D.Cur. / Midwives are responsible to assess pain before treating it; then they should reassess the pain to evaluate the effectiveness of the interventions and plan future therapy. Accurate and objective measures of labour pain continue to be scarce and the discrepancy in labour pain perceptions between parturients and health-care providers remains challenging. Various pain measurement tools are currently in use measuring chronic and acute pain, but many problems were encountered applying these methods to the woman in labour. The charts were detailed and required too much time to complete. The aim of the study was to develop a multidimensional labour pain assessment instrument to assist clinicians and midwives with labour pain control. Objectives for developing a valid and reliable instrument to accurately measure labour pain included refinement of the labour pain assessment instrument developed from literature, testing of the refined instrument on patients during labour, compilation of a final instrument and development of guidelines on how to implement the labour pain assessment instrument in nursing practice. A descriptive and exploratory approach was used to describe, evaluate, observe, explore and assemble new knowledge on assessment and measurement of pain during the first stage of labour. Development of the instrument was addressed in the literature chapter. The research was conducted in three phases, combining qualitative and quantitative research.During phase one, the instrument was refined in two stages. Focus group interviews were conducted with members regarded as knowledgeable in the field of normal labour who evaluated the face and content validity of the instrument. The most senior people teaching Midwifery at all South African universities evaluated the face and content validity of the instrument with an open-ended questionnaire thereafter, using the Delphi technique. The analysis of the first Delphi round was compared to the focus group analysis. The instrument was altered and submitted to the Delphi experts in a second open-ended questionnaire to confirm the alterations.

Monitoring of women in labour is an important aspect of the practice of the health care professionals working in the labour ward. The pregnancy of a woman mightappear to be normal but it is not possible to predict the positive outcome of labour until the baby is born because foetal distress can occur suddenly or other problems can arise during the course of labour. Doctors need to closely monitor the progress of labour of all the women regardless of whether he pregnancy is rated low risk or not. The use of Cardiotocography (CTG) during labour thus becomes critical. In the current study the perceptions of the doctors working in labour ward units will be explored and described in order to recommend activities that could optimize the use of CTG by doctors as an intrapartum monitoring tool. A qualitative research design will be used and the data collection method will be by means of semi-structured audio-taped one-on-one interviews.

Thesis (M.S.)--University of Michigan, 1995.

Thesis (M.S.)--University of Michigan, 1995.

No description available.

No description available.

In the past decade there has been growing recognition that a sexual abuse history may manifest during health care examinations. More recently, awareness has been raised about a possible link between a history of sexual abuse and traumatic labour and birth. It is theoretically likely that the intimacy of labour and birth for women with a history of sexual abuse may trigger post-traumatic stress symptomatology. In this cross sectional study, a survey method was used to establish prevalence of sexual abuse and to measure obstetric outcomes, birth experience and birth trauma in a cohort of women who have recently given birth and to test whether there are associations between sexual abuse and birth outcomes. Eighty-five women whose 3½ to 5 year old children attend kindergarten participated. Lifetime sexual abuse was found to be a common experience for study participants. One out of every three women disclosed an experience of sexual abuse in her lifetime. A history of sexual abuse was not associated with adverse labour and birth outcomes; however women with a positive sexual abuse history were more likely to report postnatal depression. A quarter of the women had PTSD symptoms but overall, women had positive birth experiences and felt well supported. Many women are able to overcome traumatic abuse experiences and successfully cope with birth, an event that may potentially replicate the dynamics of sexual abuse. Further research is needed to identify women who may be at high risk for traumatic birth experiences. Undertaking screening for sexual abuse in the antenatal period in a safe environment may provide reassurance for women and enable identification of those women at high risk for abuse related traumatic birth experiences.

The purpose of this study is to determine the effect of childbirth preparation classes on self-efficacy in coping with labor pain in Thai primiparas. The nonprobability convenience sample consisted of sixty primiparas assigned to either a control or an experimental group (thirty in each group). In order to prevent crosscontamination, all control group data were collected before initiating enrollment of the experimental group. The control group participants received standard care and education. Participants in the experimental group attended three childbirth classes over three consecutive weeks. Data were collected at the beginning of week 1 to establish a baseline (pretest), at the end of the third class which is the end of the intervention (posttest), and at 24-48 hours after delivery (follow-up) using a demographic form, postnatal data form, and the Childbirth Self-efficacy Inventory. Overall, experimental group self-efficacy expectancy increased dramatically across three data points. In contrast, control group self-efficacy expectancy decreased dramatically across three data points. There was an interaction between time of selfefficacy expectancy measurement and group, F(1.33, 71.77) = 6.34, p < .05. Selfefficacy expectancy in the experimental group was significantly different than that of the control group, F(1, 54) = 14.66, p < .001. Outcome expectancy findings were different than self-efficacy expectancy results. Control group outcome expectancy decreased dramatically across three data points while the experimental group selfefficacy increased after the class and then decreased after the birth but was higher than baseline. There was an interaction between time of outcome expectancy measurement and group, F(1.72, 935.18) = 4.83, p < .05. Data at the follow-up or 24-48 hours after delivery revealed that only one woman from the control group received an analgesic during the birthing process. The groups did not differ in duration of labor and type of delivery. These findings indicate partial effect of childbirth preparation classes on self-efficacy in coping with labor pain. The relatively small effect size reflects the high degree of variability in issues surrounding a woman's experience of pain and measures related to self-efficacy in coping with labor pain. Additional research in this population is needed. / text

The labour pain experienced by 101 women giving birth in a Scottish hospital was assessed by the McGill Pain Questionnaire and Visual Analogue Scales during active first stage labour and post-natally. Labour pain was found to be on average severe, but not intensely negatively affective. Its intensity varied considerably and was related to parity and the duration of the first stage of labour reflecting underlying differences in levels of noxious stimulation. Other obstetric and pharmacological factors which might affect noxious stimulation were not significantly related to pain scores. Induction was related to higher,and complications of pregnancy, to lower levels of pain attributable to psychological modulation. The desirability of pregnancy, positive and accurate expectations of birth, ante-natal training and the welcomed presence of the husband at the birth were associated with significantly lower levels of labour pain, particularly of non-sensory pain. A few subjects had very minimal previous experience of pain. These subjects had the lowest levels of pain in childbirth, perhaps because they were relatively insensitive to noxious stimulation. Subjects whose previous experience of pain had been extensive had significantly lower levels of labour pain than subjects whose previous pain experience had been more limited. Subjects who had extensive experience of pain used a larger number of strategies to cope with that pain than subjects whose experience had been more moderate. They used more strategies during labour, a greater proportion of which they had used previously. The use of a number of strategies in labour, either in combination or in sequence was related to lower levels of labour pain but not to painless childbirth. So too was the use of strategies which had been previously utilised. The relationship between previous pain experience and levels of labour pain was mediated by the differential use of coping strategies.

Thesis (MMidwifery)--University of South Australia, 2001.