragmatic (BED) dalam Mengurangi Intensitas Nyeri dan Kecemasan Persalinan

Childbirth is a physiological event experienced by some women. The birth process has uncomfortable effects including pain and anxiety. The aim of this research is Kneading Massage Therapy and Diaphragmatic Breathing Exercise (BED) Techniques to Reduce the Intensity of Labor Pain and Anxiety. The method used is a case study with pre-test post-test treatment. The population, namely all mothers giving birth at the Mandiraja 2 Community Health Center in December 2023, was 25 respondents. The sample used was 5 maternal respondents who experienced pain and anxiety using the Accidental Sampling technique. The results obtained after administering Kneading Massage Therapy and Diaphragmatic Breathing Exercise Technique (BED) showed a decrease in the pain scale from before therapy of 5.6 (moderate pain) to around 2.6 (mild pain) after therapy and a decrease in anxiety scale from 40 .4 (moderate anxiety) before therapy to 29.9 (low anxiety) after therapy. So it can be concluded that Kneading Massage Therapy and the Diaphragmatic Breathing Exercise (BED) technique can reduce the intensity of pain and anxiety childbirth.

Buscopan and contemporary obstetric care – A therapeutic adjunct to management of cervical dystocia, uterine inversion and unremitting pain in labour

No abstract available

Nurses' perception of epidural services in a Johannesburg academic setting.

Labour pain is associated with detrimental maternal and foetal physical and psychological effects. Labour analgesia is a basic right for all women and labour epidural analgesia has been accepted as the gold standard for providing such, with reported improvement in patient satisfaction. In South Africa, studies have shown that labour epidural rates are low. At an academic hospital in Johannesburg, a 24-h labour epidural service combined with an awareness campaign and educational programme (LEAP) was initiated with the aim of improving labour epidural rates. Results showed a short-lived uptake with a subsequent decline. This study explored the experiences of labour ward nursing staff regarding the labour epidural service at this academic hospital including perceived limitations and possible recommendations regarding improving service provision. A qualitative, descriptive and exploratory study was conducted. Purposive sampling was used with semistructured, audio-recorded individual interviews, thematic analysis was performed using Braun and Clarke's six-phase approach. The key theme is required education and supervision of epidural insertion (see page 3), management of childbirth and challenges related to epidural service provision. A positive sentiment was expressed by the participants; however, deficiencies in the service such as shortages of experienced personnel, work constraints and insufficient training may be affecting service sustainability. Further studies are recommended to form guidance towards the development and implementation of interventions to improve service delivery.Contribution:Provision of continual training and increased staffing of healthcare personnel will help improve the sustainability of the labour epidural service.

Nursing care in threatened preterm labor in the Obstetrics and Gynecology Department of a hospital

The threat of preterm labor, a pathology endangering the lives of both mother and baby, affects one in ten births and is a serious public health issue. This research aimed to manage the nursing care process for a 35-year-old pregnant woman with a threat of preterm labor, using a purely qualitative approach in a single case study, applying the five stages of the nursing care process. In the assessment stage, Maryori Gordon's 11 functional patterns guide was used, identifying 10 nursing diagnoses based on NANDA-I Taxonomy II, prioritizing: labor pain, risk of maternal/fetal dyad alteration, and infection control. The care plan was developed using NOC and NIC classifications. During the implementation stage, nursing care focused on pain management, prenatal fetal status, and infection control. These were evaluated by comparing baseline scores with achievement scores, resulting in an updated care plan with changes scored at+1, 0, and +2. In conclusion, the nursing care process was managed, providing quality and humanized care to the patient.

Effects of peanut ball use on perceived labor pain, fatigue, and mother's perception of childbirth: a randomized controlled trial.

The aim of this study was to evaluate the effects of using peanut balls on labor pain, fatigue, and the mother's perception of labor. This is a randomized controlled intervention trial. Data were collected from the Intervention (peanut ball) and Control groups between July 2022 and June 2023, with 45 pregnant women in each group. Data were collected using a personal information form, the Visual Analog Scale-Pain (VAS-P), the Visual Analog Scale for Fatigue (VAS-F), and the Maternal Perception of Childbirth Scale (MPCS). The VAS-P scores of the intervention group were statistically significantly lower than those of the control group 15min after peanut ball application (p = .000). Immediately after and 15min after peanut ball application, the mean fatigue score of the Intervention group was statistically significantly lower than that of the Control group (p = .000). There was no statistically significant difference between the mean duration of labor minutes in the two groups (p = .177). The mean MPCS scores of the intervention group and control groups were 62.73 + 7.30 and 47.17 + 9.12, respectively, and the difference was statistically significant (p = .000). The findings of this study indicate that the use of peanut balls during labor can effectively reduce labor pain and fatigue in pregnant women, without affecting the duration of labor. Additionally, the use of peanut balls has been shown to positively influence the perception of labor among pregnant women. Therefore, it is recommended that midwives educate pregnant women about the use of peanut balls during labor and provide support in their use.

Effective Epidural Analgesia during Labor: A Feasible Method to Decrease Unnecessary Cesarean Deliveries in Thailand

Thailand has reported a high rate of cesarean delivery (45%–55%), prompting global concern about an increase in cesarean delivery rates. Fear of labor pains is one of the most common reasons pregnant women opt for cesarean delivery. Labor pain is associated with cervix dilation and fetal descent into the birth canal, which is exacerbated by ischemic pain caused by uterine contraction. Modern medical and non-medical techniques have demonstrated efficacy in reducing pain and ensuring safety during labor and delivery. Neuraxial labor analgesia is a highly effective medical pain relief method but has no effect on the rate of cesarean or assisted vaginal delivery. Medication administration for pain relief during labor, using a combination of a local anesthetic and an opioid, was observed to be transmitted across the placenta to the fetus, but had no significant effects on fetal outcomes in mothers who chose epidural analgesia. There are several techniques for administering neuraxial labor analgesia that can be customized for each pregnant woman. To achieve the most wonderful feasible labor and delivery experience, effective epidural labor analgesia is a crucial technique for reducing anxiety and suffering about labor pain. It is safe, widely used world-wide, and effective. Implementing a policy to increase public and medical providers awareness and acceptance of labor pain relief, as well as establishing a safe obstetric anesthesia service provided by obstetric anesthesiologists, could improve maternal and neonatal safety while significantly lowering the rate of unnecessary cesarean deliveries.

Virtual Reality as a Method to Cope With Labor Pain: What Do Women Want?

This study aimed to determine what childbearing women want when using virtual reality as an intrapartum pain management method. Researchers performed a qualitative exploratory study using content analysis. Two focus groups were organized including pregnant women anticipating a vaginal birth and women who recently had given birth, no longer than 6 months ago. The focus groups included a 30-minute virtual reality demo. In total, 10 women participated. Five themes emerged: (1) "try, test and explore": the need to receive information and to get acquainted with virtual reality during the antenatal period; (2) "variety and diversity in physical and digital options": the preference for a variety in virtual content and view virtual reality as a complementary method to methods for intrapartum pain management; (3) "distraction versus focus": virtual reality as a method to distract from pain, from the clinical context or to help them focus; (4) "comfort both physical and digital": measures to ensure a comfortable physical and virtual experience; and (5) "birthing partner": the potential need to include partners. This study is an essential step informing the development, implementation, and research of labor-specific virtual reality and informing antenatal healthcare providers when offering women virtual reality as intrapartum pain management.

A Randomised Clinical Trial to Compare the Efficacy and Safety of Dexmedetomidine-Ropivacaine Versus Fentanyl-Ropivacaine for Epidural Labour Analgesia.

Background An epidural block is a superior potent approach to labour analgesia, and ropivacaine combined with fentanyl has been successfully practised for it. Dexmedetomidine, as a novel form of labour analgesia, must be researched further. Our study results give insight into the epidural block and come up with a pioneering approach for labour analgesia. Methodology A total of 68 parturients were assigned to two equal groups and received either dexmedetomidine with ropivacaine (Group RD) or fentanylwith ropivacaine (Group RF). Parturients received a loading dose and maintenance was given using a patient-controlled analgesia (PCA) pump. Analgesia onset time, labour duration, rescue dose requirement, and Visual Analogue Scale (VAS) pain scores were noted. Appearance, Pulse, Grimace, Activity and Respiration (APGAR) scores of newborns, Ramsay Sedation Scale (RSS) scores of mothers, and maternal side effects were observed. Results Group RDshowed a shorter onset time of analgesia (group RD: 12.50 ± 1.31 minutes vs. group RF: 15.26 ± 1.46 min), less local anaesthetics requirement (group RD: 47.54 ±5.37 ml vs. group RF: 59.05 ± 6.62 ml), less number of bolus doses (group RD: 0.15 ± 0.36 vs. group RF: 1.21 ± 0.95), and shorter duration from the epidural administration to the delivery (group RD: 312.97 ± 42.40 minutes vs. group RF: 345.94 ±14.67 minutes) than group RF. VAS values of the RD group were significantly less than the RF group. The RSS scores were comparably low in both groups, and excessive sedation was not seen in any group. Newborn APGAR values were comparably on the higher side in the two groups. Adverse effects were observed in the two groups, like hypotension, nausea/vomiting, bradycardia, shivering, and pruritus, which were insignificant. Conclusion The RD group showed an improved analgesic effect with a quicker onset of action,reduced requirement of local anaesthetics, and lower VAS scores compared to the RF group. With ropivacaine, dexmedetomidine shows more efficacy than fentanyl during epidural block and is a safe alternative for labour pain management.

A quality improvement initiative to augment success rate of labour analgesia: interrupted time series analysis

BACKGROUND Standard operating procedures (SOP) for abour analgesia for parturients in Nepal are lacking. Labour analgesia programme was being conducted without a SOP in our institution. We identified that the success rate of epidural labour analgesia (ELA) was low. We developed standard operating procedures for labour analgesia services with the combined effort of the department of anesthesia and pain management with the department of obstetrics and gynaecology in Nepal Mediciti in 2019 January. SOP and troubleshooting protocol was implemented in 2019 February and this study was conducted to investigate the impact of programmed protocol for labour analgesia. METHODS An interrupted time-series analysis was performed as a process improvement project for all cases who demanded labour analgesia from November 2017 to December 2019 with retrospective data collection. The success of epidural labour analgesia was defined as vaginal delivery with Numerical Rating Scale for labour pain of 3 or less. The time series analysis intended to identify the change in the level of success rate (increase or decrease) and change in the slope of success rate over time. RESULTS The major problems identified by the team included lack of patient counselling, inadequate followup after the first dose of epidural, delay in attending call for labour analgesia by the anesthesiologist and undefined clinical pathways for the usage of drugs and troubleshooting. After implementation of the protocol, the interrupted time series showed a 24.77% relative increase in success rate with p value &lt;0.001. CONCLUSION Interdepartmental group discussions, interviews with the patients and development of a team that worked on formulating SOP was done after problem identification. Patient counselling after 28 weeks of gestation gave patients time for psychological preparation and have realistic expectations regarding ELA than labouring parturients. Clear protocol regarding drug dosing and troubleshooting disposed interpersonal variation among the anesthesiologists. Continuous patient follow-up by the nurse-led team helped to identify any additional problems and address it and add on to the protocol. In conclusion, standard operating procedures guided epidural labour analgesia programme enhanced the success rate of epidural labour analgesia.

Dexmedetomidine Or Fentanyl as An Adjuvant to Single Low-Dose Bupivacaine Intrathecal Anesthesia for Management of Normal Labor Pain, A Randomized Control Study

Dexmedetomidine Or Fentanyl as An Adjuvant to Single Low-Dose Bupivacaine Intrathecal Anesthesia for Management of Normal Labor Pain, A Randomized Control Study

Empowering Expecting Mothers: The Impact of Antenatal Classes on Child Birth Experience.

Introduction Antenatal education is one of the ways to increase a woman's knowledge about pregnancy and childbirth, which could improve self-efficacy during labor, making the expecting mothers well-prepared for labor and nursing. One of the ways for its delivery could be via well-structured antenatal classes. Such classes are part of many countries' healthcare systems and have proven to decline maternal anxiety, shorten labor, increase partner involvement, and overall improve labor experience. However, at the same time, such classes can augment more interventions in labor, induction of labor, and epidural usage. Despite the heterogeneous results of their effect, the high demands of antenatal education amongpregnant women can justify its incorporation into antenatal care. By allowing the women to identify labor correctly and preventing admission in false labor, shortening the labor, and teaching women non-pharmacologic ways to manage labor pains, it can reduce the patient and fiscal burden on the already overwhelmed maternity units of Pakistan, hence proving to be an inexpensive health promotion tool. Methods This cross-sectional study was conducted in the Department of Obstetrics and Gynecologyof Aga Khan University Hospital Karachi, Pakistan, between December 2020 and June 2021. All pregnant women, aged 18 to 45 years, between gestational ages of 37 to 42 weeks, with singleton, cephalic pregnancy, booked during the first or second trimester, and who attended at least one antenatal class, were invited to participate. Women who had any contraindication to vaginal delivery, whose labor was induced, or who suffered from medical, psychological, or obstetric comorbidities were excused. The participants were observed for labor outcomes in terms of stage of labor on arrival, use of epidural analgesia, mode of delivery, and childbirth experience, using a validated research tool, known as the Questionnaire for Assessing the Childbirth Experience (QACE)to identify women with a positive or negative childbirth experience. A higher score representing on the questionnaire represented a more negative birth experience. A score of less than 19 was considereda positive birth experience. Data was analyzed using IBMStatistical Package for Social Sciences (SPSS) Statistics for Windows, Version 19. Results The mean QACE score was reported as 18.2±3.00, reflecting that on average the mothers had a positive childbirth experience. Modes of delivery revealed 57.6% of the women delivering spontaneously, with 60.4% of them arriving in the labor room in active labor. Demand for labor analgesia in the form of epidural was 64%. Majorly the participants attended only one antenatal class, with 66.91% of women reporting a positive childbirth experience. Conclusion Antenatal education classes are a low-input, high-yielding resourcethat can be used to empower mothers with pertinent information and support for a pleasant childbirth experience while simultaneously taking the edge off the overburdened maternity wards of low resources, in densely populated countries like Pakistan. Hence it is the need of the hour to devise plans to invest in these classes to make them available to the masses.

The Effectiveness of Foot SPA on the Intensity of Labor Pain in the Active Phase of First Stage at BPM Ani Karawang

The Effectiveness of Foot SPA on the Intensity of Labor Pain in the Active Phase of First Stage at BPM Ani Karawang

Analyzing Substance Levels and Pain Perception in Painless Labor: The Impact of Spinal Epidural Analgesia.

Inflammation affects labor by influencing contractions and dilation. Pain, often linked to tissue ischemia, involves mediators like nitric oxide (NO), TNF-α, and substance P (SP). Neuraxial analgesia, including combined spinal epidural analgesia (SEA) with levobupivacaine, is preferred for its effectiveness and minimal side effects in painless labor. Understanding the impact of painless labor techniques on biomolecular processes such as NO, TNF-α, and substance P levels is crucial for improving pain management strategies. This study investigates these effects in parturients undergoing SEA with levobupivacaine, contributing to the development of novel pain medications and enhancing obstetric care. This experimental study, conducted at a General Hospital in Indonesia, involved 60 expectant mothers in labor or in the third trimester, expected to give birth vaginally at Permata Hati Metro Hospital. Blood serum was used for analysis, and serum NO, TNF-α, and SP levels were assessed using ELISA kit. There's a significant decrease in NO levels before and post-treatment in the SEA group compared to the control group (p < 0.05). However, no significant difference in TNF-α levels was observed between groups before and after treatment (p > 0.05). Additionally, there was no significant difference in SP levels between groups before treatment, but a significant difference was seen after treatment (p < 0.05). SEA significantly reduced labor pain compared to the control group (P < 0.05), with notable improvements in vital signs and APGAR scores, while also shortening labor duration (P < 0.001). In conclusion, SEA with levobupivacaine during painless labor reduces NO levels significantly and shows a trend of decreasing TNF-α and substance P levels, although not statistically significant, with clinical benefits for both patients and babies.