Psychoprophylaxis and the rate of cesarean section
Main Article Content
Keywords
Parturition, Psychology, Relaxation therapy, Cesarean section
Abstract
Background: the psychoprophylactic programs (PPP) have been widely used in women to face the fear-tension-pain cycle, reducing anxiety and pain during labour. The aim was to demonstrate if a PPP reduces caesarean rate.
Methods: a 300 low risk pregnant women were included; 100 to the PPP group and 200 to the control group. The PPP participants assisted to theory and practical sessions; they visited labour, delivery, recovery and hospitalization areas. Chi-square, Student’s t test and odds ratio were applied.
Results: pregnancy ended by caesarean section in 35/100 of PPP group and in 99/200 (49.5 %) in control group (p < 0.02, OR = 1.8, IC = 1.1-2.9). Maternal complications occurred in 13/100 in the PPP group, and 42/200 (21 %) in control group (p = 0.09, RM = 0.56). The newborn (NB) complications were observed in 9/100 in PPP and 46/200 (23 %) in control group (p < 0.02, OR = 0.33). In the PPP group, 70 % assisted to three or more sessions. Hospital stance in control group, accumulated 17 days more in mothers and 171 days more in NB than in the PPP group.
Conclusions: in PPP group observed a caesarean rate reduction with fewer maternal and perinatal complications.
References
Grantly DR. Childbirth without Fear: The principles and practice of natural childbirth. London, UK: Pinter and Martin; 2004.
Sipinelli A, Baglio G, Donati S, Grandolfo ME, Osborn J. Do antenatal classes benefit the mother and her baby? J Matern Fetal Neonatal Med 2003;13(2);94-101.
Charles AG, Norr KL, Block CR, Meyering S, Meyers E. Obstetric and psychological effects of psychoprophylactic preparation for childbirth. Am J Obstet Gynecol 1978;131(1):44-52.
Kondas O, Scetnicka B. Systematic desensitization as a method of preparation for childbirth. J Behav Ther Exp Psychiatry 1972;3(1):51-54.
McCool WF, Simeone SA. Birth in the United States: an overview of trends past and present. Nurs Clin North Am 2002;37(4):735-746.
Puentes-Rosas E, Gómez-Dante O, Garrido-La-torre F. Las cesáreas en México: tendencias, niveles y factores asociados. Salud Publica Mex 2004;46(1):16-22.
World Health Organization. Appropriate technology for birth. Lancet 1985;2(8452):436-437.
Guzmán-Sánchez A, Ávalos LM. Parto psicoprofiláctico vs. atención obstétrica tradicional. Ginecol Obstet Mex 1983;51(316):221-224.
Rouse DJ, Owen J, Goldenberg RL, Cliver SP. The effectiveness and costs of elective cesarean delivery for fetal macrosomia diagnosed by ultrasound. JAMA 1996;276(18):1480-1486.
Herbst MA. Treatment of suspected fetal macrosomia: a cost-effectiveness analysis. Am J Obstet Gynecol 2005;193(3 Pt 2):1035-1039.
Murthy K, Grobman WA, Lee TA, Holl JL. Association between rising professional liability insurance premiums and primary cesarean delivery rates. Obstet Gynecol 2007;110(6):1264-1269.
Raio L, Ghezzi F, Di Naro E, Buttarelli M, Franchi M, Dürig P, et al. Perinatal outcome of fetuses with a birth weight greater than 4500 g: an analysis of 3356 cases. Eur J Obstet Gynecol Reprod Biol 2003;109(2):160-165.
Piasek G, Starzewski J, Chil A, Wrona-Cyranowska A, Gutowski J, Anisiewicz A, et al. Analysis of la-bour and perinatal complications in case of fetus weight over 4000 g. Wiad Lek 2006;59(5-6):326-331.
Calleri L, Ceffa C, Allegra AM, Porcelli A. Pregnancy today. Randomized study of the emotional state of the woman and her partner. Minerva Ginecol 1998;50(6):277-284.
Hernández-Castro F, Laredo-Rodríguez A, Hernández-Herrera R. Sensibilidad y valor predictivo del método de Johnson y Toshach para estimar peso fetal. Rev Med Inst Mex Seguro Soc 2006; 44(4):309-312.
Sieber S, Germann N, Barbir A, Ehlert U. Emotional well-being and predictors of birth-anxiety, self-efficacy, and psychosocial adaptation in healthy pregnant women. Acta Obstet Gynecol Scand 2006;85(10):1200-1207.