INTRODUCTION:

Pain in labour is unique and is associated with labour which is accepted as necessary part of child birth.

The concept of painless child birth gave rise to many scientific discoveries and research findings. As a result, different non-pharmacological techniques were tried. Lamaze is also one of the non-pharmacological methods of prepared childbirth.

Lamaze method can also be called as psycho-prophylactic method (PPM), because it highlights mind control. It grew out of Pavlov’s work on classical conditioning.

OBJECTIVES:

1. Educate and encourage the primigravida women to practice Lamaze method during first stage of labour.

2. Identify the pain of the primigravida women till the active phase of first stage of labour.

HYPOTHESIS:

H₀₁: Lamaze method does not decrease the degree to which pain bothers the mother during first stage of labour.

H₁₁: Lamaze method decreases the degree to which pain bothers the mother during first stage of labour.

METHODOLOGY:

Research design:

The design adopted for the present study is one group post test only design. The subjects were assigned to experimental group.

Population:

Primigravida women with 38 to 40 weeks of gestation were selected for the study

Sampling:

Purposive sampling method was used. 16 samples of primigravida women with 38 to 40 weeks of gestation were included in the study.

Settings:

The study was conducted at first stage of labour unit of Sri. Ramakrishna Hospital, Coimbatore.

Intervention:

Lamaze method is created by French obstetrician Dr. Ferdinand Lamaze. An American Woman, Marjorie Karmel was the first to participate in the Lamaze method. She wrote of her child birth experience in Thank you, Dr. Lamaze which was published in the United States in 1959.

In Lamaze method, at the first sign of contraction, a women focuses her eyes on a particular object (say a spot on the wall), thus introducing a visual stimulus that goes directly into her brain. Next, the women takes a deep breath followed by a light fingertip massage (‘effleurage”) that she performs on her abdomen introduces a tactile stimulus that, again goes directly into her brain. Finally, she gets a series of commands or verbal encouragement that introduces an auditory stimulus to her brain.

The result is at several stimuli (visual, tactile and auditory) rushes to the brain before the pain reaches the brain. When the pain ultimately reaches the brain, it is gated off and she experiences less intense of pain. (Gate- control theory).

The four major breathing techniques commonly used in child birth preparation are slow paced breathing, modified paced breathing, and patterned paced breathing and expulsion breathing. First three methods of breathing techniques are used in Lamaze method during the first stage of labour.

Each breathing technique is used according to need, not according to particular stage in labour. If one technique is not effective in helping the woman to cope with her contractions of a particular point in labour, another technique (usually a more complex one) should be used.

Instruments:

· Numeric Pain Intensity Scale was used for assessing labour pain and observational list was used for assessing behavioral responses.

· Partogram was used for assessing the progress of labour.

Data collection:

Data was collected for a period of 30 days. Education on Lamaze method was given through demonstration. Hand outs were used as an educational aid.

Pain and behavioral responses were assessed and recorded before, during and in between uterine contraction. The mothers were motivated to follow the Lamaze method during first stage of labour.

Data analysis:

Appropriate statistical techniques were applied to analyze the data to find out the significance. ‘t’ test was adopted to find out the significance of Lamaze method.

Karl pearson’s coefficient of correlation (‘r’) was used to analyze the influence of demographic variables on labour pain in response to Lamaze method.

RESULTS:

The mean score was 5.125 at 5% level of significance. Since the calculated value 20.3373 is greater than table value 1.701, the null hypothesis is rejected and research hypothesis is accepted. Hence the result of the study proves that Lamaze method influences in reducing the intensity of labour pain during first stage of labour (Table-1).

Table: 1 Post Test Labour Pain Score of Experimental Group

Group	Mean	SD	t - value
Experimental group	5.125	1.0082	20.3373*

* P < O. 05 = 1.701

The negative behavioral responses in relation to labour pain during first stage of labour were found d to be decreased (Table-2).

LIMITATIONS OF THE STUDY:

1. The study included only primigravida women between 38 to 40 weeks of gestation who were admitted in first stage of labour unit

2. The study was confined to a small number of subjects and shorter period which limits generalizations.

3. There is only an experimental group in this study.

CONCLUSION:

1. Lamaze method was effective in decreasing the degree to which pain bothers the mother during first stage of labour.

2. The negative behavioral responses in relation to labour pain during first stage of labour were found to be reduced with the use of Lamaze method.

3. Progression of labour was accelerated with the help of Lamaze method.

4. Most of the mothers were undergone normal vaginal delivery.

5. There was no influence of demographic variables on labour pain in response to Lamaze method.

RECOMMENDATIONS:

1. Lamaze method can be included in nursing curriculum due to its economic in nature.

2. Lamaze method can be demonstrated to the nurses to practice in their working area.

3. Lamaze method can be educated during third trimester and results can be observed.

4. A study can be conducted to assess the knowledge and practice of health personnel on management of labour pain.

REFERENCES:

BOOKS:

1. Bobak, M. Irene. et.al, (1994). Essentials of Maternity Nursing. (4^th Ed.). Philadelphia: the C.V. Mosby Company.

2. Burns Nancy and Susan, K. Grove. (1993). The Practice of Nursing Research. Conduct Critique and Utilization, Philadelphia: W.B. Saunders Company.

3. Dutta, D.c. (1992).Text book of Obstetrics. (3^rd Ed.) Kolkonda: New Central Book Agency.

4. Kothari C.R., (1990). Research Methodology. New Delhi: Wiley Eastern Limited.

5. Sharon (1983). Maternity Nursing. (15^th Ed.) Philadelphia: J.B. Lippincott Company.

6. Sue Moore (1997). Understanding Pain and Its Relief in Labour (1^st Ed.) Tokyo: Churchill Livingstone.

JOURNALS:

1. Auken et.al., An appraisal of Patient Training for child Birth, American journal of obstetrics and Gynaecology, January (1953), Vol 66(3), Pp: 66-100.

2. Chalmers, Do antenatal Classes have a place In modern obstetric care Journal of Obstetrics, Gynaecology and neonatal nursing,, June (1994), Vol. 15 (2), Pp 119 – 123.

3. Charles, et.al., Obstetric and Psychological effects of Psycho prophylactic Preparation for Child Birth, American Journal of Obstetrics and Gynecology, March 1978, Vol. 35 (2) Pp 34 – 44.

4. Chatterjee, Safe Motherhood How safe in India, Obstetrics and Gynaecology Today, August 1997, Pp 603 – 605.

5. Hodnett, Breathing exercises during labour, General of Gynaecology and Neonatal Nursing, January 1996, vol 28 (3), Pp. 259- 303.

6. Latha, First Stage of Labour, Health Action, April 1998, Vol 80 (3), Pp No. 23.

7. Linda et.al., Obstetric Risk of Pregnant Women, , December 2000, Pp 961 – 966. Obstetrics and Gynaecology.

8. Sudhakar, Analgesia and Anaesthesia in Obstetrics and Gynaecology, Health Action, June 1982, Vol 31 (8), Pp 21 – 23.

9. Willing, Child Birth education in the 1990s and Beyond, Journal of Obstetric Gynaecology, Neonatal Nursing, February 1996, Vol 5, Pp 425 – 431.

10. JR Scott et.al., Effect of Psycho prophylaxis (Lamaze Preparation) on Labour and delivery in Primiparas, The New England Journal of Medicine, May 1976, Vol. 294, Pp 1205 – 1207.

11. Sharron S. Humenick, Lamaze Method versus Philosophy, The Journal of Perinatal Education, 1967.

ABSTRACT:

1. Tamara. S. Anderson (2007), Effects of Imagery and Brief Lamaze Training on Pain Tolerance in a cold presser test.

2. Delke I, et.al. Effects of Lamaze Child Birth Preparation on Maternal Plasma Beta Endorphin immuno reactivity in active labour.

Received on 18.12.2010 Modified on 02.01.2011

Asian J. Nur. Edu. & Research 1(1): Jan.-March 2011; Page 25-27

Behavioral Response	Mean score of positive response	Mean Percentage (%)	Mean score of Negative response	Mean Percentage (%)
In relation to labour pain during first stage of labour	26.8125	96	7.4375	34