Assess The Effectiveness of Ambulation During First Stage of Labour on Outcome of Labour Among the Primigravida Mothers in Selected Hospital

Abstract

Background: Every year 150 million women become pregnant, but some of them do not have easy labors and have pain or even may die. Prolonged labour is one of the reasons for undergoing cesarean sections. Morbidity of cesarean section is more than normal vaginal delivery. Prolonged labour will be preventable through special care in the maternity hospital so as to encourage mothers to walk during the first stage of labour, because this action shortens the course of labour.

As per the census of India in 2016, birth rate is 19.3 births/1000 populations and death rate is 7.3 deaths/1000 populations, it indicates that there is rapid increase in India’s population. The fertility rate in India is 2.2 children born/woman. Out of 1000 mothers, 130 mothers undergo prolonged labour. With this there are many complications expected for both mother and baby, associated with prolonged labour. Hence it is necessary to prevent the prolonged labour and shorten the duration of labour by means of medical and natural techniques.

Objectives of the study

1.      To assess the effectiveness of ambulation in first stage of labour on outcome of labor among the study group

2.      To assess the routine care in first stage of labour on outcome of labour among the control group.

3.      To compare the outcome of labour among Study and control group.

Research Methodology

a) Research Approach: Quantitative

b) Research Design: Quasi experimental post test only control group

c) Setting: Selected maternity hospital

d) Population: primigravida mothers

e) Sample: Primigravida mothers with 36 weeks of gestation

f) Sampling technique: Simple random sampling

g) Sample Size: 60

h) Data collection tool: Structured observational checklist

The tool consists of 3 sections: Demographic data, Labour progress, Labour outcome.

Results

Majority of primigravida mothers among study and control group were having age between 21 -25 yrs i.e. 56.67 % and 66.67 % respectively.

56.67 % of primigravida mothers in study group are having secondary school education while 63.33 % of mothers in control group.                                                                      

93.3% of mothers among study group delivered vaginally which is higher than that of control group i.e. 83%. Only 6.6 % of mothers had undergone instrumental delivery in study group which is lower than that of control group i.e. 16.6%. 13.3% of mothers among study group are augmented with oxytocin drip which is significantly lower than that of control group i.e. 56.6% as P<0.0001.

Only 6.6 % of primigravida mothers among study group were >14 hrs of 1^st stage of labor while 80 % of mothers among control group, which is significantly higher than that of study group as P<0.0001.

Only 13.3 % of primigravida mothers were duration of 2^nd stage of labor is more than 2 hrs in study group which is significantly lower than that of control group i.e. 66.6 % as P<0.0001.

Only 6.6 % of mothers delivered with complications in study group, while 20% of mothers delivered with complications in control group, which is not statistical significant as P>0.05.

Only 3.3 % of fetus delivered with complication among study group and 16.6 % of fetus delivered with complication among control group, which is not statistical significant as P>0.05.

Conclusion: Only 6.6 % of primigravida mothers among study group were >14 hrs of 1^st stage of labor while 80 % of mothers among control group, which is significantly higher than that of study group as P<0.0001. So ambulation can be used to improve the outcome of labor in terms of duration of labor, maternal outcome and fetal outcome. Also it is a cost effective intervention which the nurse can implement independently.