Efficacy of Comprehensive childbirth preparation package on childbirth experiences and Maternal-Neonatal outcomes among Primigravidae in selected Health Center of Noida, Uttar Pradesh

Abstract

Introduction Childbirth causes physical and mental changes to pregnant women. The woman's childbirth experience is very important and her childbirth memories remain alive for lifetime. Childbirth preparation programs have shown to promote women knowledge, expectation and experience of childbirth. Childbirth preparation program can make a symbolic difference to a women childbirth experience. The purpose of the study was to assess the efficacy of comprehensive childbirth preparation package on childbirth experiences and maternal-neonatal outcomes among primigravidae in selected health center of Noida, Uttar Pradesh. Methodology The present study was conducted in two phases. In phase I, exploratory research approach was adopted to explore childbirth preparedness and childbirth experiences based on which a need based comprehensive childbirth preparation package was developed and in phase II a randomized control trial was conducted to evaluate efficacy of comprehensive childbirth preparation package on childbirth experiences and maternal-neonatal outcomes. Primigravidae between 28-34 weeks were allocated to experimental and control group by simple random sampling technique. Data collection procedure was started after obtaining ethical, administrative permission and consent from the participants. Pre-test was conducted in both the groups and intervention was delivered once a week for a period of three weeks. Post-test was conducted on 15th day of the intervention to assess childbirth preparedness, childbirth expectation. On 3rd day of delivery post-test was done to assess childbirth experiences, childbirth fear, labour outcome and breast-feeding self-efficacy. On 7th day and 6th week of delivery postnatal outcomes of mother and baby was assessed. Results There was no significant difference in the mean pre-test scores of childbirth preparedness between groups (p = 0.37) and a statistically significant difference was observed in post test scores of childbirth preparedness (p = 0.03). The pre-test childbirth expectation scores had no significant difference between experimental and control group (p = 0.75), whereas, statistically significant difference was observed in post-test childbirth expectation scores between experimental and control group (p ≤ 0.001). This reveals that comprehensive xxvi childbirth preparation package was effective in terms of childbirth expectation. A statistically significant difference among study participants in experimental and control group in childbirth fear scores (t =7.85, p= 0.001) whereas no difference was observed at pre intervention level in childbirth fear (t =1.19, p=.23) between groups. Significant difference was observed in mean score of labor and birth experience between experimental (113.9 ±5.7) and control group (85.9±6.5) at p=.001. Maternal−neonatal outcomes between experimental and control group in terms of labor outcome and breast-feeding self-efficacy found to be significant at (p<0.5). Conclusion The comprehensive childbirth preparation package was effective in terms of childbirth experiences and maternal-neonatal outcome. From the findings of the study conclusion can be drawn that primigravidae who were exposed to comprehensive childbirth preparation package were having significantly positive childbirth experiences and better maternal-neonatal outcome than the control group.