Meryem METİNOĞLU, Aylin Yalçın IRMAK, Sinem Albayrak KAYA

Doğumu Kolaylaştırıcı Non-Farmakolojik Yöntemlerin Bir Nullipar Gebe Vakasında Uygulanması

Doğum, bilinen en şiddetli ağrı kaynaklarından biri olarak tanımlanmakta ve bu süreçte yararlanılan farmakolojik FAKY ve non-farmakolojik NFAKY ağrı kontrol yöntemlerinden söz edilmektedir. FAKY’in, hissedilen fiziksel doğum ağrısını ortadan kaldırdığı, NFAKY ise ağrı yaşamayı önlediği vurgulanmaktadır. Bu vaka raporunda, habitual abortus hikayesi olan gebeye prenatal doğuma hazırlık eğitimi verildikten sonra doğum destekçisi tarafından NFAKY uygulanması bildirilmiştir.Vaka Raporu: Yirmi sekiz yaşındaki nullipar gebe doğuma hazırlık eğitimi ve doğum desteği için birinci yazara yönlendirilmiştir. 23 Nisan 2015 saat 00:45’te 38,2 gebelik haftasında doğum eylemi başlayan AE’nin travay ve doğum sürecine doğum destekçisi ve eşi dahil olmuştur. Doğum sürecinde bazı NFAKY loş ortam, müzik, tamamlayıcı sıvı ve gıdalar, aktif doğum pozisyonları, aromaterapi, akubası, buz kesesi, masaj, duş, ıslak sıcak uygulama, solunum egzersizleri kullanılmıştır.Sonuç ve Öneriler: Doğumda yapılan uygulamaların; gebenin anksiyetesinin giderilmesi, hissedilen ağrı düzeyinin hafifletilmesi, perinede hissettiği baskının azaltılması ve kontraksiyonların indüklenmesinde dikkate değer etkisi görülmüştür. Gebenin doğumdan memnuniyeti yüksek olarak belirlenmiştir. Bu vaka sonuçları ışığında benzer özellikleri taşıyan gebelerde mümkün olduğunca doğuma hazırlık eğitimlerinin ve doğum destekçisi eşliğinde NFAKY kullanımının yaygınlaştırılması önerilmektedir

Implementation of Of Non-Pharmacological Birth Facilitator Methods On a Nulliparous Pregnance Case

Giving birth is one of the most severe pain inducing experiences with both pharmacological PPCT and nonpharmacological pain control methods NPPCT used during the process of delivery. In this case report, NPPCT’s implementation was reported by the birth supporter after prenatal preparation and training for birth was given to a pregnant woman who wanted a normal delivery and had a history of premature spontaneous abortions.Case Report: The 28-year-old nullipar was directed to the first author of this article for prenatal training and birth support. On April 23, 2015 at 00:45, week 38.2 of gestation the birth began, and AE’s labor and birth process is attended by a birth attendant and her husband. NPPCT dim light, music, complementary liquids and foods, active birth positions, aromatherapy, acupressure, ice bags, massage, shower, wet hot applications, and breathing exercises were used during labor and birth process .Conclusions and Recommendations: Applications at birth had considerable effects on reducing the anxiety of the pregnant woman, relieving the level of pain felt, reducing perineal pressure, and inducing contractions. Intrapartum birth satisfaction of pregnant woman was found to be high. In the light of these results, it is recommended that the use of NPPCT assisted by birth supporters should be promoted as much as possible in the case of pregnancies with similar characteristics in preparations for birth

Keywords:

non-pharmacological pain control methods, natural childbirth, labor pain, doulas prenatal education, pregnant, psychosocial support systems,

PDF

___

1. Niven C, Murphy-Black T. Memory for labor pain: a review of the literature. Birth 2000;27:244–53. 2. Melzack R, Taenzer P, Feldman P, Kinch RA. Labour is still painful after prepared childbirth training. Can Med Assoc J 1981;125:357–63.

3. Kömürcü N. Doğum Ağrısı ve Yönetimi. İstanbul: Nobel Tıp Kitabevi; 2013. p.22–37.

4. Lowe NK. The nature of labor pain. Am J Obstet Gynecol 2002;186:S16–24.

5. Ralph WY, John SM. Obstetric analgesia and anesthesia. In: Decherney AH, Nathan L, editors. Current Obstetric & Gynaecologic Diagnosis and Treatment, 9th ed. Sydney: Lange Medical Books / McGraw-Hill; 2003. p.1242–94.

6. Brownridge P. The nature and consequences of childbirth pain. Eur J Obstet Gynecol Reprod Biol 1995;59:S9–15.

7. Jones L, Othman M, Dowswell T, Alfirevic Z, Gates S, Newburn M, et al. Pain management for women in labour: an overview of systematic reviews. Cochrane Database Syst Rev 2012;(3):CD009234. doi: 10.1002/14651858.CD009234.pub2

8. Gibson E. Women’s expectations and experiences with labour pain in medical and midwifery models of birth in the United States. Women and Birth 2014;27:185–9. doi: 10.1016/j.wombi.2014.05.002

9. Mongan MF. Hypnobirthing Mongan Yöntemi / Daha Kolay Daha Rahat Güvenli Bir Doğuma Doğal Bir Yaklaşım, 2. Basım. Çeviri editörü: Çoker H. İstanbul: Gün Yayıncılık; 2013. p.29–30.

10. Saisto T, Salmela-Aro K, Nurmi JE, Halmesmaki E. Psychosocial predictors of disappointment with delivery and puerperal depression. A longitudinal study. Acta Obstet Gynecol Scand 2001;80:39–45.

11. ACOG Committee on Ethics. ACOG Committee Opinion. Number 294, May 2004. At-risk drinking and illicit drug use: ethical issues in obstetric and gynecologic practice. Obstet Gynecol 2004;103:1021–31.

12. National Collaborating Centre for Women’s and Children’s Health (UK). Intrapartum Care: Care of Healthy Women and Their Babies During Childbirth. London: RCOG Press; 2007.

13. Romano AM, Lothian JA. Promoting, protecting, and supporting normal birth: a look at the evidence. J Obstet Gynecol Neonatal Nurs 2008;37:94–105. doi: 10.1111/j.1552-6909.2007.00210.x

14. Einarsdóttir K, Haggar F, Pereira G, Leonard H, de Klerk N, Stanley FJ, et al. Role of public and private funding in the rising caesarean section rate: a cohort study. BMJ Open 2013;3:e002789. doi: 10.1136/ bmjopen-2013-002789

15. Almushait M, Ghani RA. Perception toward non-pharmacological strategies in relieving labor pain: an analytical descriptive study. Journal of Natural Sciences Research 2014;4:5–12.

16. World Health Organization, Maternal and Newborn Health/Safe Motherhood Unit. Care in normal birth: a practical guide. 1996;34–7. http://apps.who.int/iris/bitstream/10665/63167/1/WHO_FRH_ MSM_96.24.pdf Erişim Tarihi: 26.11.2015

17. Rathfisch G. Doğal doğum felsefesi. Milyonlarca Yıldır Gerçekleşen Serüven. İstanbul: Nobel Tıp Kitabevi; 2012. p.21–32, 147–53.

18. Korukcu O, Kukulu K, Firat MZ. The reliability and validity of the Turkish version of the WIJMA delivery expectancy/experience questionnaire with pregnant women. J Psychiatr Ment Health Nurs 2008;19:193–202. doi: 10.1111/j.1365-2850.2011.01694.x

19. Rathfisch G. Gebelikten Anneliğe Yoga. Ebeveyliğe Bedensel, Zihinsel ve Ruhsal Hazırlık. İstanbul: Nobel Tıp Kitabevi; 2015. p.268–82.

20. Kennedy DO, Little W, Haskell CF, Scholey AB. Anxiolyticeffects of a combination of Melissa ofcinalis and Valeriana ofcinalis during laboratory induced stress. Phytother Res 2006;20:96–102. doi: 10.1002/ptr.1787

21. Arslan H. Doğum eylemi. İçinde: Coşkun AM, editör. Kadın Sağlığı ve Hastalıkları Hemşireliği El Kitabı. İstanbul: Koç Üniversitesi Yayınları; 2015. s.195–213.

22. Berkiten Ergin A. Doğum ve doğumun tarihçesi. İçinde: Kömürcü N, editör. Doğum Ağrısı ve Yönetimi. İstanbul: Nobel Tıp Kitabevi; 2013. s.2–19.

23. Okumuş H. Doğum Başlıyor: Normal Doğum ve Bilmeniz Gerekenler. İçinde: Okumuş H, Mete S, editörler. Anne Babalar için Doğuma Hazırlık. İstanbul: Deomed Yayıncılık; 2014. s.89–97.

24. Dugoua JJ, Herbal medicines and pregnancy. J Popul Ther Clin Pharmacol 2010;17:e370–8.

25. Forster DA, Denning A, Wills G, Bolger M, McCarthy E. Herbal medicine use during pregnancy in a group of Australian women. BMC Pregnancy Childbirth 2006;6:21. doi: 10.1186/1471-2393-6-21

26. Pinn G, Pallet L Herbal medicine in pregnancy. Complement Ther Nurs Midwifery 2002;8:77–80. doi: 10.1054/ctnm.2001.0620

27. Stevensen CJ. The psychophysiological effects of aromatherapy massage following cardiac surgery. Complement Ther Med 1995;2:27–35.

28. Kömürcü N. Travayda dinletilen tedavi müziğinin gebenin anksiyetesine etkisi. Hemşirelik Forumu 1996;2:89–96.

29. Liu YH, Chang MY, Chen CH. Effects of music therapy on labour pain and anxiety in Taiwanese first-time mothers. J Clin Nurs 2010;19:1065–72. doi: 10.1111/j.1365-2702.2009.03028.x

30. Phumdoung S, Good M. Music reduces sensation and distress of labor pain. Pain Manag Nurs 2003;4:54–61.

31. Betts D. Inducing labour with acupuncture –crucial considerations. J Chinese Med 2009;90:20–5.

32. Betts D. The essential guide to acupuncture in pregnancy & childbirth. Sussex, England: The Journal of Chinese Medicine Ltd; 2006. p.181–210.

33. Çelik R, Toksöz L. Gevşeme ve Nefes Alma Teknikleri. İçinde: Kadayıfçı O, editör. Lamaze Yöntemi ile Doğuma Hazırlık ve Doğum. İstanbul: Nobel Tıp Kitabevleri Ltd Şti.; 2005. s.62–8.

34. Field T, Hernandez-Reif M, Taylor S, Quintino O, Burman I. Labor pain is reduced by massage therapy. J Psychosom Obstet Gynaecol 1997;18:286–91.

35. Karami NK, Safarzedeh A, Fathizadeh N. Effect of massage therapy on severity of pain and outcome of labor in Primipara. Iranian J Nurse Midwifery 2007;12:6–9.

36. Chang MY, Wang SY, Chen CH. Effects of massage on pain and anxiety during labour: a randomized controlled trial in Taiwan. J Adv Nurs 2002;38:68–73.

37. Benfield RD. Hydrotherapy in labor. J Nurs Scholarsh 2002;34:347–52.

38. Benfield RD, Herman J, Katz VL, Wilson SP, Davis JM. Hydrotherapy in labor. Res Nurs Health 2001;24:57–67.

39. da Silva FM, de Oliveira SM, Nobre MR. A randomised controlled trial evaluating the effect of immersion bath on labour pain. Midwifery 2009;25:286–94. doi: 10.1016/j.midw.2007.04.006

40. Balaskas J. Active Birth: The New Approach to Giving Birth Naturally, revised ed. Harvard Common Press; 1992. p.10–55.

41. Lawrence A, Lewis L, Hofmeyr GJ, Dowswell T, Styles C. Maternal positions and mobility during first stage labour. Cochrane Database Syst Rev 2009;(2):CD003934. doi: 10.1002/14651858.CD003934. pub2

42. Gupta JK, Hofmeyr GJ, Smyth R. Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database Syst Rev 2012;(5):CD002006. doi: 10.1002/14651858.CD002006. pub3

43. Betts D. Natural Pain Relief Techniques for Childbirth Using Acupressure: Promoting a Natural Labour and Partner Involvement; 1997. p.3–27.

44. Albers LL, Anderson D, Cragin L, Daniels SM, Hunter C, Sedler KD, et al. Factors related to perineal trauma in childbirth. J Nurse Midwifery 1996;41:269–76.

45. Hastings-Tolsma M, Vincent D, Emeis C, Francisco T. Getting through birth in one piece: protecting the perineum. MCN Am J Matern Child Nurs 2007;32:158–64. doi: 10.1097/01.NMC.0000269565.20111.92

46. Gaskin IM. Ina May’in Doğuma Hazırlık Rehberi, 1. Baskı. İstanbul: Sinek Sekiz Yayınevi; 2015. s.345–9.

47. Moore ER, Anderson GC, Bergman N, Dowswell T. Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev 2012;(5):CD003519. doi: 10.1002/14651858. CD003519.pub3

48. Matthiesen A, Ransjö-Arvidson A, Nissen E, Uvnäs-Moberg K. Postpartum maternal oxytocin release by newborns: effects of infant hand massage and sucking. Birth 2001;28:13–9.

49. Phillips R. The Sacred Hour: Uninterrupted skin-to-skin contact immediately after birth. Newborn & Infant Nursing Reviews 2013;13:67–72.

50. Ferguson S, Davis D, Browne J. Does antenatal education affect labour and birth? A structured review of the literature. Women Birth 2013;26:e5–8. doi: 10.1016/j.wombi.2012.09.003

51. Stapleton LR, Schetter CD, Westling E, Rini C, Glynn LM, Hobel CJ, et al. Perceived partner support in pregnancy predicts lower maternal and infant distress. J Fam Psychol 2012;26:453–63. doi: 10.1037/ a0028332

52. Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database Syst Rev 2003;(3):CD003766. doi: 10.1002/14651858.CD003766

53. World Health Organization and United Nations Children’s Fund (WHO/UNICEF). Protecting, promoting and supporting breastfeeding: the special role of the maternity services. World Health Organization, Geneva: 1989. http://apps.who.int/iris/ bitstream/10665/39679/1/9241561300.pdf Erişim Tarihi: 18.12.2016

54. Kardong-Edgren S. Using evidence-based practice to improve intrapartum care. J Obstet Gynecol Neonatal Nurs 2001;30:371–5.

55. Artieta-Pinedo I, Paz-Pascual C, Grandes G, RemiroFernandezdegamboa G, Odriozola-Hermosilla I, Bacigalupe A, et al. The benefits of antenatal education for the childbirth process in Spain. Nurs Res 2010;59:194–202. doi: 10.1097/NNR.0b013e3181dbbb4e

56. Barragán Loayza IM, Solà I, Juandó Prats C. Biofeedback for pain management during labour. Cochrane Database Syst Rev 2011;(6):CD006168. doi: 10.1002/14651858.CD006168.pub2

57. Smith CA, Collins CT, Crowther CA. Aromatherapy for pain management in labour. Cochrane Database Syst Rev 2011;(7):CD009215. doi: 10.1002/14651858.CD009215

58. Miquelutti MA, Cecatti JG, Makuch MY. Evaluation of a birth preparation program on lumbopelvic pain, urinary incontinence, anxiety and exercise: a randomized controlled trial. BMC Pregnancy Childbirth 2013;13:154. doi: 10.1186/1471-2393-13-154