Relationship between behavioral indices of pain during labor pain with pain intensity and duration of delivery

Authors

  • Atiyeh Vatanchi Assistant Professor ofObstetrics andGynecology, Department ofObstetrics andGynecology, Faculty of Medicine,Mashhad University of Medical Sciences (MUMS), Mashhad, Iran

Keywords:

Coping behavior, Labor pain, Pain intensity

Abstract

Background: Certain behaviors can be adopted by women to cope with labor pain according to their individual characteristics, which are currently called behavioral indicators during labor pain, and include facial expressions, verbal expressions, tone of voice, body movements, degree of relaxation, and respiratory system functioning during delivery. Moreover, severity of pain and duration of labor can vary due to several factors including individual characteristics. Objective: The purpose of the present study was to determine the relationship between behavioral indicators during labor pain, severity of pain, and delivery duration.  Methods: In this cross-sectional study, 120 low risk pregnant women who referred to Omolbanin (AS) Hospital in the city of Mashhad (Iran) for delivery in 2014, were selected via convenience sampling method, which was then followed by completion of demographic information forms. From cervical dilatation of 3-5 centimeters until delivery, the Labor Pain Coping Behavior Observation Form (comprised of 6 sub-groups of facial expressions, verbal expressions, tone of voice, body movements, degree of relaxation, and respiratory function and severity and duration of pain) was completed during uterine contractions and every half an hour. Using the Inventory of Labor Information; vital signs, frequency of contractions, and duration of the first and second stages of labor were measured. Furthermore, the content validity of the questionnaire was determined and its reliability was confirmed by Cronbach’s alpha method. Then, the data were analyzed using the SPSS version 16, through Pearson Product-Moment Correlation and Spearman’s Rank-Order Correlation, Kruskal-Wallis test, and ANOVA.   Results: According to the results, 16.2% of the individuals had undesirable behavioral indicators during labor pain, 50% of them were endowed with acceptable behaviors, and 33.8% of these women had desirable behaviors. The findings also revealed that the duration of the active phase of the first stage of labor (p˂0.001 and r=-0.453), the duration of the second stage of labor (p˂0.012 and r=-0.146), and the severity of pain (p˂0.001 and r=-0.450) were significantly and inversely correlated with behavioral indicators during labor pain; i.e. an increase in the mean score of behavioral indicators during labor pain could lead to a decline in the duration of stages of labor and severity of pain. Conclusion: It was concluded that behaviors demonstrated by women in labor had effects on their pains in the course of delivery, and there was also a relationship between the duration of stages of labor and its severity of pain. Therefore, it was recommended to turn attention to behaviors by women in labor in order to achieve a desirable clinical management.

References

Ghanjavi A, Paghande T, Ebrahimi Nejad Gh. The Quality and Intensity of Labor Pain Based on Mc GillPain Questionnaire in Parturient Women Admitted in the Maternity Ward of Afzalipour Hospital inKerman. J Kerman Univ Med Sci. 2010; 18(2): 164.2)Golmakani N, Hashemi Asl M, Sadjadi A, Ebrahimzade S. Relationship between Happiness duringPregnancy, and labor Pain Coping Behaviors. Evidence based care. 2012; 2(2): 87-95.3)Roohani Mashhadi S. Effects of SP6 Acupressure on Labor Pain During First Stage of Labor at 17Shahrivar Hospital in Mashhad in 2005-2006. A Thesis presented for the Master of Science Degree inMidwifery: School of Nursing & Midwifery of Mashhad. 2006.4)Gholyan Sh, Nikkhah E, Mehran A, Vasegh F. Effect of relaxation based on meditationtechnique on painand length of active phase in nulliparous women. Journal of Nursing and Midwifery University of Tehran(hayat). 2006; 12(3): 51-61.5)Jafari E, Mohebi P, Sedaghatpisheh T, Mazloomzadeh S. Comparison of Personal Control and Its RelatedFactors, Pain and Labor Outcomes in Physiological and Routine Childbirth Groups. Rafsanjan Univ MedSci. 2015; 14(12): 1033-48.6)Tampawiboon K. Effect of Childbirth Preparation on Fear, labor Pain Coping Behaviors and ChildbirthSatisfaction in Primiparas. Master’s Thesis. Mahdioluniversity in Tailand. 2005.7)Heidarpour S, Zare E, Mehrabi E, Heidarpour F, Kolivand M. Comparison of primipara’s womenperception of pain, fear and anxiety of vaginal delivery among Persian, Kurdish and Turkish women.Journal of clinical research in paramedical sciences (JCRPS). 2015; 4(3): 223-30.8)Asghari Moghaddam M, Gholak N. Role of Coping strategies with pain in coping with chronic pain.Daneshvarraftar. 2005; 12(10): 1-23.9)Mirzai A. The Effect of Communication Skills Training on Nursing Students Coping Strategies in StressfulSituations of Clinical Courses. A Thesis Presented for the Master of Science Degree in Nursing: School ofNursing &Midwifery of Mashhad. 2009.10)Brunner Lillian Shultis. Pain Treatment, Health Check, Critical Thinking, Ethical Decision And theNursing Process (Brunnere&Suddarth). SamiPuran. Tehran: Boshra; 2014; 18-9.

Kushan M, Vaghei S. Psychiatric Nursing (Mental Health1). Tehran. AndisheRafia Publisher. 2007; 91-3.12)Kamali S, Ahmari H, Mohammadalizade S, Jafari E. Effect of supportive behaviors on the process of laborin nulliparouswomen. Qom University of Medical Sciences. 2010; 4(2): 1-14.13)Khorsandy M, Ghofranipur F, Heidarnia A, Faghihzade S, Akbarzade A, Vafai M. Self-efficacy for Laborand Childbirth in Pregnant Women. Medical Council of Islamic Republic of Iran. 2008; 26(1): 89-95.14)Rastegari L, Mohebbi P, Mazlomzadeh S. The Effect of Childbirth Preparation Training Classes onPerceived Self-efficacy in Delivery of Pregnant Women. Zanjan Univ Med Sci. 2013; 21(86): 105-15.15)Abushaikha LA. Methods of Coping with Labor Pain Used byJordanian Women. J Transcult Nurs. 2007;18(1): 35-40. doi: 10.1177/1043659606294194. PMID: 17202527.16)Dadipur S, Madani A, Alavi A, Rouzbeh N, Moradabadi A. A Survey of Growing Cesarean Rate in Iranand the World: Review Article. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2016; 19(27):8-17.17)Sodsang W. The Effects of Nursing Support During Labour on Labour Pain Coping Behaviours and thePerception of Childbirth Experience of First-time Mothers. Master’s Thesis. Mahdioluniversity in Tailand;2005.18)Sindamrong S. Marital Relationship, Self-efficacy in Labor Pain Coping. And Pain Coping BehaviorDuring Labor of the First Time Mothers. Master’s Thesis. Mahdioluniversity in Tailand; 200419)Pirdel M, Kamifard M, Bani S, Ghoujazadeh M. Comparisonof labor pain and effective factors on laborpain perception in primiparous and multiparous women Referring to Alzahra Tabriz Medical Center. TabrizNursing and Midwifery Journal. 2006; 5: 37-46.20)Houshmandi S, Dolatian M, Kamifard M, Ghoujazadeh M. Comparison of the labor pain intensity and thefactors affecting its perception amongnulliparous and multiparous womeninpublicand privatehospital.Medical Journal of Tabriz Medical University. 2012; 34(3): 117-21.21)Golmakani N, Hashemiasl M, Sadjadi A. survey of Related factor with labor pain coping behaviors. TheIranian Journal of Obstetrics, Gynecology and Infertility. 2012; 15(24): 17-25.22)Forud A, Mahdipur S. Effect of breathing patterns and massage onAttitude and Intensity of pain innulliparous women. Shahrkord University of Medical Sciences. 2005; 7(4): 70-7.23)Aliakbari S, Jamalian R, Khohan Sh, Valai N. Impact of childbirth preparation on labor pain and Length ofdelivery time. Journal of Feiz. 2001; 15: 45.24)Rezai S, Afsharnejad T, Kafi M, Soltani R, Fallahkohan S. Relationship between depression and copingstrategy with chronic back pain: a controlled study of pain intensity and duration. Bimonthly science–Research of Shahed University (Daneshvarraftar). 2009; 16(81): 63-74.

Published

2021-12-24