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      Comparison of the effects of doula supportive care and acupressure at the BL32 point on the mother's anxiety level and delivery outcome

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          Abstract

          Background:

          Natural delivery is distressing and the mother's severe pain and anxiety in this condition can have negative impacts on the fetus, mother, and the delivery process. Yet, pain and anxiety can be reduced by supporting the mother by a doula. Thus, the present study aims to compare the effects of doula supportive care and acupressure at the BL32 point on the mother's anxiety level and delivery outcome.

          Materials and Methods:

          The present clinical trial was conducted on 150 pregnant women who had referred to the Shoushtari Hospital, Shiraz, Iran for delivery in 2012. The subjects were randomly divided into two intervention groups (supportive care and acupressure) and a control group (hospital routine care). The mothers’ anxiety score was assessed before and after the intervention, using the Spielberger questionnaire. The delivery outcomes were evaluated, as well. Subsequently, the data were entered into the SPSS statistical software (Ver. 16) and analyzed using the analysis of variance (ANOVA), Chi-square test, correlation coefficient, and logistic regression analysis.

          Results:

          After the intervention, the highest and lowest mean scores of the state and trait anxieties were compared with the control and the supportive care groups, respectively, and the difference was statistically significant ( P < 0.001). A significant relationship was found between the labor length and mother's anxiety score after the intervention in the supportive care ( P <</i> 0.001) and the control group ( P = 0.006). However, this relationship was not significant in the acupressure group ( P = 0.425). Also, a significant difference was observed among the three groups regarding the mothers’ anxiety level ( P = 0.009).

          Conclusions:

          The study results showed that doula supportive care and acupressure at the BL32 point reduced the mother's anxiety as well as the labor length. Therefore, non-pharmacological methods are recommended to be used during labor for improving birth outcomes and creating a positive birth experience.

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          Most cited references49

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          Association between maternal anxiety in pregnancy and increased uterine artery resistance index: cohort based study.

          To investigate whether maternal anxiety in the third trimester is associated with an increased uterine artery resistance index. Cohort based study. 100 pregnant women, with a mean gestation of 32 weeks. Self rating Spielberger questionnaire for state anxiety and trait anxiety, and uterine blood flow waveform patterns as assessed by colour Doppler ultrasound. A significant association was found between uterine artery resistance index and scores for both Spielberger state anxiety and trait anxiety (rs=0.31, P 40 (n=15) had a higher mean uterine resistance index than those with scores 40 (n=32) had a higher mean resistance index than those with scores
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            WHO Standard Acupuncture Point Locations

            Sabina Lim (2009)
            ‘ WHO Standard Acupuncture Point Locations in the Western Pacific Region (WHO Standard) was released in 2008. Initially, there were 92/361 controversial acupuncture points (acupoints). Through seven informal consultations and four task force team meetings, 86 points were agreed upon among the 92 controversial acupoints, leaving 6 remaining controversial acupoints, demanding active research in the future. This will enhance the reproducibility and validity of acupuncture studies. It will also lead to a better understanding of acupuncture mechanisms in order to optimize its clinical efficacy for a range of diseases and syndromes. This book has two parts: General Guidelines for Acupuncture Point Locations and WHO Standard Acupuncture Point Locations. First of all, familiarity with the General Guidelines for Acupuncture Point Locations in this book can help the reader to understand and use the contents of this book in depth. I would like to thank all of the participating experts and scholars for this great work, who have overcome the limits of previous acupuncture references. I also appreciate the dedicated effort and harmonious leadership of Dr Choi Seung-hoon, former Regional Adviser in Traditional Medicine of Western Pacific Office, WHO.
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              Fear of childbirth during pregnancy may increase the risk of emergency cesarean section.

              The purpose of our study was to elucidate the association between fear of childbirth, general anxiety, and stress coping during the third trimester of pregnancy, and a subsequent delivery by emergency cesarean section. In a case-control study, 1,981 Swedish-speaking women completed three self-assessment questionnaires at 32 weeks' gestation. Ninety-seven of these women were delivered by emergency cesarean section. Fear of childbirth, general anxiety and the stress coping ability of these 97 cases were compared with the same features in 194 controls, matched for age and parity. Women, subsequently delivered by emergency cesarean section, reported a greater anxiety and a poorer stress coping ability, and, most obviously, a greater fear of childbirth at 32 weeks' gestation. After elimination of possible confounders, the odds ratio for emergency cesarean section was examined for women whose scores were above various cut-off points according to the fear of childbirth measuring instrument. For women with a serious fear of childbirth the odds ratio was 3.0 (95% confidence interval 1.4 to 6.6), and the population attributable risk 0.167. Fear of childbirth during the third trimester of pregnancy may increase the risk of subsequent emergency cesarean section.
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                Author and article information

                Journal
                Iran J Nurs Midwifery Res
                Iran J Nurs Midwifery Res
                IJNMR
                Iranian Journal of Nursing and Midwifery Research
                Medknow Publications & Media Pvt Ltd (India )
                1735-9066
                2228-5504
                Mar-Apr 2015
                : 20
                : 2
                : 239-246
                Affiliations
                [1 ]Department of Midwifery, Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
                [2 ]Department of Midwifery, Shiraz University of Medical Sciences, School of Nursing and Midwifery, Shiraz, Iran
                [3 ]Department of Biostatistics, Infertility Research Center, Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran
                Author notes
                Address for correspondence: Mrs. Marzieh Akbarzadeh, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran. E-mail: akbarzadm@ 123456sums.ac.ir
                Article
                IJNMR-20-239
                4387650
                6a808de4-e84b-488c-87f9-781095f4c822
                Copyright: © Iranian Journal of Nursing and Midwifery Research

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 24 December 2013
                : 24 August 2014
                Categories
                Original Article

                Nursing
                acupuncture points,anxiety,childbirth,doula,iran
                Nursing
                acupuncture points, anxiety, childbirth, doula, iran

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