Showering During Labor
Condition: Labor Pain; Parenting; Childbirth Problems
MeSH terms: Labor Pain
Study type: Interventional

Summary: 
      The research covers the birth memory evaluation to determine the pregnancy process, the labor
      process and the changes in the perceived pain level during this process, the parenting
      behavior immediately after the birth and the process of the birth.
    

Detailed description: 
      The Effect of Showering During Labor on Perceived Birth Pain, Parenting Behavior and Birth
      Memory Labor is a natural process in which the fetus and its appendages, which are the
      product of pregnancy, are expelled from the uterus approximately 40 weeks after the last
      menstrual bleeding. Birth is a very meaningful and unique experience for the pregnant woman
      and her family. Although it results in a positive experience, they are faced with serious
      pain, discomfort and sensory situations that will force them in this process. This pain is a
      severe acute pain and differs from other types of pain due to the fact that it is a part of a
      natural process, experienced in a limited time and mother-infant relationship. In the
      literature, labor pain can be relieved by two methods: pharmacological (drugs) and
      non-pharmacological (non-drug methods). In the guide published by the World Health
      Organization (WHO) in 2018, non-pharmacological methods are recommended to be used as they
      are more reliable and less invasive. Non-pharmacological methods are generally simple,
      reliable for mother-baby health, easy to use, accessible, economical and do not require
      special training. The application of non-pharmacological methods can be safely applied by
      midwives independently, as it does not require a physician's request and has minimal side
      effects. The midwife, who decides with the pregnant woman the non-pharmacological method to
      be used in the management of labor pain, can apply this method with her own autonomy and
      ensure that the mother has a more comfortable birth process. Non-pharmacological methods
      include hot/warm bath, hydrotherapy, hot-cold application, movement, positions, breathing,
      relaxation exercises, acupuncture, TENS, yoga, massage, aromatherapy, music, hypnosis. These
      practices increase the comfort of the pregnant woman during the labor process, relieve the
      level of pain and provide a positive birth experience and positive progress in the
      mother-baby interaction. One of the non-pharmacological methods used to reduce labor pain is
      hydrotherapy/warm application. Although there is not enough evidence about the history of
      Hydrotherapy/Hot treatment, it was reported that the spa waters of Hippocrates had a
      therapeutic effect in the fifth century. The use of water in childbirth and labor started
      with Igor Charkovsky in Russia in 1970, and then it was spread in Europe under the leadership
      of Micheal Odent. Hot application causes vasodilation in peripheral blood vessels,
      oxygenation of the region, nutrition, removal of waste materials, and relaxation is
      experienced by reducing tension in the muscles. In addition, the feeling of pain decreases.
      As a result, fetal well-being increases. The positive outcome of the birth process as a
      result of a healthy and beautiful progress also affects the understanding of mother-infant
      interaction and parenting behavior in the postpartum period. Postnatal parenting behavior is
      the behavior of the mother showing that she is interested in the newborn baby, such as taking
      care of the newborn in the postpartum period, asking questions about it, smiling at the
      newborn baby or making sounds. It can be affected by various factors, the situations
      experienced during labor and the past experiences of himself/herself. In a randomized
      controlled study conducted by Tuncay (2016), it was determined that the postpartum parenting
      behavior scale average score of the pregnants in the experimental group who received
      hydrotherapy was higher, and in other words, the pregnants in the experimental group behaved
      more positively towards the newborns in the postpartum period (p=0.001). Birth also affects
      memory. A pregnant woman who has experienced a difficult and long labor in the past is more
      anxious and fearful. However, past experiences do not always have this effect on women.
      Positive experiences with pain lead to correct behavior and positive changes. The experience
      experienced with the birth of each child is different and has the potential to change a
      woman's life in every sense. In order to protect the psychological health of the woman in the
      postpartum period, it is expected that her memories of the birth will be positive in her mind
      and that she will feel positive emotions when she remembers her birth. However, some women
      experience birth as a traumatic event rather than a positive and happy event. Some may
      describe this process as negative, while others may see it as a normal process. In the
      literature review, it has been determined that there are not enough studies on birth memory
      in Turkey. As a result, it is stated in the studies that non-pharmacological methods such as
      warm shower application may be effective in the positive outcome of labor, ensuring
      mother-infant interaction, acquiring parenting behavior and positive recall of labor in the
      future. For this purpose, the study was planned to evaluate the effect of warm shower applied
      during labor on women's pain levels, postpartum parenting behavior and birth memory.
    

Intervention name(s): warm shower
Intervention type(s): Behavioral
Intervention description(s): A warm shower will be applied for 20 minutes to the pregnant woman whose cervical dilatation reaches 4-5 cm and 7-8 cm.
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: While warm showers will be used during labor in the experimental group, routine midwifery care will be applied in the control group.
Masking: Single (Outcomes Assessor)
Primary purpose: Supportive Care
Keywords: Labor Pain; Birth Memories; Parenting Behavior; Hydrotherapy