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Maternal comfort during spontaneous and induced labour
BERANOVÁ, Jana
Bachelor thesis deals with comfort of a mother-to-be during spontaneous and induced labour. Spontaneous labour has assumed on the basis of natural mechanisms of a woman´s organism and was going on without obstetrician´s interventions. In the opposite we understand with the induced labour an artificial evocation of the womb activity in order to end pregnancy with a vaginal delivery. Comfort is closely connected with the delivery; it is defined as situation of physical, psychic and social well-being or peace. Bibliography distinguishes between a physic and social comfort and an environmental comfort. In the theoretical part of this work is this closer described based on quoted bibliography and newest findings in this field. Further is in detail elaborated the nursing care of women in induced and spontaneous labour and the role of midwives during all delivery phases. The practical part of the thesis is aimed to perception of comfort differences at spontaneous and induced delivery by women during the labour. For this thesis was set only one goal, just to find out exactly the difference in perception of spontaneous and induced delivery by mothers-to be during the delivery. Two research questions were determined. Wording of the first question: "How do women evaluate the difference of pain perception of the womb activity at spontaneous and induced labour?" Second questions pursued differences in the medical procedures: "How do women evaluate the difference in medical procedures in case of a spontaneous and induced delivery?" For processing of this problematic and finding out of the given goal was chosen a quality research. For the data collection was used the technique of half structured interviews. These interviews were later processed with the method of content analysis. The research array were women after labour at the puerperium department of hospital Nemocnice Strakonice, a. s. For the quality research were eight women selected, who have the experience with both types of the labour (spontaneous and induced). Based on these quality research results were reached further described conclusions and answers to research questions. The majority of respondents handled better the spontaneous labour. Only one respondent was more satisfied with the progress of inducted delivery. All approached respondents realized that inconveniencies and pain, which accompany the labour, are inseparable part of the labour action, however there were detected significant differences primarily in experiencing of womb contractions. During the spontaneous delivery expectant mothers reported gradual entrance of contractions, so they could have used to the pain and get ready for it. During the induced delivery was the ache sudden, sharper and permanently intense. The biggest difference in the delivery leading experienced all respondents (without one) in the possibility of free movement, which was possible only during the spontaneous labour. During the induced labour was the motion supposedly restricted by frequent CTG-checks and often repeated vaginal screening. Further they could have drunk and eaten during the spontaneous delivery. They have used more non-pharmacologic relief methods by the spontaneous delivery too - like relief positions, aromatherapy, gymnastic ball, massages, shower etc. During the induced delivery they have already asked for pharmacologic methods. An effort of the expert public, mostly of the midwife, is to create the best possible level of comfort to women in labour, so they are satisfied with the labour progress and manage the own delivery best possibly. This bachelor thesis can serve as information material for pregnant women, who are actively getting ready for coming labour. Even future midwives, who prepare their selves for this job can use it, alternatively is it aimed for special midwives ("duly") and other persons attending the delivery.
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Programmed labour as seen through the eyes of the women giving births in Jindřichův Hradec maternity hospital
MACHOVÁ, Jitka
The objective of today´s obstetrics is to turn childbirth into an exceptional family event. One of the methods currently employed in obstetrics is the choice of programmed labour, which introduces artificially induced uterine activity that is to terminate physiological term pregnancy at ideal time and under ideal conditions for everybody, the mother, fetus/newborn, woman in labour´s relatives, and nursing staff. Programmed labour is a highly controversial issue because it involves childbirth induction on the ground of non-medical indications. The programmed labour is supported as well as opposed by both, medical professionals and general public. The objective of this bachelor´s thesis was to find out how the programmed labour is perceived by women who have chosen to terminate their pregnancies on a programmed basis; what knowledge of programmed labour they have and what experience with it they have. The empirical part is based on a qualitative research. The data were gathered by semi-structured interview, which was held with selected women in labour at the Department of Gynecology and Obstetrics of the Hospital Jindřichův Hradec. Selection criterion was defined as women in programmed labour. Holding the interviews with individual respondents resulted in completion of case reports. These served as a research base for categorisation tables, which comprise of important outcomes of the research. The research was carried out in terms of defined objectives and research questions. All objectives defined in the thesis were met; questions were answered and information retrieved. Based on the research outcomes, six hypotheses were proposed. The main outcome of the research is that the respondents have knowledge of the term "programmed labour". Also, they are aware of some of the advantages relating to mental area and they are satisfied with choosing programmed labour. What these women are not aware of is the disadvantages of programmed labour. Following the research, a draft of informed consent was made up for women in labour so that they receive full information about programmed labour and can agree with pre-induction and induction of the childbirth. In order to secure provision of quality nursing care during a programmed labour, guidelines containing standard procedure of nursing care provided to women in programmed labour were created. Both materials are to be used in the delivery room of the Hospital Jindřichův Hradec.
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Know - how gravid women about after - terminal pregnancy
ŠIKOVÁ, Miroslava
The thesis on the topic of awareness of pregnant women about overdue pregnancy consists of two basic parts. In the theoretical part the thesis deals with first signs of pregnancy and how the pregnant woman can recognize them. How to calculate the due date and how long physiological pregnancy takes. Other topics mentioned are frequency, causes and risks of overdue pregnancy and ways of dealing with failed induction of labour. The aim of the research investigation was to determine whether pregnant women know the risks of overdue pregnancy, whether they know the length of pregnancy, whether they have knowledge of how to calculate the due date and whether they know the reasons leading to the induction of labour. Hypotheses were stated which were to confirm the knowledge of pregnant women about the risks of overdue pregnancy, women's knowledge about the length of pregnancy, women's knowledge about ways of calculating the due date and knowledge of the reasons to induce the labour. Quantitative research was chosen as methodology of the work, data collection was conducted using the questionnaire technique. The questionnaire was anonymous, the initial questions identified the respondents. Questions in the questionnaire were related to overdue pregnancy. The research was carried out in Strakonice Hospital and in gynecologists´ surgeries. 70 questionnaires had been distributed. The total set consisted of 60 (100%) respondents. The objectives of the thesis were met and the hypotheses were confirmed by the results of the research investigation. It was found out that pregnant women are well informed about the risks of overdue pregnancy and they have enough information about the whole issue. Women receive information from their doctor-gynaecologist, midwives and from the Internet when the Internet is not a valid resource for pregnant women. It would be beneficial to provide information about other natural methods of induction of labour. The best form of education of expecting mothers would be a focused interview during pre-birth classes or creating information brochures, which would be available in every gynecological surgery.
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