A quasi-experimental study to assess the effectiveness of slow-paced breathing exercise on Labor pain perception during first stage of Labor among primi gravid women in a selected Hospital of Dehradun

Labor pain can be quite painful for women and is caused by cervical dilatation and uterine contractions. To manage a woman in Labour, obstetricians and midwives, who are health care protectors, must provide contemporary maternity services. Most women have a difficult time giving birth, and in many cases, analgesia is required to ease the pain. For pain alleviation, there are numerous pharmacological and non-pharmacological methods. However, there could be adverse effects from these medication therapies. Breathing deeply and slowly during the early stages of labour can help the woman maintain her composure and save energy for the later, more intense stages. Slow-paced breathing exercises are a fundamental part of several childbirth preparation techniques, these workouts entail taking deep, deliberate breaths that are longer than usual. This technique aids in triggering the parasympathetic nervous system, which calms the body and inhibits the stress reaction. Because stress hormones like adrenaline can otherwise intensify pain perception and prolong labour, slow breathing thereby lowers their production. Recent studies show that by strengthening the psycho-emotional and spiritual aspects of care, the non-pharmacological approach reduces suffering. Making the pain go away is not the main objective of this approach. Instead, the woman's caregivers, childbirth educators, and support staff educate and help her to actively participate in decision-making and use non- pharmacological and self-comforting approaches to reduce discomfort and speed up the Labor process.

 

Objectives:

1.           Assess the level of Labor pain perception of primi gravid women among experimental and control group in terms of pretest.

2.           Evaluate the effectiveness of slow-paced breathing exercises on Labor pain perception by comparing the post-test level pain perception among experimental and control group.

3.           Find out the association between the pretest score with selected demographic variable.

 

TABLE-1 Classification of Respondents on Pretest Labor Pain Perception Levels among Experimental and Control group

NS: Non- significant, χ 2 (0.05, 1df) = 3.841

Table 1 shows the comparison of respondents’ pre-test labour pain perception levels between the experimental and control groups. In the experimental group, none of the respondents (0%) reported mild pain, 8 respondents (26.7%) experienced moderate pain, and the majority, 22 respondents (73.3%), reported severe pain. In the control group, none of the respondents (0%) reported mild pain, 3 respondents (10.0%) experienced moderate pain, and the majority, 27 respondents (90.0%), reported severe pain. The chi-square test value (χ² = 2.78, p > 0.05) indicated that the difference in pre-test Labor pain perception between the two groups was statistically non-significant.

TABLE-2 Aspect wise pretest Labor Pain Perception Scores among Experimental and Control Group

N=60

NS: Non-significant, t (0.05, 58df) = 1.96

Table 2 shows the comparison of mean pre-test labor pain perception scores between the experimental and control groups. In the experimental group (n = 30), the mean score was 7.13 with a standard deviation of 0.82, whereas in the control group (n = 30), the mean score was 7.17 with a standard deviation of 0.59. The independent t-test value (t = 0.38, p > 0.05) indicated that there was no statistically significant difference in pre-test labor pain perception scores between the two groups, showing that both groups were comparable before the intervention.

TABLE – 3 Overall Pre-test and Post test Mean Labor Pain Perception Scores among Experimental group

* Significant at 5% level, t (0.05, 29 df) = 2.045

Table 3 presents the comparison of mean labour pain perception scores of the experimental group before and after the intervention. The maximum possible score was 10.

In the pre-test, the mean pain score was 7.13 (SD = 0.82) with a mean percentage of 71.3%, indicating higher pain levels before the intervention. In the post-test, the mean pain score reduced to 5.07 (SD=1.64) with a mean percentage of 50.7%. The calculated enhancement (reduction in pain) was 2.07 points.

TABLE –4 Overall Pretest and Post test Mean Labor Pain Perception Scores among Control group

N=30

NS: Non-significant, t (0.05, 29 df) = 2.045

Table 4 shows the comparison of mean labour pain perception scores in the control group before and after the intervention period. The maximum possible score was 10.

 

In the pre-test, the mean pain score was 7.17 (SD=0.59) with a mean percentage of 71.7%. In the post-test, the mean pain score was 7.13 (SD = 0.63) with a mean percentage of 71.3%. The calculated enhancement (reduction) in pain score was only 0.03 points, corresponding to 0.3% improvement. The paired ‘t’ test value (t = 0.91) was not significant at the 0.05 level, indicating there was no meaningful change in pain levels from pe-test to post-test in the control group.

 

Description of level of labour pain perception of primi gravid women among experimental group and control group in terms of pretest. The distribution of respondents according to their pretest perception score in experimental group. 22 respondents experienced 73.3% severe pain. 8 respondents experienced 26.7% moderate pain. Based on the findings, Hypothesis (H1) was accepted.

 

Distribution of respondents according to their pre-test labour pain perception scores in the control group. The majority, 27 respondents (90.0%), reported severe pain. while 3 respondents (10.0%) experienced moderate pain. Based on the findings, Hypothesis (H◻) was rejected and Hypothesis (H◻) was accepted.

 

Tiwari V, Kumar V. Anu (2023) – A Quasi experimental study conducted in Madhya Pradesh. The sample size was 60 (30 experimental and 30 control group) and was drawn through purposive sampling technique. The level of labour pain perception was assessed by using Numeric pain rating scale. Slow paced breathing was instructed to practice during contractions for 2 hours during active phase for experimental group. Pre-test was assessed before intervention and Post test done after intervention for both groups. The mean post-test score on level of pain perception during first stage of labour in experimental group was 1.6, but in control group it was 2.5. The calculated unpaired„ t‟ value was 5.92, which is more than the table value at 5% significance (table value=2.02). Hence, it was statistically significant at 5% (p<0.05). It shows that slow paced breathing is effective in reduction of pain perception during first stage of labour.

 

Description of post-test labour pain perception score among experimental group. In the pre-test, 9 respondents (30%) experienced severe pain, 21 respondents (70%) reported moderate pain, and none reported mild pain. After the intervention, in the post-test, the pain distribution shifted—5 respondents (16.6%) reported severe pain, 14 respondents (46.7%) reported moderate pain, and 11 respondents (36.7%) reported mild pain. The calculated chi- square value (χ² = 13.54) was higher than the table value (χ² = 5.991, df = 2) at 0.05 level of significance. the paired t test value (t= 9.95), This indicates a statistically significant reduction in labour pain perception levels after the intervention. Therefore, Hypothesis (H3) was accepted.

 

Tiwari and Kumar (2023)- Conducted quasi-experimental research at the Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences (AIIMS), Bhopal, and assessed the effectiveness of slow-paced breathing exercises on labour pain perception among primigravida mothers. involved 60 participants, divided into experimental and control groups. The experimental group practiced slow-paced breathing exercises during contractions, while the control group received standard care. Pain perception was measured using the Numeric Pain Rating Scale before and after the intervention. The results indicated a significant reduction in pain perception in the experimental group, with a mean post-test score of 1.6 compared to 2.5 in the control group. Statistical analysis revealed a t-value of 5.92, which was greater than the critical value at a 5% significance level, confirming the effectiveness of slow-paced breathing in reducing labour pain perception.

The study concluded that both experimental and control group were comparable in their demographic and obstetric characteristics during the pretest. Slow-paced breathing exercises were found to be highly effective in reducing the labour pain perception among primi gravid women, as the experimental group reported significantly lower pain scores post intervention, while no meaningful changes was observed in the control group. The association between pretest pain scores and selected demographic variables was not significant, indicating sample homogeneity. Overall, the finding suggest that slow-paced breathing is a simple, safe and non-pharma logical intervention that can be effectively incorporated into maternity care to minimize labour pain and enhance maternal comfort.

Conflict of interest:

None

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