| dc.description.abstract | Alternative birth positions are one of the interventions in reducing maternal and
neonatal mortality and morbidity (WHO, 2020).The use of supine positions during
second stage has been associated with maternal neonatal complications. supine or
lithotomy positions is the most used position in both develop and developing
countries, despite of evidenced based literature which discourages its utilization, this
has been associated to lack of knowledge among parturient women. The study,
therefore aimed at investigating effectiveness of educational program on utilization
of alternative birth positions during second stage of labor among parturient mothers
in western Kenya. The study was a non-equivalent pre and post test quasi
experimental research design. Antenatal register was used as sampling frame and
systematic sampling was used to identify and allocate participants to both groups of
study.Sample size was computed using fleis formular with a total 500 as the sample
size. The intervention group received two sessions of 2 hours each of the training
between the 32th to 37th weeks of gestation. Data was collected using standard
questionnaire, checklist,and focus group discussions. Data was analyzed using
Statistical SPSS version 28. Chi-Square, paired t-test, logistic regression were the
main statistical tests with p<0.05.Lithotomy position was the most used birth
position during the last delivery, with 94.6% control,93.3% intervention. Both
groups had limited Knowledge about alternative birth positions at baseline, with only
1.68%(intervention) and 1.23% (control group).The intervention group had increase
in knowledge of alternative birth positions, from 0% at baseline to 68.5% at end line
( χ2= 41.6, p < 0.001),control group remained static, with no knowledge reported at
baseline and only 9.4% at end line(after education).The intervention group uptake
alternative positions from 6.7% to 68.5% at end line, control group (5.3% to 10.7%
in end line), χ2= 16.8, p= < 0.001.Being married ( p = 0.028) or being unemployed
(housewives or farmers) ( p = 0.044) decreased uptake of alternative birth position.
Necessary resources, facilitated utilization of alternative birth position (AOR =
28.64; p < 0.0001). Previous birthing experiences negatively influenced decision
regarding birth positions (AOR = 0.40; p = 0.037). Spontaneous labor was also more
in the intervention group (51.0%),control group (49.0%), χ2=4.6, p=0.032).Intact
perineums (62.1%) and a lower rate of episiotomies (4.7%) compared to the control
group, with
(χ2=96.4, χ2=306.7, respectively, p= 0.0001. Intervention group had
higher rate of blood loss less than 500ml (53.6%), control group (46.4%), χ2 =27.1,
p=< 0.0001 and a lower rate of augmentation during the second stage of labor
(28.6%) ,control group (71.4%), χ2 =6.6 , p= 0.010 was also observed. Likewise
intervention group had shorter mean duration of the second stage of labor (18.9
minutes) compared to the control group (62.1 minutes), with a t-test = -18.8, p=<
0.0001 and had a higher rate of 1st Minute APGAR scores ≥7 (57.4%),control group
(42.6%), with a p= < 0.0001.In conclusion the study showed that educating
Parturient women during prenatal visits increases the knowledge on alternative birth
positions and improves uptake of alternative birth positions during second stage of
labour. Marital status, occupation, previous birthing experiences, access to
equipment are critical factors influencing the uptake of alternative birth positions
educating parturient women on alternative birth positions during second stage will
enable them to make inform choice and enhance the overall positive birth outcomes.
the study recommend incorporating educational program into routine prenatal care to
ensure that all parturient women have access to information on alternative birthing
positions. | en_US |
