Impact of free postures combined with unprotected perineum on self-efficacy and childbirth experience in primiparas

doi:10.3877/cma.j.issn.1674-0785.2022.03.007

Abstract

Abstract:

Objective

To investigate the impact of free postures combined with unprotected perineum on self-efficacy and childbirth experience in primiparas.

Methods

A total of 125 primiparas hospitalization at Department of Obstetrics and Gynecology, Fuyang People's Hospital from July 2019 to December 2020 were selected and divided into either an experimental group (63 cases) or a control group (62 cases) using stratified randomization method. Patients in the experimental group adopted free postures combined with unprotected perineum delivery, while patients in the control group adopted the supine position combined with anal support and perineal protection in the second stage of labor. Childbirth self efficacy, perineal injury, childbirth outcome, and childbirth experience were compared between the two groups.

Results

The scores of result efficacy, expected efficacy, and childbirth self-efficacy were significantly higher in the experimental group than in the control group [(127.43±15.22) vs (116.28±13.34), (125.36±14.21) vs (112.25±13.74), and (252.79±31.32) vs (228.53±32.14); t=3.682, 5.243, and 4.274, respectively; P＜0.05 for all]. In the experimental group, the perineal integrity rate and first degree laceration rate were significantly higher than those of the control group (22.22% vs 6.45% and 52.38% vs 29.03%; χ²=6.305 and 7.053, respectively; P＜0.05 for both), but second degree laceration rate and perineal lateral incision rates were significantly lower than those of the control group (4.76% vs 17.74% and 20.63% vs 46.77%; χ²=5.294 and 9.570, respectively; P＜0.05 for both). In the experimental group, the natural delivery rate was higher than the control group (79.37% vs 58.06%, χ²=5.742, P＜0.05), the duration of the second stage of labor was shorter than that of the control group [(46.14±7.23) min vs (58.26±8.31)min, t=8.703, P＜0.05], and Apgar score of newborns was lower than that of the control group [(6.71±1.04) vs (7.86±0.92), t=6.544, P＜0.05]. In the experimental group, the scores of self-competence, professional support, safety perception, participation, and delivery experience were significantly higher than those of the control group [(25.41±4.23) vs (22.28±3.46), (20.32±2.51) vs (18.76±2.16), (18.82±3.20) vs (16.65±2.42), (17.18±2.34) vs (15.62±3.21), (81.73±10.25) vs (73.31±9.56); t=4.524, 3.722, 4.271, 3.108, and 4.748, respectively; P＜0.05 for all].

Conclusion

Free postures combined with unprotected perineum delivery can promote the development of self-efficacy during childbirth in primiparas, reduce perineal injury degree, improve childbirth outcome, and enhance childbirth experience.

Key words: Primipara, Free posture delivery, Unprotected perineum delivery, Childbirth self-efficacy, Childbirth experience

Ping Ouyang, Lingqing Shen. Impact of free postures combined with unprotected perineum on self-efficacy and childbirth experience in primiparas[J]. Chinese Journal of Clinicians(Electronic Edition), 2022, 16(03): 231-235.

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Figures/Tables 5

组别	例数	年龄（岁， $x ¯$ ±s）	孕周（周， $x ¯$ ±s）	文化程度［例（%）］			独生子女［例（%）］		居住地［例（%）］		预估胎儿体重（g， $x ¯$ ±s）
组别	例数	年龄（岁， $x ¯$ ±s）	孕周（周， $x ¯$ ±s）	初中及以下	高中或中专	大专及以上	是	否	城镇	农村	预估胎儿体重（g， $x ¯$ ±s）
试验组	63	25.43±3.25	39.32±1.14	4（6.35）	13（20.63）	46（73.02）	37（58.73）	26（41.27）	22（34.92）	41（65.08）	2 875.45±412.50
对照组	62	26.14±3.36	39.53±1.05	2（3.23）	10（16.13）	50（80.65）	42（67.74）	20（32.26）	17（27.42）	45（72.58）	2 818.14±403.36
统计值		t=1.201	t=1.071	Z=1.217			χ²=1.091		χ²=0.819		t=0.785
P值		0.231	0.436	0.228			0.424		0.635		0.658

组别	例数	年龄（岁， $x ¯$ ±s）	孕周（周， $x ¯$ ±s）	文化程度［例（%）］			独生子女［例（%）］		居住地［例（%）］		预估胎儿体重（g， $x ¯$ ±s）
组别	例数	年龄（岁， $x ¯$ ±s）	孕周（周， $x ¯$ ±s）	初中及以下	高中或中专	大专及以上	是	否	城镇	农村	预估胎儿体重（g， $x ¯$ ±s）
试验组	63	25.43±3.25	39.32±1.14	4（6.35）	13（20.63）	46（73.02）	37（58.73）	26（41.27）	22（34.92）	41（65.08）	2 875.45±412.50
对照组	62	26.14±3.36	39.53±1.05	2（3.23）	10（16.13）	50（80.65）	42（67.74）	20（32.26）	17（27.42）	45（72.58）	2 818.14±403.36
统计值		t=1.201	t=1.071	Z=1.217			χ²=1.091		χ²=0.819		t=0.785
P值		0.231	0.436	0.228			0.424		0.635		0.658

组别	例数	干预前			干预后
组别	例数	结果效能	期望效能	总分	结果效能	期望效能	总分
试验组	63	95.32±4.48	92.76±3.34	188.08±6.74	127.43±15.22^a	125.36±14.21^a	252.79±31.32^a
对照组	62	97.45±4.36	94.23±3.33	191.68±5.64	116.28±13.34^a	112.25±13.74^a	228.53±32.14^a
t值		-0.531	-0.134	-0.441	3.682	5.243	4.274
P值		0.596	0.894	0.660	0.002	＜0.001	<0.001

组别	例数	会阴完整	Ⅰ度裂伤	Ⅱ度裂伤	会阴侧切率
试验组	63	14（22.22）	33（52.38）	3（4.76）	13（20.63）
对照组	62	4（6.45）	18（29.03）	11（17.74）	29（46.77）
χ²值		6.305	7.053	5.294	9.570
P值		0.012	0.010	0.016	0.007

组别	例数	第二产程时间（min， $x ¯$ ±s）	产后2 h出血量（ml， $x ¯$ ±s）	自然分娩［例（%）］	新生儿窒息［例（%）］	新生儿Apgar评分（分， $x ¯$ ±s）
试验组	63	46.14±7.23	148.52±23.41	53（84.1）	2（3.17）	9.45±0.41
对照组	62	58.26±8.31	153.22±25.16	36（58.1）	5（8.06）	9.87±0.55
统计值		t=8.703	t=1.081	χ²=10.351	χ²=1.431	t=4.846
P值		＜0.001	0.336	＜0.001	0.095	＜0.001

组别	例数	第二产程时间（min， $x ¯$ ±s）	产后2 h出血量（ml， $x ¯$ ±s）	自然分娩［例（%）］	新生儿窒息［例（%）］	新生儿Apgar评分（分， $x ¯$ ±s）
试验组	63	46.14±7.23	148.52±23.41	53（84.1）	2（3.17）	9.45±0.41
对照组	62	58.26±8.31	153.22±25.16	36（58.1）	5（8.06）	9.87±0.55
统计值		t=8.703	t=1.081	χ²=10.351	χ²=1.431	t=4.846
P值		＜0.001	0.336	＜0.001	0.095	＜0.001

组别	例数	自身能力	专业支持	安全感知	参与性	总分
试验组	63	25.41±4.23	20.32±2.51	18.82±3.20	17.18±2.34	81.73±10.25
对照组	62	22.28±3.46	18.76±2.16	16.65±2.42	15.62±3.21	73.31±9.56
t值		4.524	3.722	4.271	3.108	4.748
P值		＜0.001	0.002	＜0.001	0.011	＜0.001

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