Assesment of the effects of antenatal maternal anxiety upon the normal vaginal delivery

OBJECTIVE: In our study; the effect of the anxiety encountered during the late term of the pregnancy and the labor, on the patients who are having normal vaginal delivery is investigated. For this purpose, it is evaluated whether the duration of the labor and vaginal lacerations occurred during the delivery are correlated with the level of the anxiety.MATERIALS AND METHODS: For the study, 50 nulipar and 35 multipar patients with 28 or more week pregnancy who applied to the obstetrics and gynecology clinics of Kocatepe University and Afyon Zubeyde Hanim Dogumevi are selected. These patients consist of pregnant women who have singular pregnancy, do not have vaginal infection, have fetuses in the occiput anterior presentation and whose examinations do not show any sign of cephalopelvic disproportion, and finally their NST is reactive. The anxiety level of the patients is determined by applying Spielberger's State Anxiety Inventory in their third trimesters and at the beginning of the labor. The patients are observed by a standard travay watch in their labor and labor stage durations and lacerations in the labor are calculated. The moment at which patient feels regular contractions is taken as the beginning of the first stage. The first stage is separated into two phases; up to 3 cm dilatation is the passive phase and 3 cm and more dilatation is the active phase. The 1. stage is considered as over when the cervical dilatation is 10 cm and effacement is % 100. From this stage to delivery is accepted as the 2. stage, and finally delivery of the baby and placenta as the 3. stage. The size of lacerations is calculated by averaging the length of the each side and variations of the lacerations are determined. Following these evaluations; maternal state and trait anxiety levels, durations of the labor stages, the size and the variations of the lacerations are compared. Besides, statistical analyses are repeated by taking the control of the effects of the maternal and fetal factors on the active phase and second stage of the labor and lacerations.RESULTS: While the trait anxiety of the patients during both third trimester and labor resembled each other, an increase in the state anxiety is observed during labor. It is observed that the trait anxiety levels for multipar patients are higher being statistically more meaningful.For nulipar patients, state anxiety in both terms, latent and active phases of the labor; first, second stage and total duration of the labor are correlated to each other with statistically meaningful correlation. Moreover, trait anxiety in both terms and total labor duration are meaningfully related at nulipar patients. There is a positive correlation with the state anxiety level only during the labor for multipar patients. The duration of the third stage of the labor is observed as related with state anxiety in both terms. When the amount of the patient?s lacerations are evaluated after taking statistically under control of the effects of maternal and fetal factors, which may contribute to the formation of lacerations, it is determined for nulipar patients that, state anxiety points at each term, length of the lacerations and the amount of the extension are meaningfully positive correlated. This correlation is caused by only for nulipar patients to whom fundal pressure is appliedCONCLUSIONS: The anxiety occurred in the last trimester of the pregnancy and during labor, particularly the acute state anxiety have negative effects on the duration of the labor stages and lacerations. It is concluded that it will have positive effects on labor if anxiety evaluations are realized and emotional support is provided to the patients beside physical care in the last trimester and during labor.