The Effectiveness of the Applications Made in Line With the Algorithm for Coping With Labor Pain
Condition: Labor Pain
MeSH terms: Labor Pain
Study type: Interventional

Summary: 
      Although labor pain is a physiological and natural process, when the woman cannot cope with
      labor pain, the health of the mother and fetus is negatively affected. These negative effects
      mostly focus on the respiratory system, cardiovascular system, neuroendocrine and limbic
      system. During birth, the mother becomes exhausted due to pain and has to use all her energy
      to cope with the pain.When the mother can effectively cope with the pain of labor, she starts
      motherhood with a positive experience, experiences the happiness of actively participating in
      the birth of the baby, can participate in practices with health professionals, and the
      problems that can be seen in the newborn are reduced because there is no need for medication.
      In this respect, it is extremely important for the mother, baby and family to end the birth
      process in the best possible way. For this reason, nursing care includes emotional, physical,
      spiritual and psychosocial continuous birth support and coping with the pain of labor. In
      this direction, the "algorithm for coping with labor pain" developed includes the
      interventions that should be done to cope with the pain in labor.
    

Detailed description: 
      Pain is defined as an unpleasant emotional sensation originating from a certain part of the
      body, often related to tissue damage, and related to the past experiences of the person.
      Labor pain is an experience that is a part of a natural process, takes place in a limited
      time, and is perceived and experienced differently by every woman. Physiological changes
      during labor such as maternal age, parity, weight of mother and baby, position of the fetus,
      anatomical structure of the pelvis, cervical dilatation and uterine contractions;
      psychological factors such as perception of threats to the body or soul, culture, ethnicity,
      anxiety, loneliness, loss of control, fear that a painful or painful event will occur,
      anxiety that the baby or himself may be harmed, previous pain experiences and healthcare
      professionals' communication with the pregnant woman Environmental factors such as noise,
      lighting, and birth pain significantly affect the pregnant woman's coping with labor pain.

      Although labor pain is a physiological and natural process, when the woman cannot cope with
      labor pain, the health of the mother and fetus is adversely affected. These negative effects
      mostly focus on the respiratory system, cardiovascular system, neuroendocrine and limbic
      system. During birth, the mother becomes exhausted due to pain and has to use all her energy
      to cope with the pain. When the mother cannot cope, she becomes tired, and her oxygen
      requirement, blood pressure and cardiac out-put increase. Fear and anxiety caused by labor
      pain increase the release of stress hormones such as adrenaline, noradrenaline and
      corticosteroid. These hormones reduce the blood flow to the uterus and cause distress in the
      fetus by reducing the amount of oxygen in the placental flow. In addition, due to the
      increased adrenaline, it causes a decrease in the amount of oxytocin during delivery. This
      causes prolongation of labor and more bleeding. At the same time, when the woman is able to
      cope with labor pain, the formation of tetany in the pregnant woman is prevented by
      preventing hyper ventilation and hypocapnia formation.

      When the mother can effectively cope with the pain of labor, she starts motherhood with a
      positive experience, experiences the happiness of actively participating in the birth of the
      baby, can participate in practices with health professionals, and the problems that may be
      seen in the newborn are reduced since there is no need for medication. In this respect, it is
      extremely important for the mother, baby and family to end the birth process in the best
      possible way. For this reason, nursing care includes emotional, physical, spiritual and
      psychosocial continuous birth support and coping with the pain of labor. Providing
      non-pharmacological pain relief methods such as relaxation and breathing exercises, massage,
      positioning, therapeutic communication, listening to music, hot-cold application, partner and
      family support, providing home environment is associated with a positive birth experience.
      Accordingly, the "algorithm for coping with labor pain" developed by Roberts et al. (2010)
      includes the interventions that should be done to cope with the pain at birth. The algorithm
      for coping with labor pain has two branches. One is the arm that shows pregnant ways of
      coping with pain, such as rhythmic activity, deep breathing, inner focus, relaxation between
      contractions, which gives clues to healthcare professionals; Another is the arm that enables
      the evaluation of the findings that show that the woman cannot cope with labor pain such as
      clenching her teeth, crying, and inability to focus. According to the algorithm, when a woman
      can cope with labor pain, there is no need to do any intervention. However, when the woman
      cannot cope with labor pain, it is easier for the woman to cope with labor pain with holistic
      birth support strategies such as providing physical comfort, emotional comfort, informative
      support and advocacy.
    

Intervention name(s): holistic birth support strategies
Intervention type(s): Other
Intervention description(s): Holistic Birth Support Strategies are composed of birth-supporting practices that were created by Horn and D'Angelo (2017) within the scope of the "Algorithm for Coping with Birth Pain" and recommended for coping with labor pain. Holistic Birth Support Strategies; It includes four parameters: physical comfort, emotional comfort, informative support and advocacy.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: The study was planned as a single center stratified block parallel group randomized controlled experimental study.
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: coping with labor pain; birth satisfaction; fear of birth