Problem statement

EFFECTIVENESS OF BREATHING EXCERCISES

ON PAIN DURING FIRST STAGE OF LABOUR
AMONG FIRST STAGE INTRANATAL MOTHERS
IN SELECTED HOSPITALS,HYDERABAD
 introduction
• “child birth is something birth is something you do, not something
that happens to you”
•
• Child birth can be one of the most exhilarating and fulfilling
experiences of a woman’s life. It can also be one of the most
stressful and painful. Even with pain medication child birth can be
uncomfortable. Breathing techniques are a helpful way to help a
woman focus and get through the sometimes long, arduous task of
delivering a baby 1 .
• While labour can seem like a scary experience for many pregnant
women, there are a variety of methods through which to cope with
pain during labour. Some of these methods work by easing labour
pain naturally, while others reduce the pain of birth medically 2.
• Pain during labour is caused by the contractions of the
uterine muscles of the body, as well as pressure on the
cervix. Women also experience discomfort during child
birth because of the pressure of the baby’s head on
the bowels and bladder3.
• The level of discomfort a woman experiences while
giving birth varies from individual to individual. Some
women experience all over body cramps, including in
the abdomen, groin and back, while others feel pain on
their sides and thighs. Women may describe pain
during labour as being similar to menstrual cramping,
while others describe it as feeling extreme pressure on
their bodies4.
• One important method of natural labour pain relief is breathing. The use of
breathing techniques to relax oneself during labour is taught in the Lamaze
techniques, which views birth as a natural process. The Lamaze technique
emphasizes breathing and massages 5.
• The Bradley method is another natural option to minimize pain during child
birth. It teaches that labour is a natural process and that child birth pain can
be alleviated through breathing, the use of medication is encouraged only
when necessary 6.
• In the initial stages of labour, it is important for a woman to help the body
relax in order for all the right processes to take place for a successful
delivery. Slow pace breathing is an exercise that helps the body do just that
relax 7 .
• Slow pace breathing is done beginning with a deep “cleansing” breath and
then taking constant, steady, deep breaths through the nose and exhaling
slowly through the mouth. This helps a woman focus on her breathing rather
than the discomfort of the labour. She can also use visualization (her
favourite place, what her baby look like in her arms among other images)
during slow pace breathing to help her focus 8 .
• Once a woman moves further on into active labour, she may feel the need
to increase the pace of her breathing to compensate for the increased pain
or discomfort. Accelerated breathing, again, begins with a cleansing breath
and then continues the
• the same as slow pace breathing, but with a faster pace and
more concentration on on each, individual breath 9 .
• Once labour hits full on, it's usually time for patterned
breathing. This type ofocusing f breathing exercise not only
helps to get the mind clear of as much of the pain as possible,
but it can also help women who feel anxiety, stress or panic 10 .
• Patterned breathing also begins with an initial cleansing breath
and then settles into a pattern of more shallow, rapid, in-and-
out breathing. Sometimes this is referred to as "hee-hee-hoo"
breathing, as that is the sound the air makes when following
the pattern 11 .
• During labour, women sometimes feel the need to push before
it is time to do so. When this happens, breathing exercises can
be helpful. If a woman feels the need to push, she should take a
cleansing breath and focus on deep breaths in through the
mouth and blow the air out again through the mouth. She
should do this as many times as needed until the urge to push
passes
• Beginning in the late 1950’s many specific methods for
non – medication pain reduction were developed. These
include the Lamaze, Dick – Read and Bradley methods.
Child birth education has been moving away from the
method approach 13 .
• Most of the methods advocated are based on three
premises. The first is that discomfort during labour can be
minimized if the woman comes into labour informed
about what is happening and prepared with breathing
exercises to use during contractions. The second premise
is that discomfort during labour can be minimized if the
woman’s abdomen is relaxed and the uterus is allowed to
rise freely against abdominal wall contractions. The third
premise is that the pain perception be altered by
distraction techniques by a “gate control” theory of pain
perception 14.
• Water therapy, such as taking warm shower or
bath during labour, can also minimize child
birth related pain. A water birth is a distinct
type of birth in which labour typically occurs
in a special birthing pool . Acupuncture and
massage are other natural options for labour
pain management while hypnotherapy is a
popular way to ease labour pain through
mental relaxation 15
 Need for study
• .
• The joys of being pregnant and motherhood are
numerous. One of the most amazing aspects of being a woman is
being able to carry and create life. Despite this many women face
the delivery of their little one with mixed emotions 16 .
• A pregnant woman who breathes properly, in a pattern or
rhythm during her labour, benefits both herself and her baby. This is
because a patterned breathing helps in providing the baby as well
as the mother the right amount of oxygen. Secondly, with the right
breathing the mother is better equipped to cope with the pain that
contractions bring about17.
• Women who come to a decision to give birth naturally will go
through all of the pain connected with delivery. The most effective
way to make it happen is through good, old fashioned diet and
exercises. A lot of women are scared of exercising during
• pregnancy fearing it may harm their baby. This could not be
farther from the truth. The truth is that exercising during
pregnancy is good for both mother and baby 18 .
• The breathing techniques focuses on deep abdominal
breathing with relaxation. This breathing is meant to be used
throughout labour and birth. Simply listen to the quiet, steady
rhythm of breathe as she breathe deeply. Notice how the
tummy expands outwardly as she breathes in, and relaxes as
she breathes out. This type of breathing is slow and very
relaxing and sets the stage for her ability to relax through the
contraction. The breathing techniques uses breathing patterns
for various responses to labour. Those are slow pace breathing ,
accelerated breathing and patterned breathing 19 .
• Studies have shown that exercising during pregnancy
decreased labour time by 33%. So time spent exercising during
pregnancy will pay itself off by causing the
• delivery of little one much easier by reducing the quantity of time
spent in labour consequently assisting to ease labour pain in
general. Exercise in pregnancy has quite a few additional
advantages as well. From a more healthy baby to a far more fit
maternity, exercising while pregnant is an all around smart option
for just about any expecting mother 20 .
• Pregnant women do have special considerations they need to
factor in when choosing an appropriate exercise program. But there
are special pregnancy exercise programs designed to specifically
meet the requirements of expecting moms. They concentrate on
low impact exercises that ensure the security of the baby even
while helping the mother to ensure she’s going to ease labour pain
by exercising while pregnant 21 .
• Antenatal exercises doesnot require equipment and
machinery but an efficient child birth educator and the
willingness to practice the exercises on the part of
pregnant women are considered as important
considering factors stated above the purposes of study
was to develop breathing exercises schedule for the
women in labour will be effective in promotion of
labour and outcomes 22 .
• As there is no awareness, among women that
breathing techniques can reduce labour pain, the
researcher felt the need to educate antenatal mothers
regarding breathing techniques 23 .
• 4.OBJECTIVES OF THE STUDY
• To assess the level of pain perception perception
among mothers in labour in the experimental group.
• To assess the level of pain perception among mothers
in control group.
• To find out the effect of breathing techniques on
labour pain perception among mother in terms of
reduction of pain perception.
• To find out association between level of pain
preception with selected demographic variable
between experimental group and control group.