ABSTRACT
Background:
It has been shown that postnatal discomfort is one of the common issues that postpartum women go through and, in most cases, have a low quality of life, thus impairing their recovery and overall well-being. This research study was aimed at establishing the effectiveness of nurse-midwife-specific interventions aimed at reducing postnatal discomfort and enhancing the quality of life among postpartum women.
Methods:
This quasi-experimental study had a control and an intervention group of postpartum women. Standardized questionnaires to assess pain and quality of life data were collected. Statistical analysis by Chi-square test and t-test to compare scores before and after the intervention in both the groups were performed.
Results:
Intervention outcomes were a significant reduction in pain scores and quality-of-life improvements compared to the control group. Therefore, interventions targeted by the nurse-midwife may improve postpartum recovery.
Conclusion:
Focused interventions by the nurse-midwife improved outcomes related to postnatal recovery. The treatment can be useful for inclusion in postpartum care to enhance the quality of life and maternal well-being.
KEYWORDS: Four square breathing exercise, prone position, quality of life
INTRODUCTION
This “fourth trimester” of postpartum is a time of deep physical and emotional transformation, and new mothers are often in full bloom with discomforts such as pain, fatigue, and psychological distress. These can seriously impact QoL. Yet, postpartum care tends to be more body-focused on recovery rather than interventions that also take into account wide aspects of their physical and emotional well-being.[1,2] Therefore, nurse-midwives are significantly positioned to lead the way in being more central in postnatal care since they are primary caregivers with specific interventions that are individualized for the benefit of newly born mothers.[3]
Research has supported the notion that effective postnatal care does improve maternal health outcomes; however, some evidence is presently wanting on the targeted nurse-midwife interventions regarding postnatal discomfort and QoL.[4] The research into this knowledge gap is crucial for today’s rising concern over postpartum depression, chronic pain, and long-term recovery of new mothers.[5] Preliminary studies highlight how these tailored interventions by nurse-midwives in pain management, emotional support, and counseling on breastfeeding would be of immense help.[6] However, studies should continue to measure their efficacy in reducing discomfort and improving QoL, and a base should be laid down for evidence-based, holistic strategies for postpartum care.
MATERIALS AND METHODS
This study employs a quasi-experimental design to compare the outcomes of mothers receiving focused nurse-midwife interventions with those receiving standard postpartum care. The study includes two groups: the intervention group and the control group. A total of 120 postnatal mothers were recruited and randomly assigned to either the experimental group, which received focused nurse-midwife interventions, or the control group, which received routine postnatal care. The interventions provided to the experimental group included non-pharmacological techniques, such as four-square breathing exercises and prone positioning, aimed at alleviating postnatal discomfort and enhancing maternal well-being. Data were collected before and after the interventions using standardized questionnaires designed to assess maternal discomforts and quality of life. These measures allowed for a comprehensive comparison of the effectiveness of focused nurse-midwife interventions versus routine care in improving postpartum recovery outcomes.
RESULTS
For the evaluation of the effectiveness of nurse-midwife interventions on postnatal mothers’ pain levels and quality of life, statistical tests were applied for the analysis of data. In addition, descriptive statistics like the mean and standard deviation were calculated for both the experimental and control groups. A paired t-test was used to compare the pretest and posttest scores in each group, and an independent t-test was conducted to check the differences between the two groups. Determining the significance of changes in pain levels and quality of life was based on a P value < 0.05. This could allow for the identification of the impact of non-pharmacological interventions on the outcome during maternal care [Table 1].
Table 1.
Comparison of maternal pain and quality of life scores between experimental and control groups during the postpartum period
| Measure | Group | Mean | SD | Mean Difference | t | P |
|---|---|---|---|---|---|---|
| Maternal Pain Score - Pretest | Experimental | 35.78 | 5.42 | 0.65 | 0.64 | 0.52 (NS) |
| Maternal Pain Score - Pretest | Control | 35.13 | 5.78 | |||
| Maternal Pain Score - Posttest | Experimental | 13.8 | 1.26 | 19.75 | 25.95 | 0.001*** (S) |
| Maternal Pain Score - Posttest | Control | 33.55 | 5.76 | |||
| Quality of Life Score - Pretest | Experimental | 56.42 | 3.65 | 0.55 | 0.7 | 0.48 (NS) |
| Quality of Life Score - Pretest | Control | 55.87 | 4.85 | |||
| Quality of Life Score - Posttest | Experimental | 93.2 | 2.32 | 35.98 | 59.38 | 0.001*** (S) |
| Quality of Life Score - Posttest | Control | 57.22 | 4.08 |
Posttest level of maternal pain score between experimental and control group. In the experimental group, 80.00% of them have no pain score, and 20.00% of them have discomfort pain score. In the control group, 85.00% of them have Discomfort pain score, and 15.00% of them have severe pain score. Statistically, there is a significant difference between the experimental and control group.
Posttest level of Quality-of-life score between experimental and control group. In the experimental group, 23.33% of them have a moderate QOL score, and 76.67% of them have good QOL score. In the control group, 73.33% of them have poor QOL scores, and 26.67% of them have moderate QOL scores. Statistically, there is no significant difference between the experimental and control group. It was assessed using the Chi-square test.
DISCUSSION
This research also proved that in the pretest, 83.33% of mothers in the treatment group had discomfort while having severe pain for 16.67%. In the control group, it was found that 85.00% had experienced discomfort while 15.00% had severe pain. But the difference between groups was not found to be statistically significant (χ2 =0.06, P = 0.81). In the posttest, 76.67% of mothers experience no pain while 23.33% of mothers felt discomfort in the treatment group. On the other hand, in the control group, 0% reported no pain, 91.67% reported having pain, and 8.33% reported severe pain. The variation between groups was statistically significant at χ2 =75.36, P = 0.001.
The findings were compared to a research by Fadare RI et al.[7] which was a randomized controlled trial at a tertiary care hospital with 100 postnatal women in each group. The experiment group was thus provided with focused nurse-midwife interventions in the form of four-square breathing and prone positioning, while the control group received routine postnatal care. According to Gandeh MB et al., 25% of mothers in the experiment group felt uncomfortable post-test, which was a great improvement from the pretest record of 85%, as 75% had no experience of pain. This outcome is in consonance with the present study and highlights the importance of focused interventions in reducing negative symptoms and the enhancement of postnatal recovery.
Comparative study undertaken with another one by Gandeh, M.B et al.[8] and Ghag S.S, et al.[9] proved that patients who underwent four-square breathing exercises during postnatal recovery had a marked decline in pain and anxiety levels. This was evident in that 70% of the patients were comforted and painful intensity reduced from the control group. This validates the results of the present study, which indicated a significant reduction in pain and discomfort after the interventions. Therefore, four-square breathing exercises and prone positioning, as non-pharmacological approaches, may serve as a useful tool in postpartum well-being.
CONCLUSION
The midwife plays a critical role in reducing postnatal discomforts and improving the overall quality of life for mothers through targeted interventions. This study emphasizes integrating nurse-midwife interventions into routine postnatal care to promote maternal recovery and well-being. The findings indicate that such interventions significantly reduced postnatal discomforts and enhanced quality of life in the experimental group at a tertiary care hospital in Chennai. Notably, a significant number of mothers reported no pain post-intervention, with quality of life scores improving substantially, demonstrating the effectiveness of enhanced postnatal care practices.
Conflicts of interest
There are no conflicts of interest.
Funding Statement
Nil.
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