The Effect of Non-pharmacological Methods of Pain Relief in Labor Mothers Postpartum Depression, Anxiety and Stress in Women referring to Ardabil Alavi Hospital for Childbirth: A Randomized Controlled Trial ,2012.

Abstract

‎Abstract: Background & Objective: The global prevalence of depression for women is roughly twice that ‎for men and it reaches its highest possible rates during their reproductive years. In Iran, the ‎pattern of prevalence of postpartum depression follows the pattern of developing countries that is ‎about three times higher than in developed countries.‎ Childbirth as the most stressful physical and mental event affects women's physiological and ‎psychological indicators during childbirth. There is a significant relationship between labor pain ‎and women's stress. Prenatal Anxiety is also a predictor of postpartum depression. Postpartum ‎anxiety is an acute and common phenomenon which leads to increasing the use of mothers’ health ‎care after clearing and reducing the duration of breastfeeding. This research was done for ‎studying the effect of non-pharmacological methods of pain relief on mothers’ postpartum ‎depression, anxiety and stress in Women referring to Ardabil Alavi Hospital for childbirth as a ‎randomized controlled trial in 2012.‎Methods:in a double-blinded randomized controlled trial, 320 referring women were allocated in ‎two treatment groups (N=158) and control group (N=162) as randomized blocking method. The ‎treatment includes using special pelvic movements via birth ball, using different positions during ‎active phase until childbirth, bathing and taking shower, Aromatherapy with lavender in the form ‎of an inhaler and music. The data gathering was done through demographic and obstetric ‎questionnaire, Edinburg depression scale (in two stages), perceived stress questionnaire (in three ‎stages), Spielberg trait anxiety questionnaire (in three stages) and Partograph form and data were ‎analyzed via chi-square, Fisher, Independent t-test and General Linear Model.‎ Results: There is no significant statistical difference between treatment and control group in terms of ‎demographic and obstetric particulars and also mean of prenatal depression, stress and anxiety ‎‎(P>0.05). There is no significant difference between two groups in terms of the mean of anxiety ‎six hours after childbirth and mean of depression, anxiety and stress scores eight weeks after ‎childbirth (P>0.05) while mean of stress in treatment group was significantly less than control ‎group in six hours after childbirth (0.01-1.9- confidence interval 95%, 1.0- adjusted mean ‎difference), apparent anxiety in treatment group was significantly less than control group in six ‎hours after childbirth (2.8-6.1- confidence interval 95%, 4.5- adjusted mean difference) and ‎apparent anxiety in treatment group was significantly less than control group in eight weeks after ‎childbirth (1.0-5.4, confidence interval 95%, 3.2- adjusted mean difference). ‎Conclusion: The results showed that the use of the non-pharmacological methods of pain relief can ‎significantly reduce the mothers’ stress in labor and their apparent anxiety during labor and after ‎childbirth and significantly increase their consent from normal vaginal delivery. ‎Keywords: Non-pharmacological methods of pain relief in labor, Traditional delivery, Postpartum ‎depression, Stress, Anxiety.