Birth
-
Randomized Controlled Trial Clinical Trial
Prevention of perineal trauma by perineal massage during pregnancy: a pilot study.
Although the performance of perineal massage by a woman or her partner during the last weeks of pregnancy may help to prevent perineal trauma at delivery, the technique has never been evaluated rigorously. This study examined the feasibility of a randomized, controlled trial, and more specifically assessed the participation rate, the acceptability of the intervention, and whether or not an attending physician could remain blind to participants' groups. The pilot study was a single-blinded, randomized, controlled trial. ⋯ No woman in the control group practiced massage. The attending physician was aware of the woman's group in only three instances (6.7%). Based on the results of this pilot study, a randomized, controlled trial to evaluate the efficacy of perineal massage in preventing perineal trauma at birth appears feasible.
-
This descriptive, retrospective study examined levels of self-esteem, social support, and satisfaction with prenatal care in 193 low-risk postpartal women who obtained adequate and inadequate care. The participants were drawn from a regional medical center and university teaching hospital in New Mexico. A demographic questionnaire, the Coopersmith self-esteem inventory, the personal resource questionnaire part 2, and the prenatal care satisfaction inventory were used for data collection. ⋯ Women who were likely to seek either adequate or inadequate prenatal care were those whose total family income was $10,000 to $19,999 per year and high school graduates. Statistically significant differences were found in self-esteem, social support, and satisfaction between the two groups of women. Strategies to enhance self-esteem and social support have to be developed to reach women at risk for receiving inadequate prenatal care.
-
Data on expectations and experiences of pain in labor are presented from a prospective study of over 700 women who gave birth in six maternity units in southeast England. Most women preferred to keep drug use to a minimum, even though they expected labor to be "quite" or "very" painful. The ideal of avoiding drugs was unrelated to education or social class. ⋯ In general, women tended to get what they expected. Breathing and relaxation exercises were widely used, and were most successful for those who had expected them to be so. Anxiety about the pain of labor was a strong predictor of negative experiences during labor, lack of satisfaction with the birth, and poor emotional well-being postnatally.
-
We sought to determine whether women's attitudes and concerns, confidence in ability to control pain, and practice of pain-control techniques would predict pain and coping or distress-related thought during labor. During the third trimester of their pregnancies, 115 women completed the prenatal self-evaluation inventory and measures of confidence and practice of pain-control techniques. During the latent (less than or equal to 3 cm), active (4-7 cm), and transition (greater than or equal to 7 cm) phases of labor, interviews were conducted to assess levels of pain and the content of women's cognitive activity on a continuum that ranged from coping-related thought to distress-related thought. ⋯ High scores on the Prenatal Self-Evaluation Inventory fear of pain and helplessness scale predicted high levels of distress during latent labor. Two other scales, concern for self and baby and acceptance of pregnancy, were significant predictors of pain and distress in active and transitional labor. The results suggest that, with the shift from latent to active labor, women's fundamental concerns and anxieties become manifest, and may take precedence over the skills acquired through childbirth education in moderating experienced pain and distress.