Assessment the several types of pain in the first stage of labor: the effect of mother's selected positions

ABSTRACT

Attention to labor pain and its sedation are important parts of maternity care. Mother positioning seems to be effective in pain intensity and positions that women choose in order to become more comfortable are often those that tend to promote the baby's progress through the birth canal. Women often describe less pain when the fetus and pelvis are better aligned. This study investigated the effects of mother's selected positions on the intensity of several types of pain in the first stage of labor. This is a clinical trial on 68 pregnant women with singleton fetus in vertex presentation, 38-42 weeks gestational age and normal labor progress at Zeinab hospital in Mashad in 2004-5. They were randomly allocated to selective positions group and routine positions group. Mothers in selective positions group changed position as they wished while mothers in routine positions group were cared in bed. Pain intensity of low back and abdomen were measured hourly by visual analog scale. Data were gathered by using forms of interview and observation, and visual analog scale and analyzed in SPSS using Student t-test, Chi-square, Mann-whitney and Fisher's exact test. Scores of total pain [average of low back pain and abdominal pain] arid low back pain were significantly lower for the selective positions group than those for the routine positions group [p=0.007 and p<0.001 respectively]. Score of abdominal pain was the same in both groups. In accordance with time and location, the mean score of low back pain between contractions was significantly lower for the selective positions group than that for the routine positions group [p<0.001]. This study showed that in the active phase of the first stage of labor, mother's selective positions reduce intensity of low back pain between contractions. Therefore using alternative positions are simple and cost effective methods that reduce labor pain