Effects of a pushing intervention on pain, fatigue and birthing experiences among Taiwanese women during the second stage of labour.

OBJECTIVES

To evaluate maternal labour pain, fatigue, duration of the second stage of labour, the women's bearing-down experiences and the newborn infant Apgar scores when spontaneous pushing is used in an upright position.

DESIGN

Quasi-experimental study.

SETTING

Medical centre in Taichung, Taiwan.

PARTICIPANTS

66 Women giving birth at the hospital, with 33 primigravidas assigned to each group.

INTERVENTIONS

During the second stage of labour, the women in the experimental group pushed from an upright position and were given support to push spontaneously; the women in the control group pushed from a supine position and were supported via Valsalva pushing.

OUTCOME MEASURES

Pain scores were recorded at two evaluation time points: at 10 cm of cervical dilation and one hour after the first pain score evaluation. One to four hours after childbirth, the trained nurses collected the fatigue and pushing experience scores.

FINDINGS

The women in the experimental group had a lower pain index (5.67 versus 7.15, p = 0.01), lower feelings of fatigue post birth (53.91 versus 69.39, p < 0.001), a shorter duration of the second stage of labour (91.0 versus 145.97, p = 0.02) and more positive labour experiences (39.88 versus 29.64, p < 0.001) compared with the control group. There was no significant difference in the Apgar score for newborn infants during either the first minute (7.70 versus 7.73, p = 0.72) or the fifth minute (8.91 versus 8.94, p = 0.64).

KEY CONCLUSIONS

The pushing intervention during the second stage of labour lessened pain and fatigue, shortened the pushing time and enhanced the pushing experience.

IMPLICATIONS FOR PRACTICE

Pushing interventions can yield increased satisfaction levels for women giving birth.