The Effect of Shower on Birth Pain, Postpartum Fatigue and Comfort

Kırklareli University

Status: Completed

Conditions: Fatigue; Pain

Treatments: Other: hydrotherapy group

Study type: Interventional

Funder types: Other

Identifiers

NCT06183957

KırklareliAS-9

Details and patient eligibility

About

According to the definition of the International Association for the Study of Pain, pain; It is an unpleasant sensory and emotional sensation and behavior related to the individual's past experiences, caused by real or potential tissue damage originating from any part of the body. Birth pain is the most severe pain experience known and defined, with physiological as well as psychological and sociocultural components that may vary among individuals.Pharmacological and non-pharmacological applications are used to relieve birth pain. While pharmacological methods reduce pain, they distract women from the physiological reality of birth and prevent women from accepting pain as a natural part of birth. Non-pharmacological methods are alternative options that will help women manage pain during birth by ensuring that women experience pain.

Showering (hydrotherapy), one of the non-pharmacological methods used to reduce pain in labor, is used to increase relaxation and reduce birth pain. In a study conducted domestically, it was stated that the use of hydrotherapy during labor pain helped the woman relax, reduced the pain felt, lowered blood pressure and increased diuresis. Fatigue, in addition to being a universal symptom associated with diseases, is also a common complaint among healthy individuals.

In line with the literature information, this study aims to examine the effect of shower applied during birth on postpartum fatigue and postpartum comfort.

Full description

According to the definition of the International Association for the Study of Pain, pain; It is an unpleasant sensory and emotional sensation and behavior related to the individual's past experiences, caused by real or potential tissue damage originating from any part of the body. Birth pain is the most severe pain experience known and defined, with physiological as well as psychological and sociocultural components that may vary among individuals. Physiological components; The pressure on the tissues of the birth canal and the stretching of the tissues are psychosocial components; It is related to fear, anxiety and coping ability during the birth process. The individual's response to pain with cultural values and learned behaviors constitutes the sociocultural dimension of pain. In addition to these known characteristics of labor pain, the degree of pain varies according to the frequency, duration and intensity of contractions and the cervical opening. The American Society of Obstetrics and Gynecology states that labor pain should be treated and that it may have negative effects on maternal and neonatal health in cases where the pregnant woman has difficulty coping with labor pain.

Pharmacological and non-pharmacological applications are used to relieve birth pain. While pharmacological methods reduce pain, they distract women from the physiological reality of birth and prevent women from accepting pain as a natural part of birth. Non-pharmacological methods are alternative options that will help women manage pain during birth by ensuring that women experience pain. The World Health Organization (WHO) recommends the use of non-pharmacological methods such as massage and touching, distraction and imagination, movement and position, music, making sounds and praying, aromatherapy, hydrotherapy, acupressure, hot and cold applications in labor pain.

Showering (hydrotherapy), one of the non-pharmacological methods used to reduce pain in labor, is used to increase relaxation and reduce birth pain. In a study conducted domestically, it was stated that the use of hydrotherapy during labor pain helped the woman relax, reduced the pain felt, lowered blood pressure and increased diuresis. The use of water during labor and regular feeding of the uterus in the first stage of labor has helped to feel less pain during contractions and to have shorter and less invasive births.

Fatigue, in addition to being a universal symptom associated with diseases, is also a common complaint among healthy individuals. The North American Nursing Diagnosis Association (NANDA) defines fatigue as "a predominant, persistent feeling of exhaustion and a decrease in normal physical and mental working capacity". defines. Symptoms of fatigue; Inability to carry out daily tasks, impaired concentration, difficulty in remembering, short-term memory loss, indifference to the environment, decreased awareness, lack of energy, fatigue, difficulty in making decisions, muscle weakness, increased physical complaints, emotional changes, tendency to sleep, hallucinations, perceptual weakness. is suffering.

Fatigue is a common symptom during pregnancy, birth and the postpartum period. In addition to being a very special, happy experience for women, birth also means coping with physical pain and difficulties and fatigue due to insomnia. With the birth, the six-week period begins, called the postpartum period, during which the woman feels social, physical and psychological changes. This process is a woman's; It is a difficult period in which all systems and organs in the body return to their pre-pregnancy state, the woman tries to adapt to the new roles and responsibilities acquired in the transition to parenthood, and many progressive and regressive changes occur in the woman's body. Fatigue, which is an inevitable part of this period, can increase until the sixth postpartum week. In the study of Kılıç et al., it was reported that 88.5% of women experienced fatigue in the postpartum period.

In line with the literature information, this study aims to examine the effect of shower applied during birth on postpartum fatigue and postpartum comfort.

Enrollment: 80 patients

Sex: Female

Ages: 20 to 35 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• -Voluntarily agreeing to participate in the study
• She will have her second birth spontaneously vaginally at term (between 37-42 weeks of pregnancy).
• The fetal weight estimated by ultrasound is 2500-4000 grams
• Single fetus and head presentation
• Being in the active phase of labor (cervical dilation 4 cm)
• Ability to establish written/verbal communication
• Not taking any analgesia or anesthesia to relieve pain and fatigue before birth and during labor.
• Newborn APGAR score is 7 or above

Exclusion criteria

• giving up on research
• Having received infertility treatment
• Birth by cesarean section
• Having an interventional birth (forceps, vacuum, episiotomy application)
• Being primiparous, having a third or more birth (grandmultiparous)
• Having any systemic, chronic and neurological disease (Diabetes Mellitus, Hypertension, Thyroid diseases, Multiple Sclerosis, Epilepsy, etc.)
• Regular use of medication due to any disease
• Receiving psychiatric treatment (pharmacotherapy/psychotherapy)
• Any induction application that will affect uterine contractions and dilation
• Having any pregnancy complications (placenta previa, preeclampsia, premature rupture of membranes, oligohydramnios and polyhydramnios, contraction anomalies, presentation disorder, intrauterine growth retardation, intrauterine dead fetus, macrosomic babies, fetal distress, etc.)
• Having any problem that prevents communication (such as not knowing Turkish, hearing, speaking and understanding impairment),

Trial design

Primary purpose: Supportive Care

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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80 participants in 2 patient groups

hydrotherapy group

Experimental group

Description:

When women in this group are taken to their labor rooms (when the dilation is 4-5cm), they should be standing or standing, depending on their preferences, on their waist, abdomen or whole body, with the temperature of the water between 32-37 °C (the temperature preferred by the woman will be applied) for at least 20 minutes. Sitting shower application will be performed under the observation of the researcher midwife. The temperature of the flowing water will be measured with a bucket and a thermometer that helps evaluate the temperature. The application will be repeated when the dilation is 6-8 cm.

Treatment:

Other: hydrotherapy group

Control group

No Intervention group

Description:

Women in this group will not undergo any treatment other than routine hospital protocol (midwifery care). Additionally, the vital signs (blood pressure, pulse) of the participants will be measured and recorded hourly by the midwife. These data will be recorded in each participant's file.