"A Strong Intention, A Relaxed Body and An Open Mind Are The Main Ingredients For An Active Birth" - Janet Balaskas

CHAPTER 1
INTRODUCTION
“A strong intention, a relaxed body and an open mind are the main ingredients
for an active birth”
-Janet balaskas
Motherhood is a great responsibility and it is women’s highest crown of honour.
Therefore maintaining good health during pregnancy, intranatal and postpartum
period is very important especially in the present stressful life. Childbirth is a time
when a woman’s power and strength emerges full force, but it is also a vulnerable
time and a time of many changes. The labour and birth process is an exciting and
anxiety provoking situation for a woman and her family. The time of labour and
birth, though short in comparison with the length of pregnancy, is the most dramatic
and significant period of the expectant woman. The transition from pregnancy to
labour is a sequence of events that begins gradually, with the onset of regular uterine
contractions and culminates in complete dilatation of cervix.
Labour is an inevitable physiological process that most women experience a high

intensity of pain. Labour is mostly considered to be one of the most painful
experiences in the life of women . Pain is described as any physical discomfort
caused by illness or any physical injury that can greatly impact one’s daily life
activities. Labour pain is an expected and intricate part of childbirth . The extent to
which labour pain is experienced affects maternal psychology, labour progress and
foetal well-being . Physiological factors, such as uterine contractions and cervical
dilatation, although very essential for the progress of labour but forms as the major
contributors to the pain experienced during labour. Psychological factors such as
stress, anxiety, fear, sense of loss of control and sense of abandonment also
contribute to the level of severity of the pain experienced . There is also a wide range
of factors which may influence labour pain, including personal, physical and
medical characteristics associated with the woman in labour. Agani Afaya (2021)
According to Rafal, S. Filip (2013) Pain is an unpleasant sensory and emotional

feeling accompanying existing or impending tissue damage or referenced to such
damage. Pain is the most common experience reported by patients, and patient
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anxiety is a form of warning signal. It is a sensual and perceptual phenomenon,
which causes suffering and emotional state of risks connected with anxiety. Pain has
many forms. It warns against damage to the body, which is important for
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avoiding injuries and consequently for survival. Pain not caused by acute injuries can
be unpleasant for the patient, or it can alter a person’s life, reduce the quality of life,
and also have an impact on the patient’s family. The word “pain” for the patient
means disease and suffering, for the doctor it is a symptom and for the physiologist it
is a kind of feeling that has its own anatomical and physiological system which
begins with the receptors and ends up in the brain cortex. Pain not caused by acute
injuries can be unpleasant for the patient, or it can alter a person’s life, reduce the
quality of life, and also have an impact on the patient’s family.
According to Gill Thomson (2019) Non-pharmacological pain relief methods

associated with relaxation and massage are referred to as mind-body interventions.
Relaxation methods such as yoga, music, breathing techniques and different forms
of massage (e. g. shiatsu, reflexology) are designed to induce calm and to
distract/alleviate pain in labouring women. Trials of relaxation techniques during
labour have reported less intense pain, increased satisfaction with pain relief and
lower rates of assisted vaginal birth without any adverse outcomes. Many women use
pharmacological or non-pharmacological pain relief methods during childbirth.
Jayme Moye et. al(2018) stated that Lamaze breathing practices for
childbirth has clear physical benefits. Breathing techniques keep the body more relaxed
and thus better able to cope with the discomfort of contractions and delivery. Mentally, too,
breath awareness creates an anchor point, one element that a woman in labour can control
among all the dramatic changes happening in her body when the baby is ready to be born.
Lamaze teaching has evolved to surround whatever type of patterned breathing works best for
the woman to stay relaxed and on top of her contractions and confident that she can deliver
her baby. In Lamaze classes, the expecting couple will learn a variety of techniques that they
can practice to find the woman’s preferred rhythm for different parts of labour and delivery
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BACKGROUND OF THE STUDY
According to McKinney (2018) stated that Labour pain was part of a normal process.
Although expected during labour process, it is considered as the most undesirable
and unpleasant aspect of the labour experience during childbirth. Labouring women
often experience intense pain due to uterine contractions. During descent, the fetus
head exerts pressure on the mother’s pelvic floor, vagina and perineum causing
somatic pain transmitted to the pudendal nerve. As woman’s labour progresses,
labour pain also increases especially in primiparas. Pain during birth involves two
components; the physiologic component which includes reception by sensory nerves
and transmission to the central nervous system and the psychological component
which involves recognizing the sensation, interpreting it as painful, and reacting to
the interpretation.
Abiy Todesse Angelo(2020) conducted a study in United Kingdom to determine the

pain experienced by the mothers during labour depicted that 93. 5% of the women
described the pain as severe, while in Finland, 80% described intolerable. Besides
this, laboring mothers experienced 10. 9% severe acute postpartum pain in 36 hours,
9. 8% persistent pain, and 11. 2% depression at 8 weeks. Although strong and
persistent pain during labor might not be considered as a source of complication for a
healthy patient, it stimulates the sympathetic nervous system, which causes an
increase in the heart rate, blood pressure, sweat production, endocrine
hyperfunction, delays the patient’s prognosis, and traumatic childbirth experiences.
Kavitha Devi (2021) conducted a study in CLR, Nehru Hospital PGIMER

Chandigarh, from 18th July to 8th September. Thirty nine primigravida mothers
were selected by total enumerative sampling technique. The mothers were introduced
to the investigator and explained about the research project. The primigravida
mothers were assessed for the level of anxiety and routine care was given. First
assessment of labour pain was done at 3-4 cm. dilatation of cervix, second
assessment done after 2 hours of first observation and third assessment was done after
2 hours of second observation in the subjects. Duration of active phase of first stage
of labour was assessed by partograph from 3-4 cm. to full dilatation of cervix. to
assess the level of anxiety, intensity of labour pain and duration of first stage of
labour in the primigravida mothers. Intensity of labour pain was measured by
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Numeric P ain Rating scale (mild;1-3, moderate;4-6, and severe;7-10). The study
results showed that the intensity of labour pain in the study subjects were mostly
moderate (61. 5%) to severe (33. 3%) type of pain during first observation. and
average duration of active phase of first stage of labour is 6 hours in primigravida
mothers, and also 51. 3% mothers had duration of 3-6 hours and 43. 6% mothers had
> 6 hours of duration of active phase of first stage of labour .
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According to Shilpa Katoch(2018) labour pain is the result of many complex
interactions, physiological and psychological, excitatory as well as inhibitory.
Women experience a wide range of pain in labour and exhibit an equally wide range
of responses to it. The pain of childbirth results from hypoxia of uterine muscle,
dilation and stretching of the cervix, pressure and pulling on adjacent organs and
pressure from the presenting part on the vagina and perineum during birth. The fetal
size and position influence length of labour as well as pain. Childbirth is a unique
and special experience for every woman. It is exciting as well as strenuous with pain,
fatigue and fear both physically and psychologically. Pain in labour is nearly a
universal experience for childbearing women and pain relief process a major role.
The excruciating pain that a woman feels during labour is caused by contraction of
the muscles of the uterus and the pressure created on the cervix. The pain is felt as
strong cramping and aching in the abdomen, back, groin as well as sides of the
thighs. The pressure created by the baby’s head on the bladder and bowels and the
stretching of the vagina and the birth canal also causes pain.
The Lamaze method was originally created in France in 1951 by Dr. Fernand
Lamaze. It encompassed methods of breathing and relaxation, emotional support,
and childbirth education classes. It was Marjorie Karmel who first introduced the
Lamaze method in U. S. In 1960, she and Elisabeth Bing co-founded the American
Society for Psychoprophylaxis (ASPO), now known as Lamaze International.
Lamaze techniques quickly became very popular, as they allowed expectant parents
to prepare themselves for labor. Such classes taught conscious relaxation strategies to
cope with the pain of contractions. Controlled breathing patterns also represent a
fundamental part of Lamaze childbirth education. They serve as a distraction, thus
reducing the brain’s perception of pain during labor. They’re thought to be most
effective when used in combination with other forms of pain management. Over the
years, the focus of Lamaze classes have shifted towards the development of
individualized breathing and relaxation strategies suited to each woman’s specific
needs. MarinaSavchenko(2020)
According to Janine Kellbach (2017) Lamaze breathing techniques

teaches to pattern the breathing and to decrease the pain perception feel. As each
contraction begins, a deep, or cleansing, breath has to be taken. Deep breath is
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followed by slow, deep breathing taken inside through the nose and out through
pursed lips. The focus on careful breathing distracts and decreases the discomforts
perception. Another breathing regimen is to pant slowly while repeating the sounds
“hee, hee, hee. ” Partner will assist , breathing with and encouraging . If there is an
urge to push before the cervix is fully dilated, may need to blow out more rapid,
short breaths. Encouraged to learn and practice these breathing techniques ahead of
time, finding the one which will be most useful during labor.
According to Lamaze International (2021) The goal of Lamaze classes is to

"increase women's confidence in their ability to give birth. " Toward that end,
women learn a variety of simple coping strategies, of which breathing is only one.
The classes aim to help women "learn how to respond to pain in ways that both
facilitate labor and increase comfort. "The Lamaze philosophy of birth stipulates that
"birth is normal, natural, and healthy" and that "women have a right to give birth
free from routine medical interventions. " But Lamaze also educates women so that
when interventions are needed, or pain relief medication is desired, women are able
to give true informed consent.
Wendy C. Budin(2018) stated that the goal of Lamaze classes is that every woman
gives birth confidently, free to find comfort in a wide variety of ways, and supported
by family and health care professionals who trust that she has within her the ability to
give birth. By achieving our goal, Lamaze contributes to larger advocacy efforts,
which will, over time, make birth normal again. Women in Lamaze classes are
encouraged to make informed choices about birth within the context of the limited
options that currently exist for most women. Lamaze International believes that only
when normal birth is again the standard women will have the opportunity of making
truly informed choices about the birth of their babies.
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NEED FOR THE STUDY
Pain during labor and childbirth is a unique and the most severe pain event in
women’s life.
The extent to which a woman feels in control of pain during labor is an important
indicator of maternal emotional wellbeing in childbirth . More than 90% of the
tension and stress during the pregnancy period is related to childbirth . Loss of labor
pain control was reported by 54. 6% of women in the Netherland. A study conducted
in Sweden showed that 41% of participants reported labor pain as the worst
experience
GLOBAL SCENARIO
Gulay Yildirim(2022) conducted a study at SSK Bakirkoy Women and Children’s
Hospital (Istanbul, Turkey) among primigravida mothers who were in first stage of
labour. The result revealed that in experimental group, 22(84. 6%) of mother had
moderate pain and 4(15. 4%) of mother had mild pain after administration of Lamaze
breathing technique. In control group 19(73. 1%) of mother had worst pain and 7(26.
9%) of mother had severe pain. The study concluded that Lamaze Breathing
Technique was effective in reducing labour pain during first stage of labour among
primigravida mothers.
INDIAN SCENARIO
A study was conducted at Community Health center, kolar road, Bhopal (M. P. ).
among primigravida mothers who were in first stage of labor. The result revealed
that 70% (14) of primigravida mothers were having severe pain and 30% (6) mothers
were having moderate pain in control group. Where as, in experimental group, 65%
(13) mothers were having mild pain, 35% (7) of them were having moderate pain
which shows Lamaze breathing exercises were more effective in pain perception
among primigravida mothers Mamata Kamble. (2018)
TAMILNADU SCENARIO
Ellappan(2019) conducted a study at Government head quarters hospital
Thiruvalluvar among primigravida mothers. . The result revealed that in experimental
group 31(51. 67%) had mild pain, 25 (41. 67%) had moderate pain and 6 (10%)had
severe pain, and 0(0%) had very severe pain, 0(0%) had strong pain . In control group
out of 60 , 0(0%) had mild pain 0(0%) had moderate pain and 12(20%) had severe
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pain 26(43. 33%) had very severe pain, and 22(36. 67) had strong pain , So the result
showed that , after receiving the Lamaze breathing exercises, pain perception was
reduced.
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KANYAKUMARI SCENARIO
Remya S Nair (2014) conducted a study in selected hospitals at Kanyakumari
District. 60 samples were selected using random sampling technique. Labour pain
was assessed and paced breathing exercises were provided to the experimental group.
During pre test both experimental and control group, 60(100%) had severe pain .
During post test , experimental group , 14 (46. 6%) had mild pain 16(53. 3%)had
moderate pain and none had severe pain . The study concluded that the pain
experienced by the mothers during labour can be reduced by performing paced
breathing exercises which is cost effective and best method
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STATEMENT OF PROBLEM
“ A study to evaluate the effectiveness of selected Lamaze breathing technique
on pain perception during first stage of labour among primigravida mothers
admitted in a selected hospital at Kanyakumari district”
OBJECTIVES OF THE STUDY
 To evaluate the level of pain perception among primigravida mothers
 To determine the effectiveness of Lamaze breathing technique on level of pain
perception during first stage of labour among primigravida mothers .
 To find out the association between the pre-test level of pain among
primigravida mothers with their selected demographic variables and obstetrical
variables in experimental and control group.
HYPOTHESES
H1 :There will be a significant difference in the level of pain perception after

administering Lamazebreathing technique among primigravida mothers
H2 : There will be a significant association between the pre test level of pain
perception with selected demographic and obstetrical variables in experimental and
control group.
OPERATIONAL DEFINITION
Evaluate
In this study , evaluate refers to the act of judging or assessing the effectiveness of
Lamaze breathing technique using Yazbek labour pain score .
Effectiveness
In this study , effectiveness refers to desired change in the level of pain after giving
Lamaze breathing technique among primigravida mothers and measured in terms of
Yazbek labour pain score .
Lamaze breathing technique
In this study, Lamaze breathing technique refers to a form of relaxation technique
done by the primigravida mothers during the latent and active phase of labour. which
focuses on deep breathing. It consists of five levels in which the mothers will start
with a slow deep breath by inhaling through nose and slowly breathe out through
mouth during uterine contractions releasing all physical tension from head to toes.
Every contractions starts and stopped when the contractions fades away.
Level-1
Slow chest breathing of comfortable but full respiration at rate of 6 -12 breath per
minute. This level is used during early contraction when the cervical dilatation is
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between 1-3 cm.
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Level -2
 Lighter and more rapid breathing than level -1

 The ribcage should expand but it’s so light that the diaphragm base should be
moved
 The rate of respiration is up to 40 perminute
 This is a good level of breathing when cervical dilatation is between 4 and 6
cm
Level-3
 Even more shallow and more rapid breathing for 20seconds

 The rate is 50-90 breaths per minute
 As the respiration becomes faster , the exhalation must be a little stronger than
the inhalation to allow good air exchange and to prevent hypoventilation.
 This level of breathing technique is used when the cervical dilatation is
between 7-8cm
 Keeping the tip of her tongue against the roof of her mouth help prevent her
oral mucosa from drying out during such rapid breathing.
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Level -4
 A “plant -blow’ pattern or taking three or four quick breaths then a forceful
exhalation .
 It is sometime referred to as “choo-choo” or hee-hee-hoo breathing.
between7-8cm
Level-5
 Quite continuous very shallow panting at about 60 breath/mnt
 This can be used during strong contractions to reduce painperception.
between 9-10 cm
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Pain perception
In this study, labour pain refers to the pain experienced by primigravida

mothers who are in first stage of labour and it is measured by Yazbek labour pain
score .
First stage of labour
In this study , it refers to the mothers who have 1-10 cm cervical dilatation and who
are inlatent and active phase of labour.
Primigravida mothers
In this study , it refers to the mothers who are delivering for the first time and are in
first stage of labour with 1-10cm dilatation
ASSUMPTION
The study assumes that
 The primigravida mothers may experience severe pain during labour

 Breathing technique may reduce labour pain perception by enchancing release
of endorphins into the body , which are the natural pain killers of the body
DELIMITATION
This study is delimited to
 Selected hospitals at Kanyakumari district

 A sample size of 60mothers
 A data collection period of 4 weeks
CONCEPTUAL FRAMEWORK
A conceptual framework is an analytical tool with several variations and contexts. It is in

which ideas are organized to achieve a research project’s purpose . Conceptual framework is
inter-related concepts or abstract that is assembled together in some rational scheme.
The conceptual framework selected for this study was based on the comfort theory by
Katharine Kolcaba (1990). This theory based on concept. The concepts are followed by:
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 Health care needs of mother
 Comforting interventions
 Intervening variables
 Enhanced comfort
 Health seeking behaviour
 Institutional integrity
HEALTH CARE NEEDS

According to comfort theory, health care needs are the comfort needs of
patients.
In this study health care needs refers to evaluate the effectiveness of
Lamaze breathing technique on labour pain perception during first stage of labour
among primigravida mothers.
COMFORTING INTERVENTION
According to Comfort theory it is an immediate desirable outcome of nursing
care
Comforting intervention used in this study is administration of Lamaze breathing
technique.
INTERVENING VARIABLES
According to Comfort theory factors that are not likely to change and over which
providers have little control (such as prognosis, financial situation, extent of social
support, etc)
In this study it refers to the socio demographic variables such as age, educational
status, occupation, area of residence, family monthly income and type of family.
ENCHANCED COMFORT
Nurses attained the outcome of enhanced comfort with implementation of

appropriate interventions in caring way
Assessment of pain by Yazbek labour pain scale
HEALTH SEEKING BEHAVIOUR
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Behaviours of a patient in an effort to find health
In this study it refers to the mothers reaction exhibited in Yasbek pain scale after
administration of Lamaze breathing technique.
INSTITUTIONAL INTEGRITY
Enhanced comfort maximizes health seeking behavior and increment in health
seeking behavior results in better institutional.
According to comfort theory in this study , it refers to the outcome /mothers comfort
by reduction of labour pain perception.
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SUMMARY
This chapter there fore deals with the background of the study , need for the study,
statement of the problem
, objectives of the study, assumptions, operational definition, hypothesis, inclusion
and exclusion criteria, delimitations and conceptual framework of the study.
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CHAPTER II
REVIEW OF LITERATURE
Review of literature is one of the most important step in the research process. It is an
account of what is already known about a particular phenomenon.
Review of literature is a critical summary of research on a topic of interest generally
prepared to put a research problem in context or to identify gaps and weakness in
prior studies so as to justify a new investigation
Polit and
Hungler (1995)
A literature review is body of text that aims to review the critical points of knowledge
on a particular topic of research
AMERICAN NURSES ASSOCIATION (2000)
Review of literature is discussed under following headings:
 Studies related to labour pain perception
 Studies related to common non pharmacological management of pain during
labour
 Studies related to Lamaze breathing technique
1. STUDIES RELATED TO LABOUR PAIN PERCEPTION
B . Jayabharathi (2019) conducted a descriptive study to assess the perception of labour

pain among primimothers. The data were collected in Government general hospital
Kancheepuram district. The total sample under the study were 60 primimothers who were
selected by convenient sampling method . The study was based on demographic variables
and obstetric variables. The tool was devided into two section. Section A structured
questionnaire to elicit demographic variables of primimothers . Section B comprised of
visual analogue categerical numerical pain scale which was used to assess the pain
perception of primimother. The result of the study revealed that 7(11. 6%) had no
pain 39 (65. 0%) mild pain 14(23. 45%) moderate pain , severe pain and no one had
worse pain. The study concluded majority 35 (58%) of primimothers had moderate
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labour pain.
A descriptive study was done by Adebayo Akadri (2018) to assess labour pain
perception among parturient mothers . The sample consisted of 132 pregnant women
who had vaginal delivery. The study was conducted in tertiary hospitals in south
west Nigeria. Data analysis was performed by IBM-SPSS statistics with windows
version 21. 0. A structured questionnaire was administered to women with in 24
hours of delivery to record details of labour and delivery . Labour pain perception
was assessed using the visual analogue score. The result revealed majority of the
114(86. 4) desired some form of pain relief.
The body mass index of respondents and birth weight of their babies had statistically
significant association with pain perception . Factors associated with increased odds
of having severe pain perception include unbooked status , secondary level education,
BMI <30 and gestational age>37 weeks.
Lydia Aziato (2017) conducted a descriptive study to assess the indepth

understanding on labourpain experiences and perceptions of postpartum mothers. The
research design was descriptive design. The setting of the study was at the tertiary
health facility in Acra Ghana. The participants drawn from the postnatal clinic. The
sample consisted of 14 participants. The study subjects were selected by using the
purposive sampling technique . Data were collected through individual interview.
Informed consent was obtained from all the participants . After transcription of
interviews the data were analysed inductively using content analysis technique. This
study gained indepth understanding of the womens experience of labour pain and
their perception on it which showed the individuality of labour pain experience. The
result revealed that a women experienced pain during labour rated as mild, moderate
and severe and the pain was felt at the waist area, vagina, lower abdomen and the
general body . Some women endured the pain, cried inwardly and others showed no
signs of pain. Some women believed that crying during labour is a sign of weakness.
Pain reliefs such as pethidine (meperidine) was occasionally given.
A prospective study was conducted to investigate predictors of severe labour pain .
The setting of the study was Kyiv city maternity hospital in Ukraine . Around 366
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women took part in the research study , 282 of participants rated their pain as <60
and 84 patients reported their pain >70. Data was collected from December 2020-
May 2021 by observation method and using visual analog scale. In postpartum
period all patients filled questionnaires and interviewed from 1-3 days after delivery .
The result revealed that in group 1 included 282 patients (pain level >7 mm
according to the VAS, group 2 included 84 patients (pain level is 6 mm using the
VAS). Anastasiia Romanenko (2022)
According to Sibel Oztiik (2019) conducted a descriptive study to assess and

determine the perception and feelings of women towards labour pain. The study was
conducted in child hospital and cross sectional design was used for this study. A total
sample of 300 women were taken for the study . Data were collected from March
2016 to October 2016. Data were obtained by researchers through face to face
interview in a postpartum clinic with in the first hour post partum The tool used for
data collection was visual analogue scale for assessing pain perception . The data
analysis were performed using SPSS version 20. 0. The result revealed that 37. 3% of
women found labour to be difficult terrifying and , 72. 26% of the women stated
that they received support during childbirth and they received this
support mostly from midwives. Also Primiparas women had significantly higher fear
(p<o. oo1), panic (p<0. 001), anxiety (p<. 001) need for support and fear of losing
infant (p<0. 05) than multiparas. The study concluded that women perceived
intolerable labour pain.
2. STUDIES RELATED TO COMMON NON PHARMACOLOGICAL

MANAGEMENT OF PAIN DURING LABOUR
Manju Mohan(2021) Conducted a quasi experimental study, to evaluate the effect

of reflexology on relieving labour pain among primigravida mothers. The study was
conducted in Amrita Institute of medical science, labour room Kerala, South India.
The sample consists of 50 primigravida mothers ( 25 Primigravida mothers
experimental group and 25 primigravida mothers control group)The research design
was quasi experimental, non randomized pre test /post test design. The pain
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perception was assessed by using visual analogue scale. Subjects were selected by
convenience sampling technique. The study based on demographic variables. The
data analysis was performed by using chi-square . The result revealed that foot
refelexology was effective in relief of labour pain . The study concluded that foot
reflexology was effective in reducing labour pain.
An experimental study was conducted to evaluate the effectiveness of back massage in

relieving pain during the first stage of labour in primi mothers. The study was conducted at
a tertiary care center in Karad
, Maharashtra. . The study included 40 primipara mothers(experimental group(massage
therapy 20 & control group(control group) 20) between the age group of 22-25 years.
Samples were selected by simple random sampling technique. Data collected was based on
socio demographic data . Data analysis was performed by oneway ANOVA and independent
‘t’ test. The tool used was numerical rating pain scale. . The study concluded that back
massage was effective in reducing pain during the first stage of labor in primipara
mothers . Mansasi P . Pawale
(2020)
Minerva Thame (2020 ) conducted an experimental study to assess the effect of

music therapy on labour pain, anxiety, and analgesia requirement in primipara
patients. The study was conducted in University Hospital of the West Indies. The
research design used was randomized controlled trial. The sample consisted of 260
primiparas expected to have a normal spontaneous delivery. The data were collected
from January 2022-October 2022. Labour pain was assessed using visual pain score.
The result of the study concluded that music therapy was effective in reducing pain
during first stage of labour in primiparous mother.
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randomised controlled trial was conducted to evaluate the effectiveness of safety and
harm of birth ball used bypregnant women in labour compared to treatment . The
study was conducted in Obstetrics and Gynaecological unit of five public hospitals in
Hong Kong China . The sample consisted of 512 pregnant women. The data were
collected from March2026-March 2017. Labour pain was assessed using visual
analogue scale. Data were analysed by linear mixed model. The study concluded
that birth ball was effective in reducing labour pain .
Katrina Wai Kay (2019)
Fereshteh Jahdi (2017) conducted a randomized control trial to assess the effect of
antenatal yoga program on perceived meternal labour pain and delivery outcomes.
The study was conducted Iin Mirza K Oochak Khan hospital in Tehran, Iran. The
sample consisted of 60 primiparous women
. The data were collected from March 2013-June 2014. Labour pain relief was
measured by visual analogue scale. The study was based on demographic and
obstetrical information. Data were analysed by using ‘ t’ test and chi-square test. The
antenatal yoga program was conducted for 1 hour with supervised yoga class , three
times weekly and, starting at 26 weeks of gestation. The result revealed that Yoga
during pregnancy may contribute in reducing labour pain and improved adequacy of
childbirth. The study concluded that yoga during pregnancy may contribute in
reducing labour pain.
An experimental study was conducted to evaluate the effectiveness of acupressure

Sanyinjiao point on the labour pain among Turkish nulliparous women. The study was
conducted in Bahcelievler Nisa Hospital in Istanbul. The sample consisted of 100
participants and divided into 2 groups as Acupressure group and Placebo group . The study
design used was single blinded, prospective technique. The data were collected from April-
September 2014. The samples were selected by random allocation . Labour pain was
assessed using visual analogue scale . Data were analysed by using IBM SPSS statistics
21. 0. The result revealed that, acupressure at the sp-6 point reduced the intensity
of pain during labour .
Halime Oncu
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Celik (2020)
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3. STUDIES RELATED TO LAMAZE BREATHING TECHNIQUE
Hatlin Sugi M (2021) conducted an experimental study, to assess the effectiveness

of Lamaze breathing technique on reduction of labour pain among primigravida
mothers. The study was conducted in primary health center Kovilpalayam
Coimbatore. The research design was one group pre test post test design. 30
primigravida mothers were selected by using convenient sampling technique.
Labour pain relief was measured by numerical pain intensity scale. The data collected
a period of four weeks. The result concluded that Lamaze breathing technique was
effective in reducing labour pain during first stage of labour among primigravida
mothers.
An experimental study was conducted to assess the effectiveness of Lamaze breathing

on labour pain and anxiety towards labour outcome among primigravida mothers
during first stage of labour. The study was conducted in Community health center,
Kolar road, Bhopal. The study was based on demographic variables. 40 samples
were selected by purposive sample technique. The data were collected from 25-8-
2015-7-9-2015. The pain perception was assessed by using visualanalogue scale data
were analysed by using descriptive and inferential statistics. (t-test, chi square test and
Karl Pearson ) The result revealed that Lamaze breathing exercises during first stage
of labour was found effective . The study concluded that practice of breathing
exercises shortens the duration of labour
, and prevents the complications during labour.
Akshaykumari Jhala(2021)
Varalakshmi(2019) conducted a quasi experimental study to assess the effectiveness

of Lamaze breathing exercise on labour pain and anxiety towards the outcome among
primiparous mothers . The study was conducted in Government head quarters hospital
Thiruvalluvar. Study consist of 120 samples selected by purposive sample technique.
The data were collected for 10 days. The tool used for data collection was visual
analogue scale for assessing the level of pain. The result revealed that, in
experimental group 31 (51. 675) had mild pain, 25(41. 67%) had moderate pain and
6(10%) had severepain , 0(0%) had moderate pain and 12(20%) had severe pain. The
study concluded that Lamaze breathing technique was effective.
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Nilima R Bhore (2016) conducted an experimental study to assess the effectiveness
of selected aspects of Lamaze method on pain among primigravida mothers during
first stage of labour. The study
was conducted in hospital of Sangali. The research design was true experimental
design. The sample consist of 30 primigravida mothers. The study was selected
by simple random sampling technique
26
. The researcher collected the information of the participants through demographic
performa and VAS was used to assess the pain perception. The study result revealed
that breathing exercises helped in reduction of pain perception in experimental group
and the women perceived less pain comparing to the control group. The study
concluded breathing exercise and massage helped in reduction of pain score level in
the experimental group and the mother perceived less pain.
A quasi experimental study was conducted to evaluate the effectiveness of video
based Lamaze nursing care intervention on pain perception, anxiety, fatigue and
labour outcome among Primigravida women admitted during childbirth. The study
was conducted in Cosmo Politian Hospital. The sample consisted of 200 primigravida
mothers in which 100 mothers were selected in control group and 100 mothers in
experimental group by convenient sampling technique The data were collected from
July to December 2012. Labour pain perception relief was measured by using
universal pain scale. The study was analyzed by using descriptive and inferential
statistics (‘t’ test, chi- square, Karl Pearson formula). The result revealed that , score
of pain in experimental group 2. 6 (SD=1. 4) was lesser than the control group 3.
6(SD=1. 9). The obtained ‘t’ value t=4. 11(p=0. 01) was significant. Hence, the null
hypothesis was rejected and alternative hypothesis was accepted. It was inferred that
pain perception in experimental group was less when compared to control group.
The study concluded that Lamaze method was effective among primigravida mothers
in coping with labour pain in first stage of labour. Sindhu Kuruvilla (2019)
An experimental study was conducted by Parimalam Priya (2021) to evaluate the

effectiveness of lamaze method in terms of pain perception, anxiety, fatigue and
labour outcome during labour process among primigravida mothers. The study was
conducted in Melmaruvathur Adhiparasakthi Institute of Medical Sciences and
Research in Tamil nadu. The sample consisted of 60 samples of primigravida
mothers in which 30 mothers were selected control group and 30 mothers in
experimental group by simple random sampling technique . The data were collected
from July to December 2012. Labour pain perception was measured by using
Speilberger’s anxiety scale, fatigue assessment scale and checklist for labor outcome.
The result revealed that the mean score was 5. 37 with the standard deviation of 9.
62 and calculated ‘t’ value of 2. 16 which was highly significant at p< 0. 05 level. So
finally, it was concluded that Lamaze method was highly effective for primigravida
27
mothers during labor process.
28
CHAPTER III
RESEARCH METHODOLOGY
Research methodology is a systematic way of setting a problem . This chapter depicts
the description and various methods adopted to collect and organize data for the
present study
In this study , the researcher intended to evaluate the effectiveness of Lamaze

breathing technique in reduction of pain during first stage of labour among
primigravida mothers admitted in a selected hospital at Kanyakumari district.
RESEARCH APPROACH
The research approach indicates what to collect and how to analyse it. it also suggest
possible conclusion to be drawn from the data, in view of the nature of the problem
under study.
-Denis F .
Polit, (2011)
The research approach adopted for this study was quantitative research
approach.
RESEARCH DESIGN
A research design is the arrangement of conditions for collection and analysis of data
in a manner that aims to combine relevance to the research purpose with economy
procedure.
Kothari ,
(2013)
Quasi experimental pre-test and post-test only design was adopted for this
study. SCHEMATIC REPRESENTATION
Experimental group O1 X O2
Control group O3 - O4
O1- Pre test level of pain perception among primigravida mothers by using Yazbek
labour pain score in experimental and control group
29
X - Intervention (Lamaze breathing technique)
O2- Post test level of pain perception among primigravida mothers by using Yazbek
labour pain score in experimental and control group
SETTING OF THE STUDY
Setting refers to the area where the study is conducted .
The present study was conducted in PPK Hospital , Marthandam. PPK hospital is a
230 bedded multispeciality hospital located at a distance of 2. 4 Km from
Kuzhithurai. The total number of outpatients were 750-800 per month. The total
number of inpatients were 120-140 per month . . The total number of patients
admitted in the labour ward were 20-25 per week and 5-7 per day . The total number
of patients admitted in labour ward were 15-18 per week.
VARIABLES
Variables are defined as an attribute that take on different values.
Dependent variables
Dependent variables is defined as the variable , hypothesized to depend on or be
caused by another variable of interest
In this study the dependent variable was the perception of pain among
primigravida mothers
Independent variables
Independent variable is defined as the variable that is believed to cause or influence
the dependent variable.
In this study, the independent variable was the Lamaze breathing technique
SAMPLING CRITERIA
Sampling criteria involves selecting the sample that fulfill some predetermined
criteria . The criteria for sample selection are mainly depicted under two headings,
which includes the inclusion and exclusion criteria
INCLUSION CRITERIA
30
Primigravida mothers who were
 at term
 in labour pain and admitted in latent and active phase of labour with 1-10 cm
dilatation
 willing to participate in the study
 available at the time of data collection
 able to understand Tamil , Malayalam or English
EXCLUSION CRITERIA
The primigravida mothers who were

 having neurological disorders or other medical problem
 having breathing disorders and respiratory tract infection
 receiving analgesics and epidural analgesia
POPULATION
A population is the entire set of individuals or objects having some common
characteristics.
The target population is the entire population , in which a researcher is interested and
to which she would like to generalize the study results . In this study , the target
population comprises of all primigravida mothers with labour pain
The accessible population is the list of population that the researcher finds in study
area. Accessible population for this study consists of primigravida mothers admitted
for labour in PPK Hospital -Marthandam, .
SAMPLE
Sample refers to a fraction of portion of the element in an universe drawn out
deliberately in a planned for studying interested characteristics of a large group of
31
population .
Denise F. Polit, 2017
In this study , the sample consist of primigravida mothers between 20-35 years
of age during first stage of labour admitted in PPK Hospital , Marthandam, who
fulfilled the inclusion criteria.
SAMPLE SIZE
Sample size is the number of individual from whom the required information is
obtained.
The sample size was 60 primigravida mothers (30 in experimental group and 30 in
control group) between the age group of 20-35 years
SAMPLING TECHNIQUE
Sampling technique is defined as the process of selecting a portion of the population
to represent the entire population .
For the present study , purposive sampling technique was adopted to select the
sample. By using purposive sampling technique, those mothers who were admitted in
antenatal ward were taken as experimental group and those mothers who came
directly to labour ward were included in control group. Every day mothers were
selected who fulfills the inclusion criteria until the calculated 60 sample size was
achieved.
SAMPLE SIZE CALCULATION
The sample size was estimated by power analysis prior to the commencement of the
study. N=4pq/d2 where ‘p’ was 16 . The calculated sample size was 54 . Expecting
case attrition 60 samples were recruited for the study
DISCRIPTION OF THE TOOL

It consists of 4 parts Section A , Section B, Section C, and Section D
Section A :Demographic variables
32
It consists of 10 items which includes age , religion, educationalstatus,
occupation, income, type of work, type of family, place of residence, recieved
information regarding labour pain relief and have attended yoga and parenthood
classes
Section B :Obstetrical variables

It consists of 7 items which includes , gestational weeks, antenatal checkup, time of
labour started, level of pain, frequency of pain, cervical dilatation in cm.
Section C : Yazbek labour pain score
It has 5 items and scored on a 2 point scale . The total score for this scale is 10 .
Based on the score, level of pain was assessed.
Section D : Self -satisfaction rating scale

It has 10 items and rated on a 4 point scale, scored as 4 highly satisfied, 3
moderately satisfied, 2 just satisfied and 1 dissatisfied . The total score for this scale
was 40. Based on score level of satisfaction was assessed.
SCORING PROCEDURE
Section I a, Demographic variables
Information on demographic variables were collected from the study sample

using structured questionnaire. The information were used to find out the association
between the pretest level of pain perception with selected demographic variables
Section I b, Obstetrical variables

Information on obstetrical variables were collected from the study sample using
structured questionnaire. The information were used to find out the association
between the pre test level of pain perception with selected obstetrical variables.
33
Section II: Yazbek labour pain score
Score interpretation
It consists of 5 items . Total maximum and minimum score were 10 and 0
respectively . The score was interpreted as
SCORE INTERPRETATION
No pain 0
Mild pain 1-3
Moderate pain 4-6
Severe pain 7-10
Section 1II:Self satisfaction scale Scoring interpretation

It consists of 10 items . Total maximum and minimum score were 40 and 10
respectively The score was interpreted as
Category Scoring
Low satisfaction <20
Moderate satisfaction 21-30
High satifaction >30
VALIDITY
Validity is defined as “extent to which an instrument accurately reflects the abstract
construct being examined.
Suresh K. Sharma (2007)
To ensure the validity the modified data collection tool was submitted to 8 experts (5
experts from obstetrical and gynaecological nursing department . I Obstetrician, 1
Yoga therapist and 1 Statistician). The experts were requested to judge the items for
relevance , appropriateness and degree of agreement for the study . All the experts
gave their consensus and tool was finalized
RELIABILITY
Reliability is defined as “The degree of consistency or dependability with which an
instrument measures an attribute”
Reliability of the Yazbek labour pain score was tested by using inter
rater method . The reliability coefficient r=0. 83. which was considered good
reliability. Reliability of the self satisfaction rating scale was tested by split half
method using Karl Pearson’s Correlation coefficient method . The reliability
coefficient r=0. 89 a good correlation and the tool was found to be reliable
ETHICAL CONSIDERATION
34
The investigator strictly followed the ethical principles proceding the study, formal
approval was obtained from research committee of Annammal College of Nursing,
Kuzhithurai. Official permission was obtained from the Administrative officer and
HOD of OBG (Obstetrics ) in PPK Hospital Marthandam. Oral and written consent
was obtained from each participant before starting the data collection. Assurance
was given that the data collected will be kept confidential and they have the right to
withdraw at any time during the course of the study.
PILOT STUDY
Pilot study is defined as a small scale version or trial run , done in preparation of a
major study
Denise F . Polit(2011)
In order to check the feasibility, relevance and practicability of the study , pilot study
was conducted at PPK Hospital Marthandam. Initial permission was sought from the
Medical Superintendent of PPK Hospital Marthandam for conducting the pilot study .
Pilot study was conducted in the month of July for a period of one week. The purpose
was explained to the subjects and confidentiality was assured. The investigator
selected 6 samples (3 in experimental group and 3 in control group). For the present
study purposive sampling technique was adopted to select the sample. By using
purposive sampling technique, those mothers who were admitted in antenatal ward
were taken as experimental group and those mothers who came directly to labour
ward were included in control group. The tool used to collect the data were
demographic variables proforma, obstetrical variables proforma, Yazbek pain sacle
and self- satisfaction rating scale. Pre test was done in order to assess the level of
labour pain during first stage of labour in the primigravida mothers. . Investigator
administered Lamaze breathing technique during the latent and active phase of labour
for post test was done using the same tool and the pilot study findings revealed that
study was feasible and practicable.
DATA COLLECTION PROCEDURE
Prior permission was obtained from Institutional Review Board. Formal permission
35
was obtained from the Chief Medical Officer of concerned settings . The data
collection procedure was done for a period of 1 month (August). The data were
collected from hospitalized primigravida mothers between the age group of 20-35
years.
The data were collected by 3 phases
Phase I
At first, rapport was established with the primigravida mothers and the purpose of the
study was explained to them . Written consent was taken from the mothers.
Investigator assured that all data would be kept strictly confidential and will be used
only for study purpose. For the present study , purposive sampling technique was
adopted to select the sample. The pre-test was conducted to assess the labour pain
perception during first stage of labour.
Phase II
Lamaze breathing technique was given during latent and active phase of first stage
labour with 1-10cm cervical dilatation by the researcher.
Phase III
Post -test was done after 10 cm cervical dilatation of first stage labour using the same
tool
PLAN FOR DATA ANALYSIS
Data analysis is the systematic organization and synthesis of research data testing
hypothesis by using the obtained data. Polit and Beek
(2011)
Data collected were analysed using both descriptive and inferential statistics such
as mean
, standard deviation paired ‘t’ test and chi square.
Descriptive statistics
 Frequency and percentage distribution of samples was done according to
demographic and obstetrical variables .
 Mean and standard deviation was used to assess the effectiveness of Lamaze
breathing technique.
Inferential statistics
 Paired ‘t” test was used to compare the pretest and post test level of pain
36
among primigravida mothers in experimental group and control group.
 Chi-squre was used to find out the association between the pre-test levels of
knowledge with the selected demographic variables and obstetrical variables .
37
ANNEXURE -XII
Tool for data collection (English)

SECTION I a
DEMOGRAPHIC VARIABLE PROFORMA
Purpose:
This proforma is used to measure the demographic variables such as age, religion
, educational status, occupation, area of residence , family monthly income , type of
family and sources of information
Instructions: The researcher will ask the study participant and fill the details.
1. Age (in years) a) 20-25
b) 26-30
c) 31-35
2. Religion
a) Hindu
b) Muslim
c) Christian
d) Others
3. Educational status of the mother
a) Illiterate
b) Primary school
c) High school
d) Higher secondary
e) Graduate
f) Postgraduate
g) Scholar 4. Occupation of themother
a) Private
b) Government
c) Coolie
d) Homemaker
5 Monthly income of the family . (Modified Kuppusamy Socioecnomic Scale -2021)
a) >123, 322
b) 61, 663 -123, 321
c) 46129-61, 662
d) 30, 831-46, 128
e) 18, 497-30, 830
f) 6, 175-18, 496
38
g) <6174
39
6. Type of family
a) Nuclear family
b) Joint family
7. Place of residence
a) Rural area
b) Urban area
8. Have you participated yoga classes?
a) Yes
b) No
9. Have you participated parenthood classes?
a) Yes
b) No
If yes, the topic attended
a) Prenatal care
b) Family planning
c) Newborn care
d) All of the above
e) None
10. Social support during delivery
a) Mother
b) Mother in law
c) Sister
d) Others
40
SECTION I b
OBSTETRIC VARIABLE PROFORMA
Purpose: This proforma is used to measure the obstetric variables .

Instructions: The researcher will be using the record, assess of the mother and fill
the details.
1 Gestational weeks
a) 28-32
b) 33-36
c) 37-40
2Antenatal checkup
a) Regular
b) Irregular
c) Nil
3. Time of labour started
d) 1-2 hrs
e) 3-4 hrs
f) 5-6 hrs 4. . Level of pain
a) Mild
b) Moderate
c) Severe 5. Frequency of pain
a) <20 sec
b) 20-40 sec
c) > 40 sec
6 Cervical dilatation
a)1-3 cm
b)4-6 cm
c)7-8 cm
d) 9-10 cm
41
SECTION II
Yazbek labour pain score
Purpose:
This score is used to assess the level of pain experienced by the primigravida mothers during first sta
.
Instructions:
The researcher will ask the study participant and mark the appropriate response
DATE
TIME
MIDWIFE RATING 0 1 2
INTENSITY
QUALITY Aching Sore Exhausting

Miserable Hurting Horrible
Tiring Unbearable
Discomforting
Tender
Agonising Excruciating
Annoying Intense Overwhelming
BEHAVIOUR & Happiness Muscular tension Crying out

PHYSIOlOGIC
Excitement Restlessness Nausea/ vomiti
Uncontrolled an
Relaxation Rising anxiety
42
FATIGUE Normal activity Active/ Tired Fatigue
/Sleepy
Normal Not eating
Liquid intake
eating /drinking
43
Normal voice Irritability
Little talking
Normal breathing
Rapid breathing Breathing
PSYCHOSOCIAL Support sufficient Rely on support Support

& EMOTIONAL
Interact normal More focused Interact difficul
Anticipation Frustrated Discouraged
Some fear Fear ofunknown Fear to be alone
TOTAL
PATIENT RATING :no pain 0…1…. . 2…3…4…5…6…7…8…9…10 unbearable
44
Score : /10
SCORE INTERPRETATION:
SCORE INTERPRETATION
No pain 0
Mild pain 1-3
Moderate pain 4-6
Severe pain 7-10
45
SECTION -III
SELF SATISFACTION RATING SCALE
Purpose: This scale is used to assess the level of satisfaction by the primigravida
mothers after Lamaze breathing technique.
Instruction: The researcher will ask the study participant and mark the appropriate
response
S. no statements Highly Moderately Just satisfied Dissatisfie

Satisfied Satisfied
4 3 2
1 Very easy to use

2 Pain reduction
3 Promotion of relaxation
4 Help to increase the coping

ability
5 Reduction of anxiety
6 Help to reduce
physical
tension
7 Helps to improve
oxygenation
8 Has no complications to
physical health
9 Helps to enhance labour
process
10 Helps to improve energy
Score: /40
SCORING INTERPRETATION
Category Scoring
Low satisfaction <20
Moderate satisfaction 21-30
High satifaction >30
46
SECTION IV LABOUR OUTCOME
Purpose:
This scale is used to assess the labour outcome of primigravida mothers after Lamaze
breathing technique.
Instruction:
The researcher will assess the mother and mark the appropriate answer.
1) Mode of delivery
a) Normal vaginal delivery
b) Assisted vaginal delivery
c) Caesarean section
2) Duration of labour
a) 12 – 15 hours
b) 16 – 18 hours
c) 19 – 21 hours
3) Duration of placental expulsion

a) 5-15 mts
b) 16- 30 mts
c) 31 - 45 mts
4) APGAR score
a) 0 - 3
b) 4 - 6
c) 7 - 10
47
CHAPTER IV
DATA ANALYSIS AND INTERPRETATION
The data analysis is defined as the organization and synthesis of research data testing
of hypothesis using those data. Analysis is a process of summarization , evaluation
and interpretation of the information collected in such a way that they provide answer
to research questions. Interpretation is the process of making results and examining
the findings within broader context.
Data collected were organized, edited, tabulated, analysed, interpreted and findings
obtained were presented in the form of descriptive and inferential statistics based on
the objectives formulated for the study
OBJECTIVES OF THE STUDY

 To determine the effectiveness s of Lamaze breathing technique on level of
pain perception during first stage of labour among primigravida mothers .
HYPOTHESES
H1 :There will be a significant difference in the level of pain perception after
administering Lamaze breathing technique among primigravida mothers
H2 : There will be a significant association between the pre test level of pain
control group.
48
Organized data were presented under the following headings:
Data pertaining to frequency and percentage distribution of demogr

Table-1
variables among primigravida mothers in Experimental and control
Section -A
Data pertaining to frequency and percentage distribution of selected

Table -2
obstetrical variables among primigravida mothers in experimental a
control group
Data pertaining to frequency and percentage distribution of pretest

Table-3
test level of pain perception among primigravida mothers in Experi
Section-B group
Table-4 Data pertaining to frequency and percentage distribution of pre test
test level of pain perception among primigravida mothers in contro
Section-C Table -5 Data pertaining to the effectiveness of Lamaze breathing technique

of pain perception among primigravida mothers
Table -6 Data pertaining to association of pre -test level of pain perception a

primigravida mothers with selected demographic variables in exper
group
Section-D
Table -7 Data pertaining to association of pre-test level of pain perception am

primigravida mothers with selected demographic variables in contr
Table -8 Data pertaining to association of pre -test level of pain perception a

Primigravida mothers with selected obstetrical variables in experim
group
Table-9 Data pertaining to association of pre-test level of pain perception am

primigravida mothers with selected obstetrical variables in control
49
Section-E Table-10 Data pertaining to frequency and percentage distribution of level of
satisfaction among primigravida mothers in experimental group aft
administration of Lamaze breathing technique.
50
SECTION-A
Table 1: DATA PERTAINING TO FREQUENCY AND PERCENTAGE

DISTRIBUTION OF DEMOGRAPHIC VARIABLES AMONG
PRIMIGRAVIDA MOTHERS IN EXPERIMENTAL AND CONTROL
GROUP
(N=60)
SI. No DEMOGRAPHIC EXPERIMENTAL GROUP CONTROL GROUP (n=30
VARIABLES (n=30)
f % f %
1 Age
a) 20-25 08 27 06 20
b) 26-30 13 43 18 60
c) 31-35 09 30 06 20
2 Religion
a) Hindu 14 47 16 53
b) Muslim 04 13 08 27
c) Christian 12 40 06 20
d) Others 00 00 00 00
3 Education
a) Illiterate 04 13 05 17
b) Primary 03 10 05 17
school 03 10 02 07
c) High school 03 10 04 13
d) Higher 07 23 08 27
secondary 10 33 06 20
e) Graduate 00 00 00 00
f) Postgraduate
g) Scholar
4 Occupation
a) Private 07 23 08 27
b) Government 00 00 00 00
c) Coolie 00 00 00 00
d) Homemaker 23 77 22 73
51
5 Income
a) >123, 322 00 00 00 00
b) 61, 663 -123, 321 00 00 00 00
c) 46129-61, 662 00 00 00 00
d) 30, 831-46, 128 03 10 05 17
e) 18, 497-30, 830 20 67 19 63
f) 6, 175-18, 496 07 23 06 20
g) <6174 00 00 00 00
6 Type of family
a) Nuclear 05 17 11 37
family 25 83 19 63
b) Joint family
52
7 Place of residence
a) Rural area 20 67 10 33
b) Urban area 10 33 20 67
8 Yoga
a) Yes 00 000 00 000
b) No 30 100 30 100
9 Parenthood
a) Yes 00 000 00 000
b) No 30 100 30 100
10 Social support
a) Mother 22 73 21 70
b) Mother in law 04 13 05 17
c) Sister 04 13 04 13
d) Others 00 00 00 00
Table :1 The above table represents the frequency and percentage distribution
of demographic variables among primigravida mothers in experimental and
control group
In experimental group regarding Age, Majority of primigravida mothers 13(43%) 26-
30 years, 09(30%) 31-35 years, and 08 (27%) were between 20-25 years. In
Religion , Majority of primigravida mothers 14(47%) were Hindu, 12(40%) were
Christian and 04(13%) were muslim, In Educational status Majority of primigravida
mothers 10(33%) were postgraduate, 07(23%) were graduate, 04(13%) were illiterate
and 03(10%) obtained higher secondary school education. In Occupation Majority of
primigravida mothers 23(77%) were homemakers and 07(23%) were working in
private sector. In Monthly income of family Majority of primigravida mothers
20(67%) ranges between 18, 497-30, 830, 07(23%) ranges between 6, 175-18, 496,
03(10%) ranges between 30, 831-46, 128, . In Type of family Majority of
primigravida mothers 23(83%) were joint family 05(17%) were nuclear family, In
place of residence Majority of primigravida mothers 20(67%) were residing in rural
family and 10(33%) were in urban family. In Social support during delivery Majority
of primigravida mothers 22(73%) received social support from mothers 04(13%)
received support from mother in law, 04(13%) received support from sisters,
In control group, regarding Age, Majority of primigravida mothers 18(60%) were

between 26-30 years, 06(20%)were between 31-35 years, and 06 (20%) were
between 20-25 years. In Religion, Majority of primigravida mothers 16(53%) were
53
Hindu, 08(27%) were Muslim 06(20%)Christian, In Educational status Majority of
primigravida mothers 08(27%) were graduate, 06(20%) were postgraduate, 05(17%)
were illiterate and 05(17%) were primary school, 02(07%) were high school,
04(13%) obtained higher secondary school education. In Occupation Majority of
private sector. In Monthly income of family, Majority of primigravida mothers
05(17%)
54
ranges between 30, 831-46, 128, . In Type of family Majority of primigravida
mothers 19(63%) were joint family and 11(37%) were nuclear family, In Place of
residence majority of primigravida mothers 20(67%) were residing in urban family,
and 10(33%) were in rural family. In Social support during delivery Majority of
primigravida mothers 21(70%) received social support from mothers 05(17%)
received support from mother in law, 04(13%) received support from sisters.
55
AGE IN YEARS
70
18(60%)
60
50
13(43%) 20-25
40 26-30
PERCETAGE
09(30%) 31-35
30 08(27%)
06(20%) 06(20%)
20
10
0
Experimental Group Control Group
Fig-1 Frequency and percentage distribution of primigravida mothers with regard to Age
56
RELIGION
16(53%)
60 14(47%)
50
Hindu
PERCENTAGE
40 08(27%) Muslim
06(20%) Christian
30 Others
4(13%)
12(40%)
20
0(0%) 0(0%)
10
0
57
Fig-2 Frequency and percentage distribution of primigravida mothers with regard to Religion
58
INCOME
20(67%)
70 16(63%)
60 >123,322
61,663-123,321
50
PERCENTAGE
46129-61,662
40 30,831-46,1282
07(23%)
06(20%) 18,497-30,830
30 03(10%) 6,175-18,496
05(17%) <6174
20
0(0%) 0(0%) 0(0%) 0(0%) 0(0%) 0(0%)
0(0%) 0(0%)
10
0
Fig-5 Frequency and percentage distribution of primigravida mothers with regard to Income
59
EDUCATION
35 10(33%)
30
Illiterate
25 07(23%) 08(27%) Primary School
PERCENTAGE
20 High School
05(17%)
04(13%) 03(10%) 06(20%) Higher Secondary
15 05(17%)
03(10%)03(10%) School Graduate
10 04(13%) Post Graduate
5 02(7%) Scholar
0(0%)
0
0(0%)
Experimental Group
Control Group
Fig-3 Frequency and percentage distribution of primigravida mothers with regard to Education
60
OCCUPATION
80 23(77%)
70 22(73%)
60
PERCENTAGE
50 Private
Governement
40
07(23%) Coolie
30
0(0%) 08(27%) Homemaker
20 0(0%)
10 0(0%)
0(0%)
0
Experimental Group
Control Group
61
Fig-4 Frequency and percentage distribution of primigravida mothers with regard to Occupation
62
TYPE OF FAMILY
25(83%)
90 19(63%)
80
70
PERCENTAGE
11(37%)
60 Joint Family
Nucler Family
50
40 05(17%)
30
20
10
0
Fig-6 Frequency and percentage distribution of primigravida mothers with regard to Type of family
63
ATTENDED YOGA CLASSES
30(100%) 30(100%)
100
90
PERCENTAGE
80
Yes
70
60
No
50
40
30 0(0%) 0(0%)
20
10
0
Fig-8 Frequency and percentage distribution of primigravida mothers with regard to Attended yoga classes
64
ATTENDED PARENTHOOD CLASSES
30(100%)
30(100%)
100
PERCENTAGE
80 Yes
No
60
40 0(0%)
20 0(0%)
0
Experimental Group
Control Group
65
Fig-9 Frequency and percentage distribution of primigravida mothers with regard to Attended parenthood classes
66
PLACE OF RESIDENCE
80
70 20(67%) 20(67%)
60
PERCENTAGE
50
Urban Area
40 Rural Area
10(33%) 10(33%)
30
20
10
0
Fig-7 Frequency and percentage distribution of primigravida mothers with regard to Place of residence
67
SOCIAL SUPPORT DURING DELIVERY
22(73%) 21(70%)
80
70
Mother
PERCENTAGE
60
Mother in Law
50 Sister
40 05(17%) 04(13) Others
30
04(13%) 04(13%)
0(0%) 0(0%)
20
10
0
Fig-10 Frequency and percentage distribution of primigravida mothers with regard to Social support during delivery
68
TABLE 2: DATA PERTAINING TO FREQUENCY AND PERCENTAGE
DISTRIBUTION OF SELECTED OBSTETRICAL VARIABLES AMONG
PRIMIGRAVIDA
MOTHERS IN EXPERIMENTAL AND CONTROL GROUP
( N=60)
SI. No OBSTETRICAL EXPERIMENTAL GROUP CONTROL GROUP
VARIABLES (n=30) (n=30)
f % f %
1 Gestational weeks a) 28-
32 00 00 00
b) 33-36 00 00 00
c) 37-40 30 100 30
2 Antenatal checkup
a) Regular 30 100 30
b) Irregular 00 000 00
c) Nil 00 000 00
3 Time of labour started
a) 1-2 hrs 13 43 10
b) 3-4 hrs 17 57 20
c) 5-6 hrs 00 00 00
4 Level of pain
a) Mild 30 100 30
b) Moderate 00 000 00
c) Severe 00 000 00
5 Frequency of pain
a) <20 sec 30 100 30
00 000 00
b)20-40 sec
00 000 00
c)> 40 sec
6 Cervical dilatation
a) 1-3 cm 30 100 30
b) 4-6 cm 00 000 00
00 000 00
69
c) 7-8 cm 00 000 00
d) 9-10 cm
70
Table :2 The above table represents the frequency and percentage distribution
of obstetrical variables among primigravida mothers in experimental and
control group.
In experimental group , regarding Gestational weeks, Majority of primigravida

mothers 30(100%) were between 37-40 . Regarding Antenatal check up, every
primigravida mothers 30(100%) attended regularly, In Time of labour started
Majority of primigravida mothers 17(57%) were between 3-4 hrs, and 13(43%) were
between 1-2 hrs . In Level of pain every primigravida mothers 30(00%) were having
mild pain, In Frequency of pain Majority of primigravida mothers 30(100%) were
having <20 sec. In cervical dilatation majority of primigravida mothers 30(100%) ,
were having 1-3 cm.
In control group regarding Gestational weeks, Majority of primigravida mothers

30(100%) were between 37-40. Regarding antenatal check up, every primigravida
mothers 30(100%) attended regularly, In Time of labour started Majority of
primigravida mothers 20(67%) were between 3-4 hrs and 10(33%) were between 1-2
hrs . In Level of pain every primigravida mothers 30(100%) were having mild pain,
In Frequency of pain Majority of primigravida mothers 30(100%) were having <20
sec. In Cervical dilatation Majority of primigravida mothers 30(100%) , were having
1-3 cm.
71
GESTATIONAL WEEKS
80
21(70%)
70 20(67%)
60
PERCENTAGE
50 20-25
26-30
40 31-35
30
06(20%)
20 05(17%) 05(17%
03(10%
10
0
Fig-11 Frequency and percentage distribution of primigravida mothers with regard to Gestational weeks
72
ANTENATAL CHECKUP
30(100%) 30(100%)
100
90
80
PERCENTAGE
70 Regular
60 Irregular
Nil
50
40
30 0(0%) 0(0%) 0(0%)
0(0%)
20
10
0
Fig-12 Frequency and percentage distribution of primigravida mothers with regard to Antenatal checkup
73
74
TIME OF LABOUR STARTED
20(67%)
17(57%)
70
60 13(43%)
1 to 2 Hrs
PERCENTAGE
50 10(33%)
3-4 Hrs
40 5-6Hrs
30
20 0(0%)
0(0%)
10
0
Fig-13 Frequency and percentage distribution of primigravida mothers with regard to Time of Labour started
75
LEVEL OF PAIN
30(100%)
30(100%)
100
PERCENTAGE
80
Mild
60 Moderate
Severe
40
20 0(0%) 0(0%)
0(0%) 0(0%)
0
Experimental Group
Control Group
Fig-14 Frequency and percentage distribution of primigravida mothers with regard to time of Level of pain
76
FREQUENCY OF PAIN
30(100%) 30(100%
100
90
80
PERCENTAGE
70 >20 Sec
60 20-40 Sec
<40
50
40
30
0(0%) 0(0%) 0(0%)
20 0(0%)
10
0
Fig-15 Frequency and percentage distribution of primigravida mothers with regard to Frequency of pain
77
78
30(100%) CERVICAL DILATATION
30(100%)
100
90
80
1-3 cm
PERCENTAGE
70
4-6 cm
60
7-8 cm
50 9-10 cm
40
30
0(0%)
0(0%) 0(0%) 0(0%) 0(0%)
20 0(0%)
10
0
Fig-16 Frequency and percentage distribution of primigravida mothers with regard to Cervical dilatation
79
SECTION-B
TABLE :3 DATA PERTAINING TO FREQUENCY AND PERCENTAGE
DISTRIBUTION OF PRE TEST AND POST TEST LEVEL OF PAIN AMONG
PRIMIGRAVIDA MOTHERS IN EXPERIMENTAL GROUP
(n=30)
Experimental group
Level of pain
Pre test Post test
f% f %
No pain 00 00 00 00
0
Mild pain 00 00 10 37
(1-3)
Moderate pain 10 33 20 67
(4- 6)
Severe pain (7- 20 67 00 00
10)
Table -3: The above table depicts the frequency and percentage distribution of
pretest and post -test level of pain among experimental group.
The findings revealed that, In pre test majority of the primigravida mothers 20(67%)
had severe pain 10(33%) had moderate pain and none of the mothers had mild or no
pain . In post test majority of primigravida mothers 20(67%) had moderate pain
10(37%) had mild pain and none of the primigravida mothers had no pain or severe
pain.
80
20(67%) 20(67%)
70
60
50
PERCENTAGE
10(37%) No Pain
40 10(33%)
Mild Pain
Moderate Pain
30
Severe Pain
20
0(0%)
0(0%) 0(0%) 0(0%)
10
0
POST-TEST POST-TEST
Fig- 17 Frequency and percentage distribution of pretest and post -test level of pain perception among experimental group.
81
TABLE 4: DATA PERTAINING TO FREQUENCY AND PERCENTAGE
DISTRIBUTION OF PRETEST AND POST TEST LEVEL OF PAIN
PERCEPTION AMONG PRIMIGRAVIDA MOTHERS IN CONTROL
GROUP
( n=30)
Control group
Pre test Post test

Level of pain
f% f %
No pain
0 00 00 00 00
Mild pain
(1-3) 06 20 00 00
Moderate pain
(4- 6) 11 36 04 13
Severe pain (7-10)
13 43 26 87
Table -4: The above table depicts the frequency and percentage distribution of
pretest and post -test level of pain perception among control group.
The findings revealed that , In pre test majority of the primigravida mothers 13(43%)
had severe pain, 11(36%) had moderate pain, 06(20%) had mild pain and 00(00%)
had no pain . In post test majority of primigravida mothers 26(87%) had severe pain
04(13%) had moderate pain and none of the primigravida mothers had no pain or
mild pain.
82
90
20(87%)
80
70
60
PERCENTAGE
50 13(43%) No pain
40 11(36%) Mild pain
30 Moderate Pain
06(20%)
20
Sever Pain
0(0%)
10 0(0%) 0(0%)04(13%)
0
PRE-TEST
POST-TEST
Fig- 18 Frequency and percentage distribution of pretest and post -test level
of pain among control group.
83
SECTION -C
Table 5 :DATA PERTAINING TO THE EFFECTIVENESS OF
LAMAZE BREATHING TECHNIQUE ON LEVEL OF PAIN PERCEPTION
AMONG PRIMIGRAVIDA MOTHERS
n=30
‘t’
Variable Group Pretest Post test Mean P=
difference
M SD M SD MD
Pain Experimental group 7. 13 1. 55 4 0. 96 3. 13 9.
TABLE 5 : The above table depicts the data pertaining to the effectiveness of
lamaze breathing technique on level of pain perception among primigravida
mothers
The above table reveals that, pretest mean score was 7. 13±1. 55 and the post test
mean score was 4±0. 96. The mean level of pain perception was 3. 13 and the
calculated ‘t’value was 9. 48, which was higher than the table value 3. 396 at p>0.
001. Therefore , the findings indicated that after administering Lamaze breathing
technique in experimental group there was significant decrease in level of pain
perception . Hence, H1 hypotheses was accepted.
84
SECTION -D
Table 6: DATA PERTAINING TO ASSOCIATION OF PRE-TEST LEVEL OF

PAIN PERCEPTION AMONG PRIMIGRAVIDA MOTHERS WITH
SELECTED DEMOGRAPHIC VARIABLES IN EXPERIMENTAL GROUP
(n=30)
Experimental group P
Variables (p
No pain Mild pain Moderate Severe pain χ2

pain
1. Age
00 02 06 00 17. 39 df
a) 20-25
00 06 07 00 12
b) 26-30
00 04 05 00 P
c) 31-35
2 Religion
a) Hindu 00 04 10 00 1. 875 df
b) Muslim 00 00 02 00 16
c) Christian 00 06 08 00 P
00 00 00 00
d) Others
3. Education
a) Illiterate 00 00 02 00 24. 43 df
b) Primary school 00 00 03 00 28
c) High school 00 02 01 00 P
00 01 02 00
d) Higher secondary
00 03 04 00
e) Graduate
00 02 08 00
f) Postgraduate
85
00 01 01 00
g) Scholar
86
4. Occupation 00 01 06 00 df
a) Private
00 00 00 00 21. 83 P
b) Government
00 00 00 00
c) Coolie
00 09 14 00
d) Homemaker
5. Income
a) >123, 322 00 00 00 00 49. 85 df
b) 61, 663 -123, 321 00 00 00 00 87
c)46129-61, 662 00 00 00 00
00 02 02 00
d) 30, 831-46, 128
00 06 14 00
e) 18, 497-30, 830
00 01 05 00
f) 6, 175-18, 496
00 00 00 00
g) <6174
6. Type of family
a) Nuclear family 00 00 04 00 2. 6 df
b) Joint family 00 08 18 00 P
df
a) Rural area
00 05 10 00 0. 35 7.
b) Urban area
00 04 11 00 P
8. Attended Yoga
classes 00 00 00 00 0 df
a) Yes
00 10 20 00 P
b) No
87
9. Attended
Parenthood classes 00 00 00 00 0 df
a) Yes
00 10 20 00 P
b) No
88
10. Social support 00 09 13 00 df
during delivery
a) Mother 00 00 04 00 6. 04 P
00 00 04 00
b) Mother in law
00 00 00 00
c) Sister
d) Others
TABLE 6: The above table represents the association of pre-test level of pain
perception among primigravida mothers with selected demographic variables in
experimental group
The above findings revealed that , there was a significant association between pre-test
level of pain perception and demographic variables such as age (χ2 =17. 39, df=6 ),
occupation (χ2 = 21. 83, df = 9), income
(χ2=49. 85, df=18), Therefore Age, occupation, and income, were significantly
influencing the level of pain perception among primigravida mothers at PPK hospital,
Marthandam in Kanyakumari district. Hence, the research hypotheses H2 was
accepted.
89
TABLE :7 DATA PERTAINING TO ASSOCIATION OF PRE-TEST LEVEL
OF PAIN PERCEPTION AMONG PRIMIGRAVIDA MOTHERS WITH
SELECTED DEMOGRAPHIC VARIABLES IN CONTROL GROUP
(n=30)
Variable Control group Pv
No pain Mild Moderate Severe pain χ2 (p=
pain pain
1. Age
a) 20-25 00 00 00 06 4. 32 df=
b) 26-30 00 00 02 16 12
c) 31-35 00 00 01 05 P<
2 Religion
a) Hindu 00 00 02 14 0. 08 df=
b) Muslim 00 00 01 07 16
c) Christian 00 00 01 05 P<
d) Others 00 00 00 00
3. Education
a) Illiterate 00 00 01 04 17. 924 df=
b) Primary school 00 00 01 04 28
c) High school 00 00 00 02 P<
00 00 01 03
d) Higher secondary
00 00 01 07
e) Graduate
00 00 00 06
f) Postgraduate
00 00 00 00
g) Scholar
4. Occupation
a) Private 00 00 00 08 23. 202 df=
b) Government 00 00 00 00 16
c) Coolie 00 00 00 00 P>
90
d) Homemaker 00 00 04 18
91
5. Income
a) >123, 322 00 00 00 00 df=
b) 61, 663 -123, 321 00 00 00 00 7. 323 24
c)46129-61, 662 00 00 00 00 P<
00 00 00 05
d) 30, 831-46, 128
00 00 02 17
e) 18, 497-30, 830
00 00 02 04
f) 6, 175-18, 496
g) <6174
6. Type of family
a) Nuclear family 00 00 01 14 1. 14 df=
b) Joint family 00 00 03 12 P<
a) Rural area 00 00 00 10 29. 95 df=
b) Urban area 00 00 04 16 7.
P>
8. Attended Yoga
classes 00 00 00 00 0 df=
a) Yes
00 00 04 26 P<
b) No
9. Attended
Parenthood classes 00 00 00 00 0 df=
a) Yes
00 00 04 26 7.
b) No
P<
92
10. Social support
during delivery 00 00 03 18 0. 972 df=
a) Mother
00 00 01 04 P<
b) Mother in law
00 00 00 04
c) Sister
00 00 00 00
d) Others
93
TABLE 7 :The above table represents the association of pre-test level of pain
perception on among primigravida mothers with selected demographic variables
in control group
The above findings revealed that , There was a significant association between pre-
test level of pain perception and demographic variables such as occupation ( χ2 =23.
202, df = 9), place of residence (χ2 29. 95, df=3), Therefore Occupation and place of
residence were significantly influencing the level of pain perception among
primigravida mothers at PPK hospital, Marthandam in Kanyakumari district. Hence
the research hypotheses H2 was accepted.
94
SECTION-D
TABLE 8: DATA PERTAINING TO ASSOCIATION OF PRE-TEST LEVEL OF PAIN PERC

AMONG PRIMIGRAVIDA MOTHERS WITH SELECTED OBSTETRICAL VARIABLES IN
EXPERIMENTAL GROUP
EXPERIMENTAL GROUP P val
Variables 05)
No pain Mild pain Moderate pain Severe pain
χ2
Gestational weeks
00 00 00 00 3. 15 df=6
a) 28-32
b) 33-36 00 00 00 00 P<0.
c) 37-40 00 10 20 00
Antenatal checkup
00 10 20 00 0 df=6
a) Regular
b) Irregular 00 00 00 00 P<0.
c) Nil 00 00 00 00
Time of labour
started
a) 1-2 hrs 00 04 09 00 0. 037 df=6
b) 3-4 hrs 00 06 11 00 P<0.

c) 5-6 hrs 00 00 00 00
Level of pain
00 00 00 00 df=6
a) Mild
b) Moderate 00 00 00 00 0 P<0.
c) Severe 00 10 20 00
95
Frequency of pain
00 00 00 00 0 df=6
a) <20 sec
b) 20-40 sec 00 00 00 00 P<0.
c) > 40 sec 00 10 20 00
96
Cervical dilatation
a) 1-3 cm 00 00 00 00 df=6
b) 4-6 cm 00 00 00 00 0 P<0.
c) 7-8 cm
00 00 00 00
d) 9-10 cm
00 10 20 00
perception among primigravida mothers with selected obstetrical variables in
experimental group.
The above findings revealed that there was no significant association between pre-
test level of pain perception and obstetrical variables. Hence , Lamaze breathing
technique was not influenced by any other factors.
97
TABLE 9: DATA PERTAINING TO ASSOCIATION OF PRE-TEST LEVEL
OF PAIN PERCEPTION AMONG PRIMIGRAVIDA MOTHERS WITH
SELECTED OBSTETRICAL VARIABLES IN CONTROL GROUP
( n= 30)
CONTROL GROUP P va
Variable 05)
No pain Mild pain Moderate pain Severe pain
χ2
Gestational weeks
00 00 00 00 6. 43 df=6
a) 28-32
b) 33-36 00 00 00 00 12. 5
c) 37-40 00 00 07 23 P<0.
Antenatal checkup
00 00 04 26 df=6
a) Regular
b) Irregular 00 00 00 00 1. 8 12. 5
c) Nil 00 00 00 00 P<0.
Time of labour
started
a) 1-2 hrs 00 00 02 06 31. 282 df=6
b) 3-4 hrs 00 00 02 15 12. 5

c) 5-6 hrs
00 00 00 05 P>0.
Level of pain
00 00 00 00 df=6
a) Mild
b) Moderate 00 00 00 00 1. 8 12. 5
c) Severe 00 00 04 26 P<0.
98
Frequency of pain
00 00 00 00 1. 8 df=6
a) <20 sec
b) 20-40 sec 00 00 00 00
c)> 40 sec 00 00 04 26 P<0.
99
Cervical dilatation
00 00 00 00 1. 8 dF=9
a) 1-3 cm
b) 4-6 cm 00 00 00 00 P<0.
c) 7-8 cm 00 00 00 00
d) 9-10 cm
00 00 04 26
perception among primigravida mothers with selected obstetrical variables in
control group
The above findings revealed that, there was a significant association between pretest
level of pain perception and obstetrical variables like time of labour started (χ2=31.
282, df=6) . Therefore, Time of labour started was significantly influencing the level
of pain perception among primigravida mothers at PPK hospital , Marthandam,
Kanyakumari district. Hence, the research hypotheses H2 was not accepted
100
SECTION- E
TABLE:10 DATA PERTAINING TO FREQUENCY AND PERCENTAGE

DISTRIBUTION OF LEVEL OF SATISFACTION AMONG PRIMIGRAVIDA
MOTHERS IN EXPERIMENTAL GROUP AFTER THE ADMINISTRATION
OF LAMAZE BREATHING TECHNIQUE.
n=30
Level of satisfaction f
Low satisfaction 00
<20
Moderate satisfaction 21-30 14
High satisfaction 16
>30
TABLE:10 The above table depicts the data pertaining to

frequency and percentage distribution of level of satisfaction among
primigravida mothers in experimental group
after the administration of lamaze breathing technique.
The findings revealed that after the administration of Lamaze breathing technique
16(53%) of primigravida mothers were highly satisfied and 14(47%) were moderately
satisfied by this technique.
101
LEVEL OF SATISFACTION
0%
Low satisfaction
47%
Moderate
53% satisfaction Highly
Satisfaction
Fig-19 Frequency and percentage distribution of level of satisfaction among primigravida mothers in experimental group after
administration of Lamaze breathing technique
102
SUMMARY
This chapter deals with analysis and interpretation of data observed by the researcher.
The analysis of the result revealed that the level of pain was decreased among the
primigravida mothers after the administration of Lamaze breathing technique . This
implied that the Lamaze breathing technique had significant effect on reducing the
level of pain among primigravida mothers
103
CHAPTER V
DISCUSSION
This chapter deals with the discussion of the analysed data based on the objectives
and hypothesis of the
study. The present study was done to evaluate the effectiveness of Lamaze breathing
technique on reduction of Labour pain perception among primigravida mothers
admitted at selected hospital in Kanyakumari district.
THE OBJECTIVES OF THE STUDY WERE:

THE HYPOTHESES TESTED WERE:
 H1 :There was a significant difference in the level of pain perception after

 H2 : There was a significant association between the pre test level of pain
control group.
The findings were discussed based on the obectives of the study.
Characteristics of primigravida mothers based on their demographic variables

in experimental group and control group.
In experimental group Majority of primigravida mothers were between 13(43%) 26-

30 years of age. 14(47%) were Hindu, 10(33%) were postgraduates, 23(77%) were
homemakers. 20(67%) family monthly income ranges between 18, 497-30, 830.
23(83%) were living in joint family 05(17%), 20(67%) were residing in rural family.
22(73%) received social support from mothers .
In control group, majority of primigravida mothers 18(60%) were between 26-30
104
years of age, 16(53%) were Hindu, 08(27%) were graduate, 22(73%) were
homemakers. 19(63%) ranges between 18, 497-30, 830, 19(63%) were joint family,
20(67%) were residing in urban family 21(70%) received social support from mothers
The above study was congruent with the study done by Remya Nair(2014) on
effectiveness of Lamaze breathing technique in reducing laboir pain perception
among primigravida mothers at Kanya kumari district. A true experimental pretest
post test design was used. 60 samples were selected by simple random technique. The
demographic characteristics revealed that the majority of the mothers 22(73%) in the
experimental group and control group 15(50%) belongs to 23-26 years of age group,
Most of the mothers experimental group and control group 15(50%) , 13(43. 3%) had
Hindus , Most of the mothers in the experimental group 17 (57%) were graduates
where as the mothers in the control group 15(50%) were graduates . Most of the
mothers in the experimental and control group 13(43%), 13(46. 6%) were private
employees. Most of the mothers both in the 21(70%) experimental group and control
group 21(70%) were earning monthly family income of Rs. 6001-10000, Most of the
mothers in the experimental and control group 21(70%) , 22(73%) was to living in
rural area, Most of the mothers in the 13(43%) of them belongs to extended family,
Most of the mothers 10 (33. 3%) belongs to nuclear, respectively.
Characterstics of primigravida mothers based on their obstetrical variables
In experimental group, majority of primigravida mothers 30(100%) were between

37-40 gestational weeks. 30(100%) attended antenatal check up regularly. 17(57%)
mothers were admitted between 3-4 hrs, and 13(43%) after the labour started,
30(00%) were having mild pain, In frequency of pain majority of primigravida
mothers 30(100%) were having <20 sec. In cervical dilation majority of primigravida
mothers 30(100%) , were having 1-3 cm cervical dilatation
In control group regarding gestational weeks, majority of primigravida mothers
30(100%) were between 37-40. In antenatal check up, every primigravida mothers
30(100%) attended regularly, In Time of labour started majority of primigravida
mothers 20(67%) labour started were between 3-4 hrs and 10(33%) were between 1-2
hrs . In level of pain every primigravida mothers 30(100%) were having mild pain,
105
In frequency of pain majority of primigravida mothers 30(100%) were having <20
sec. In cervical dilation majority of primigravida mothers 30(100%) , were having 1-
3 cm.
Akshaykumari Jhala(2017) conducted a study to evaluate the effectiveness of

Lamaze breathing technique in reducing labour pain perception among primigravida
mothers at community health center, Kolar, Bhopal. Purposive sample technique was
used and 40 samples were selected. The obstetrical variables characteristics revealed
that the majority of the mothers highest percentage 67. 5%
(27) of respondents were having their onset of pain before 6 hours, (31) 77. 5%
respondents were having 6 cm of cervical dilatation, 62. 5% (25) respondents were
having severe pain. Majority of respondents 70% (28) were having pain in 5-10
minutes.
 To evaluate the level of pain perception among primigravida mothers.

In experimental group, the findings revealed that in pre test majority of the
primigravida mothers 20(67%) had severe pain 10(33%) had moderate pain and none
of the mothers had mild or no pain . In post test majority of primigravida mothers
20(67%) had moderate pain 10(37%) had mild pain and none of the primigravida
mothers had no pain or severe pain.
In control group the findings revealed that , In pre test majority of the
primigravida mothers 13(43%) had severe pain, 11(36%) had moderate pain,
06(20%) had mild pain and 00(00%) had no pain . In post test majority of
primigravida mothers 26(87%) had severe pain 04(13%) had moderate pain and none
of the primigravida mothers had no pain or mild pain.
The above findings were congruent with the study done by Shahnaj Qumer (2021)
to assess the level of pain perception among primigravida mothers at in selected
hospital at Moradabad. A randamized controlled trail pretest, post test design was
used. In this study in experimental group pretest 20(67%) had severe pain , 7(26. 9%)
moderate pain and 1(3. 8%) unbearable pain . In control group pre test 18(69. 2%)
severe pain 4(15. 4%) moderate pain 4(15. 4) unbearable pain . The result of post test
106
in experimental group 22(84. 6) of mother having moderate pain and 4 (15. 4) mother
had mild pain and in control group 19(73. 1%) of mother severe pain and 7(26. 9%)
of mother moderate pain .
 To determine the effectiveness of Lamaze breathing technique on level of
pain perception among primigravida mothers
In experimental group pretest mean score was 7. 13±1. 55 and the post test mean
score was 4±0. 96. The mean level of pain perception was 3. 13 and the calculated
‘t’value was 9. 48, which was higher than the table value 3. 396 at p>0. 001.
Therefore , the findings indicated that after administering Lamaze breathing
technique in experimental group there was significant decrease in level of pain
perception . Hence H1 hypotheses was accepted.
Similar findings were obtained by Nilima R. Bhore (2016) conducted a study to

assess the effectiveness of Lamaze breathing technique for reduction on pain
perception among primigravida mothers The study was conducted at Sangli. True
experimental pre test post test design was used in this study . The mean of control
group is 7. 55 and of experimental group are 4. 55. Mean percent is 75. 5% and 45.
5% of control and experimental group respectively. and, SD of control group is 0.
945 and of experimental group, it is 1. 234. The ‘t’ value is 3. 96. The difference
was found statistically significant at P value is P<0. 001 level of confidence and can
be attributed to the effectiveness of Lamaze breathing technique.
 To determine the association between pre -test levels of pain perception

among primigravida mothers with their selected demographic variables in
experimental group and control group.
In experimental group there was a significant association between the pre-test
level of pain perception and demographic variables such as age (χ2 =17. 39, df=6 ),
occupation (χ2 = 21. 83, df = 9), income(χ2=49. 85, df=18), Therefore age,
occupation, income, were significantly influencing the level of pain perception
among primigravida mothers at PPK hospital, Marthandam in Kanyakumari district.
107
In control group there was a significant association between pre-test level of pain
perception and demographic variables such as occupation ( χ2 =23. 202, df = 9),
place of residence
(χ2 29. 95, df=3), were significantly influencing the level of pain perception among
primigravida mothers at PPK hospital, Marthandam in Kanyakumari district . Hence
the research hypothesis H2
Was accepted.
Varalakshmi (2021) conducted an experimental study to

evaluate the effectiveness of Lamaze breathing technique in reducing labour pain
admitted at selected hospital at Moradabad. Simple random sampling technique was
used and 40 samples were selected . In experimental group the chi-square value of
selected demographic variables like age (χ2=0, 25)occupation (χ2=0. 55), Income
(χ2=0. 66). In control group . In control group the chi-square value of selected
demographic variables like occupation (χ2=0. 55)place of residence( χ2=0. 66) . In
this study association of demographic characteristic of primigravida mothers pre-test
labour pain of experimental and control group shows that there is significant for age,
occupation, , income, place of residence.
 To determine the association between pre -test levels of pain perception

among primigravida mothers with their selected obstetrical variables in
experimental group and control group.
In experimental group findings revealed that there is a no significant association

between pre-test level of pain perception .
In control group findings revealed that there was a significant association between
pretest level of pain perception and obstetrical variables like time of labour started
(χ2=31. 282, df=6) . Therefore time of labour started was significantly influencing
the level of pain perception among primigravida mothers at PPK hospital ,
Marthandam, Kanyakumari district. Hence the research hypotheses H2 was not
accepted.
108
Parimala Priya (2019) These findings were supported by who
conducted an experimental study to evaluate the effectiveness of lamaze breathing
technique in reduce labour pain perception during labour process among primigravida
mothers admitted at Adhiparasakthi Institute of Medical Sciences and Research
Melmaruvathur, Kancheepuram District. Simple random sampling technique was
used and 60 samples were selected. In control group the chi-square value of selected
obstetrical variables like time of labour started (χ2= 1. 405). In this study association
of obstetric characteristic of primigravida mothers pre-test labour pain of
experimental and control group shows that there is significant for time of labour
started.
SUMMARY
This chapter dealt with the discussion of the study with reference to objectives and
supportive study. The analysis of the result showed that Lamaze breathing technique
has an effective role in reducing level of pain among the primigravida mothers.
109
CHAPTER VI
SUMMARY, NURSING IMPLICATIONS,
RECOMMENDATIONS AND CONCLUSION
This chapter deals with the summary of the study findings, conclusion drawn, nursing
implication of the study for different areas like nursing practice, nursing education,
nursing administration and nursing research and recommendation for future research
in the field.
The effectiveness of Lamaze breathing technique on level of pain perception among

primigravida mothers admitted at selected hospitals of Kanyakumari district was
carried out by Reg. No 301823152 in partial fulfillment of the requirement for the
degree of Masters of Science in nursing under the Tamil Nadu Dr. MGR Medical
University, Chennai.
THE OBJECTIVES OF THE STUDY WERE:

THE HYPOTHESES TESTED WERE:
 H1 :There was a significant difference in the level of pain perception after

 H2 : There was a significant association between the pre test level of pain
control group.
The conceptual frame work selected for the above study was based on the
comfort theory Katharine Kolcaba(1990) An extensive review of literature was
collected from books, journals Internet etc. The study design adopted was two-group
110
pre test post test design. The main study was conducted at PPK Hospital
Marthandam. The total number of 60 primigravida mothers who met the inclusion
criteria were selected from PPK Hospital by purposive sampling technique. The
tool used to collect the data were demographic variables proforma, obstetrical
variables Yazbek pain scale, self
satisfaction rating scale. The Lamaze breathing technique was given during first
stage of labour for the collected data were analysed by using descriptive and
inferential statistics. Inferential statitistics such as paired ‘t’ test was used analyse
the effectiveness between pre and post test and chi-square test was used to find
association with the selected demographic variables.
Review of literature was discussed under following headings:
In this study the researcher had organized the review of literature under the following
headings. They were:
 Studies related to labour pain perception

 Studies related to common non pharmacological management of pain during
labour
 Studies related to Lamaze breathing technique
In order to check the feasibility , relevance, and practicability, Pilot study was
conducted at PPK Hospital . The investigator selected 6 samples by purposive
sampling technique. The study revealed that the study was feasible . Quasi
experimental pre test post test research design was selected for this study. To ensure
the validity the modified data collection tool was submitted to 8 experts (5 experts
from obstetrical and gynaecological nursing department . I Obstetrician, 1 Yoga
therapist and 1 Statistician). The experts were requested to judge the items for
relevance , appropriateness and degree of agreement for the study . All the experts
gave their consensus and tool was finalized. Reliability of the Yazbek labour pain
score and self satisfaction rating scale .
111
Major findings of the study were presented under following headings:
 Findings related to the frequency and percentage distribution of

demographic variables among primigravida mothers in experimental and
control group.
In experimental group regarding Age, Majority of primigravida mothers 13(43%) 26-
30 years, 09(30%) 31-35 years, and 08 (27%) were between 20-25 years. In
Religion , Majority of primigravida mothers 14(47%) were Hindu, 12(40%) were
Christian and 04(13%) were muslim, In Educational status Majority of primigravida
mothers 10(33%) were postgraduate, 07(23%) were graduate, 04(13%) were illiterate
and 03(10%) obtained higher secondary school education. In Occupation Majority of
private sector. In Monthly income of family Majority of primigravida mothers
primigravida mothers 23(83%) were joint family 05(17%) were
nuclear family, In place of residence Majority of primigravida mothers 20(67%)

were residing in rural family and 10(33%) were in urban family. In Social support
during delivery Majority of primigravida mothers 22(73%) received social support
from mothers 04(13%) received support from mother in law, 04(13%) received
support from sisters,
In control group, regarding Age, Majority of primigravida mothers 18(60%) were

between 26-30 years, 06(20%)were between 31-35 years, and 06 (20%) were
between 20-25 years. In Religion, Majority of primigravida mothers 16(53%) were
Hindu, 08(27%) were Muslim 06(20%)Christian, In Educational status Majority of
primigravida mothers 08(27%) were graduate, 06(20%) were postgraduate, 05(17%)
were illiterate and 05(17%) were primary school, 02(07%) were high school,
04(13%) obtained higher secondary school education. In Occupation Majority of
112
private sector. In Monthly income of family, Majority of primigravida mothers
primigravida mothers 19(63%) were joint family and 11(37%) were nuclear family,
In Place of residence majority of primigravida mothers 20(67%) were residing in
urban family, and 10(33%) were in rural family. In Social support during delivery
Majority of primigravida mothers 21(70%) received social support from mothers
05(17%) received support from mother in law, 04(13%) received support from
sisters.
 Data pertaining to frequency and percentage distribution of selected

obstetrical variables among primigravida mothers in experimental group and
control group.
In experimental group , regarding Gestational weeks, Majority of

primigravida mothers 30(100%) were between 37-40 . In Antenatal check up, every
primigravida mothers 30(100%) attended regularly, In Time of labour started
Majority of primigravida mothers 17(57%) were between 3-4 hrs, and 13(43%) were
between 1-2 hrs . In Level of pain every primigravida mothers 30(00%) were having
mild pain, In Frequency of pain Majority of primigravida mothers 30(100%) were
having <20 sec. In cervical dilatation majority of primigravida mothers 30(100%) ,
were having 1-3 cm.
In control group regarding Gestational weeks, Majority of primigravida

mothers 30(100%) were between 37-40. In antenatal check up, every primigravida
mothers 30(100%) attended regularly, In Time of labour started Majority of
primigravida mothers 20(67%) were between 3-4 hrs and 10(33%) were between 1-2
hrs . In Level of pain every primigravida mothers 30(100%) were having mild pain,
In Frequency of pain Majority of primigravida mothers 30(100%) were having <20
sec. In Cervical dilatation Majority of primigravida mothers 30(100%) , were having
1-3 cm.
 Findings related to the frequency and percentage distribution of pretest
113
and post -test level of pain among experimental group.
The findings revealed that, In pre test majority of the primigravida mothers
20(67%) had severe pain 10(33%) had moderate pain and none of the mothers had
mild or no pain . In post test majority of primigravida mothers 20(67%) had moderate
pain 10(37%) had mild pain and none of the primigravida mothers had no pain or
severe pain.
 Findings related to the frequency and percentage distribution of pretest

and post -test level of pain perception among control group.
The findings revealed that , In pre test majority of the primigravida mothers
13(43%) had severe pain, 11(36%) had moderate pain, 06(20%) had mild pain and
00(00%) had no pain . In post test majority of primigravida mothers 26(87%) had
severe pain 04(13%) had moderate pain and none of the primigravida mothers had no
pain or mild pain.
 Findings related to the data pertaining to the effectiveness of lamaze

breathing technique on level of pain perception among primigravida mothers
The above table reveals that, pretest mean score was 7. 13±1. 55 and the post
test mean score was 4±0. 96. The mean level of pain perception was 3. 13 and the
calculated ‘t’value was 9. 48, which was higher than the table value 3. 396 at p>0.
001. Therefore , the findings indicated that after administering Lamaze breathing
technique in experimental group there was a significant decrease in level of pain
perception . Hence H1 hypotheses was accepted.
 Findings related to the association of pre-test level of pain perception

among primigravida mothers with selected demographic variables in
experimental group
The above findings revealed that , There was a significant association between pre-
test level of pain perception and demographic variables such as age (χ2 =17. 39, df=6
), occupation (χ2 = 21. 83, df = 9), income (χ2=49. 85, df=18), Therefore Age,
occupation, and income, were significantly influencing the level of pain perception
among primigravida mothers at PPK hospital, Marthandam in Kanyakumari district.
Hence the research hypotheses H2 was accepted.

among primigravida mothers with selected demographic variables in control
114
group
The above findings revealed that , There was a significant association
between pre-test level of pain perception and demographic variables such as
occupation ( χ2 =23. 202, df = 9), place of residence (χ2 29. 95, df=3), Therefore
Occupation, and place of residence were significantly influencing the level of pain
perception among primigravida mothers at PPK hospital, Marthandam in
Kanyakumari district. Hence the research hypotheses H2 was accepted.

among primigravida mothers with selected obstetrical variables in experimental
group.
The above findings revealed that there was no significant association between pre-
test level of pain perception and obstetrical variables. Hence , Lamaze breathing
technique was not influenced by any other factors.

among primigravida mothers with selected obstetrical variables in control group
The above findings revealed that there was a significant association between pretest
level of pain perception and obstetrical variables like time of labour started (χ2=31.
282, df=6) . Therefore, Time of labour started was significantly influencing the level
of pain perception among primigravida mothers at PPK hospital , Marthandam,
Kanyakumari district. Hence the research hypotheses H2 was not accepted.
 Findings related to the frequency and percentage distribution of level of

satisfaction among primigravida mothers in experimental group after the
administration of lamaze breathing technique.
The findings revealed that after the administration of Lamaze breathing

technique 16(53%) of primigravida mothers were highly satisfied and 14(47%)
were moderately satisfied by this technique.
IMPLICATIONS TO NURSING RESEARCH
Based on the findings of the study the following implications have been stated. As
evaluated.
 The study findings revealed that even though there is decrease in pain in both
groups the mean difference in experimental group is higher than that in the control
115
group. Hence Lamze breathing technique was found effective in decreasing the level
of pain perception among primigravida mothers.
 This study also showed it large association between the demographic variables
and obstetrical variables and hence it is suggested that study can be done with large
samples for the generalization of the findings.
 These study findings can be effectively utilized by the emerging researchers
to expand their own professional knowledge.
 This study will serve as a valuable reference material for future investigators.
 Disseminate the findings of research through conferences, seminars, and
publishing in nursing journals.
IMPLICATIONS TO NURSING PRACTICE

Based on the findings of the study the following have been stated. As evaluated
 Lamaze breathing technique was found effective in reducing pain perception
during first stage of labour. . Hence, , the obstetric nurses must implement Lamaze
breathing technique while taking care of primigravida mothers.
 The obstetric nurse can educate about the importance of Lamaze breathing
technique to student nurse and confirm practicing the technique in the ward
IMPLICATIONS TO NURSING EDUCATION

Based on the findings of the study the following implications have been stated. as
evaluated.
 The findings of the study serve as a foundation for the nurse educator to teach
about the effectiveness of Lamaze breathing technique on pain perception among
 Nurse educators must arrange facilities and opportunities for special educators
and personnel to attend workshops and conferences to update their knowledge
regarding the importance of Lamaze breathing technique .
 These findings can be utilized to organize in service education or continuing
education for short term and long term courses.
116
IMPLICATIONS TO NURSING ADMINISTRATION
Based on the findings of the study the following implications have been
steted . As evaluated.
 Nurse administrators should announce the importance of Lamaze breathing
technique through media , postures, pamphlets and handouts.
 Nurse administrators can encourage the nursing personnel to conduct the
research regarding Lamaze breathing technique with large sample and in different
settings
 Nurse administrators can carry out health programme on Lamaze breathing
technique.
 Nurse administrators can carry out health programme on Lamaze breathing
technique
 Nurse administrators can prepare a protocol based on institutional policy
regarding the benefits of Lamaze breathing technique for reducing pain perception in
RECOMMENDATIONS
 Training programme can be conducted to acquire necessary skill required to
practice Lamaze breathing technique
 Lamaze breathing technique is not expensive and can be practiced as a
routine care in the hospital set up
 Similar study can be done with large sample to generalize the study fndings.
 The results of the study can be disseminated through the mass media .
 Similar study can be conducted without control group.
CONCLUSION
The study concluded that, there was significant reduction in the level of pain
perception among primigravida mothers after administering Lamaze breathing
technique. There was a significant association between pre test level of pain
perception regarding Lamaze breathing technique among primigravida mothers and
socio demographic variables such as age, occupation, income and prior information
regarding Lamaze breathing technique. Therefore age, occupation and income were
117
significantly influencing the level of pain perception . In control group there was a
significant association between pretest level of pain perception and demographic
variables such as occupation, place of residence. Therefore occupation and
place of residence were significantly influencing the level of pain perception among
primigravida mothers. In experimental group there was no association between
pretest level of pain perception and obstetrical variables . Hence Lamaze breathing
technique was not influenced by any other factors. In control group there was a
significant association between pre test level of pain perception and obstetrical
variables like time of labour started. Therefore, time of labour started was
significantly influencing the level of pain perception among primigravida mothers.
The investigator concluded that Lamaze breathing technique was effective in
reducing labour pain during first stage of labour among primigravida mothers.
118
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technique on reduction of labour pain among primigravida mothers”, Asian
journal of nursing education and research , volume -11 Issue no -3 july 1, 2021
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technique on reduction of labour pain among primigravida mothers”, Indian
Journal of Research, volume VIII, Issue VIII, August -2019
3. Mamata Kamble “A comparative study to assess the effectiveness of relaxation

versus Lamaze breathing techniques on labour pain relief among 1 st stage of
NVD Primimothers”, at selected Hospitals. International Journal of Science and
Research , volume 8, issue 3, March 2019
4. Nilima R. Bhore “A study to assess the effectiveness of selected aspects of

Lamaze method pain among primigravida mothers during first stage of
labour”’in selected hospitals of Sangali. Recent Scientific Research , volume 7,
issue 10, October 2016
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Labour Pain among Primigravida Women”, Journal of South Asian Federation of
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Technique on Pain during First Stage of Labour among Primigravida Mothers”,
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Reducing Pain Perception among Primigravida mothers”, . IOSR journal of
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Exercise on Reducing Pain Perception among Primigravida mothers”,
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Exercise on Reducing Pain Perception among Primigravida mothers”,
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Exercise on Reducing Pain Perception among Primigravida mothers”, Journal
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ELECTRONIC VERSION
1. https://www. researchgate, net
2. http://respiratory -tnmgrmu. ac. in
3. https://www. ncbi. nim. nih. gov
4. https://www. medicalnewstoday. com
122
5. https://ajner. com
6. https://www. ijsr. net
7. https://www. healthline. com
8. https://www. webmd. com
9. https://libraryaplos. com
10. https://www. medicopublication. com
11. https://www. hindawi. com
12. https://www. academic. edu
13 https://www. britannica. com
ANNEXURE-VI
EVALUATION CRITERIA CHECKLIST FOR TOOL

VALIDATION
Instructions The expert is requested to go through the following criteria for

evaluation. Three columns are given for responses and a column for remarks.
Kindly place tick mark in the appropriate column and give remarks.
S. NO CRITERIA 1 2 3 REMARKS
123
1 Content
 Adequacy
 Relevance
 Organised
Language
2
 Simplicity
 Clarity
 Relevant
Scoring
3
 Easy to score
 Clarity
 Relevant
Practicability
4  Procedure
 Utility
 Feasibility
Interpretation of column:Column I : Meets the criteria.
Column II : Partially meets the criteria.
Column III: Does not meet the criteria
Name : Signature
of the Expert Designation:
ANNEXURE -VII
LIST OF EXPERTS VALIDATED THE RESEARCH

TOOLS
1. Dr. Henita. Ph. D (N)
124
Associate professor
Dr S M CSI Medical College and Hospital, Karakonam
2. Mrs. Sajitha . S M. Sc (N)
Associate Professor
Nims College of Nursing, Neyyatinkara
3. Mrs. Remya . R M. Sc (N)
Associate professor
Saraswathy College of Nursing Karode
4. Dr. Arzta Sophia Ph. D (N)
Associate professor
CSI Medical College Neyyor
5. Mrs. Ajitha. L M. Sc (N)
Assistant Professor
Dr S M CSI Medical College and Hospital, Karakonam
6. Mrs. Senthil Kumar
Professor of Biostatistics
Annammal College of Nursing
7. Dr. Divya Renjith MBBS, MD
Gynaecologist
PPK Hospital, Marthandam
8. Prof. T. Justin
Yoga therapist
Parassala
ANNEXURE-VIII
125
RESEARCH PARTICIPATION CONSENT FORM
Dear participant,
I am Usha. A II year M. Sc Nursing student of Annammal College

of Nursing, Kuzhithurai as a part of my academic requirement , I am conducting “A
study to evaluate the effectiveness of selected Lamaze breathing technique on pain
perception during first stage of labour among primigravida mothers admitted at
selected hospital in Kanyakumari district”, The findings of the study will be helpful to
evaluate the effectiveness of selected Lamaze breathing technique on pain perception
during first stage of labour among primigravida mothers. The study does not possess
any threat to health and well being rather it enhances the emotional status of mother
and reduces the labour pain. I here by seek your consent and cooperation to
participate in the study. The information collected will be maintained.
Signature of the Reaearcher
……………………here by given my consent to participate in the study.
Place……………………………….
Date………………………………. . .
Signature of the
participant
126
ஆராய்ச்சி ஒப்புதல் படிவம்
அன்பார்ந்த பங்கு பெறுவோரே,
உஷா ஆகிய நான் அன்னம்மாள் செவிலியர்
கல்லூரியில் செவிலியர் முதுகலை பட்டம் இரண்டாம் ஆண்டு படித்து
வருகிறேன். எனது படிப்பின் ஒரு பகுதியாக நான் ஆய்வு செய்யும்
“முதல்முறையாக கர்ப்பமாகும் தாய்மார்களை தேர்ந்தெடுத்து அவர்களுக்கு
முதலாம் கட்டமான பிரசவத்தின் போது சுவாச பயிற்சி செய்து பிரசவ
வேதனை உணர்திறனை எவ்வாறு குறைப்பது என்பதை மதிப்பிடுவதற்காக
ஒரு ஆய்வை செய்கிறேன், ஆய்வு முடிவின்போது முதன் முறையாக
கர்ப்பமாகும் தாய்மார்களின் முதலாம் கட்டமான பிரசவ வேதனையின்
உணர்வு திறனை மூச்சுப் பயிற்சி நுட்பத்தின் செயல்திறனை
மதிப்பிடுவதற்கு ஆய்வின் கண்டுபிடிப்புகள் உதவியாக இருக்கும். இந்த
ஆய்வு உடல்நலம் மற்றும் நல்வாழ்வுக்கு எந்த அச்சுறுத்தலையும்
ஏற்படுத்தாது, மாறாக இது தாயின் உணர்ச்சி நிலையை மேம்படுத்துகிறது
மற்றும் பிரசவ வலியைக் குறைக்கிறது. ஆய்வில் பங்கேற்க உங்கள்
சம்மதத்தையும் ஒத்துழைப்பையும் நான் வேண்டுகிறேன். தயவு செய்து
உங்களுடைய பதில்கள் உண்மையாகவும் வெளிப்படையாகவும் இருக்க
வேண்டுகிறேன். உங்கள் பதில்கள் அனைத்தும் ரகசியமாக
பாதுகாக்கப்படும் என உறுதி அளிக்கிறேன்.
ஆராய்ச்சியாளரின் கையொப்பம்
127
நான்…………………………………………. இந்த ஆராய்ச்சியில் பங்கு பெற சம்மதிக்கிறேன்.
இடம் :
நாள் :
பகுதி-I
சமூக நல காரணிகள்
நோக்கம் : இந்த செயல்திறன் வயது மதம் கல்வி நிலை, தாயின்
தொழில், குடும்பத்தின் மாத வருமானம் குடும்பத்தின் விவரம் வசிக்கும்
இடம் போன்ற மக்கள்தொகை மாறிகளை அளவிட பயன்படுகிறது.
வரைமுறைகள் : ஆய்வாளர் ஆய்வில் பங்கேற்பாளரிடம் கேட்டு
விவரங்களை நிரப்புவார்.
1. வயதுவரம்பு (ஆண்டுகளில்)
அ. 20-25
ஆ. 26-30
இ. 31-35
128
2. மதம்
அ. இந்து
ஆ. முஸ்லிம்
இ. கிறிஸ்தவர்
ஈ. மற்றவை
3. தாயின் கல்வி தகுதி
அ. அனுபவ அறிவு மட்டும்
ஆ. ஆரம்பப் பள்ளி வரை
இ. உயர்நிலை பள்ளி வரை
ஈ. மேல்நிலைப்பள்ளி வரை
உ. இளநிலை பட்டம் வரை
எ. முதுநிலை பட்டம் வரை
4. தாயின் தொழில்
அ. தனியார் நிறுவனம்
ஆ. அரசாங்க வேலை
இ. கூலி
ஈ. இல்லத்தரசி
5. குடும்பத்தின் மாத வருமானம்
அ. >123, 322
ஆ. 61, 663 -123, 321
129
இ. 46129-61, 662
ஈ. 30, 831-46, 128
உ. 18, 497-30, 830
ஊ. 6, 175-18, 496
எ. <6174
6. குடும்பத்தின் விவரம்
அ. தனிக் குடும்பம்
ஆ கூட்டுக்குடும்பம்
7. வசிக்கும் இடம்
அ. கிராமப்புறம்
ஆ. நகர்புறம்
8. நீங்கள் யோகா பயிற்சி பெற்றது உண்டா?
அ. ஆம்
ஆ. இல்லை
9. நீங்கள் பெற்றோர் வகுப்பில் பங்கேற்றீர்களா?
அ. ஆம்
ஆ. இல்லை
ஆம் என்றால் எந்தெந்த தலைப்பில்,
அ. பெற்றோர் ரீதியான பராமரிப்பு
ஆ. குடும்ப கட்டுப்பாடு
இ. பச்சிளம் குழந்தை நலம்
130
ஈ. மேற்குறிப்பிட்ட அனைத்தும்
உ. எதுவும் இல்லை
10. பிரசவத்தின் போது ஆதரவாய் இருந்தவர்கள்
அ. அம்மா
ஆ. மாமியார்
இ. அக்கா/ தங்கை
ஈ. மற்றவை
பகுதி- II
மகப்பேறியல் காரணிகள்
நோக்கம் : இந்த செயல்திறன் மகப்பேறியல்காரணிகளை அளவிட
பயன்படுகிறது.
வரைமுறைகள் : ஆய்வாளர் பதிவைப் பயன்படுத்தி தாயை மதிப்பிட்டு
விவரங்களை நிரப்புவார்
1. கர்ப்ப கால வயது (வாரங்களில்)
அ. 28-32
ஆ. 33-36
இ. 37-40
2. கர்ப்ப கால பரிசோதனை
131
அ. ஒழுங்கான
ஆ. ஒழுங்கற்ற
இ. ஒன்றும் இன்மை
3. பிரசவம் தொடங்கும் நேரம்
அ. 1-2
ஆ. 3-4
இ. 5-6
4 வலியின் நிலை
அ. லேசான
ஆ. மிதமான
இ. கடினமான
5. வலியின் அதிர்வெண் வரம்பு
அ. <20 நிமிடம்
ஆ. 20-40 நிமிடம்
இ. > 40 நிமிடம்
6 கற்பவாய் திறப்பு
அ. 1-3 செமீ
ஆ. 4-6 செமீ
இ. 7-8 செமீ
ஈ. 9-10 செமீ
132
பகுதி 2
யாஸ்பக் பிரசவ வலி அளவடு

ீ
நோக்கம் :
பிரசவத்தின் முதல் கட்டத்தில் முதல்முறையாக கர்ப்பமாக

இருக்கும் தாய்மார்கள் அனுபவிக்கும் வலியின் அளவை
மதிப்பிடுவதற்கு இந்த மதிப்பெண் பயன்படுத்தப்படுகிறது
வரைமுறைகள்:
ஆய்வில் பங்கேற்பாளரிடம் ஆராய்ச்சியாளர் கேட்டு மற்றும்

பொருத்தமான பதிலை குறிக்கவும்
நாள்
நேரம்
செவிலியரின் 0 1 2
மதிப்பீடு
தீவிரம்
தரம் வலி மிகுந்த குழப்பம் களைப்பு
பரிதாபகரமான காயம் பயங்கரமான
அனுபவம்
அசௌகரியம் சோர்வு தாங்க முடியாத
வலி
மென்மையான கடும் போராட்டம் கடும் வேதனை
எரிச்சல் தரும் தீவிரமான அடக்குதல்
அனுபவம்
133
நடத்தை சந்தோஷம் தசை இறுக்கம் கூக்குரல்
முறைகள்
உற்சாகம் மன உளைச்சல் குமட்டல்/ வாந்தி
மற்றும்
உடலியல்
மாற்றம் தளர்வு கவலை கட்டுப்பாடற்ற
அதிகரிப்பு பதற்றம்
சோர்வு இயல்பான சுறுசுறுப்பான உடல்சோர்வு/
செயல்பாடு /சோர்வு
மந்தமான
சாதாரண உணவு தண்ணி சாப்பிட மற்றும்
உட்கொள்ளுதல் உட்கொள்ளுதல் குடிக்க
இயலாமை
சாதாரணமான கொஞ்சமாக எரிச்சல்
குரல் பேசுவது
சாதாரண அதிகப்படியான சுவாசித்தல்
சுவாசம் சுவாசம்
உளவியல் போதுமான ஒருவரை சார்ந்து பயனுள்ள
மற்றும் ஆதரவு இருத்தல் ஆதரவு
உணர்ச்சி இயல்பாக அதிக கவனம் கஷ்டமான
பிணைப்பு பழகுதல் தொடர்பு
எதிர்பார்ப்பு விரக்தியடைந்த வலுவிழத்தல்
சில பயம் தெரியாத பயம் தனியாக இருக்க
பயப்படுதல்
மொத்தம்
134
நோயாளி மதிப்பீடு : வலி இல்லை 0…. . 1. . 2…3…. . 4…5…6…. 7…. 8…9…. 10 தாங்க முடியாத
மதிப்பெண் : /10
மதிப்பெண் விளக்கம்.
மதிப்பெண் விளக்கம்
வலி இல்லை 0
லேசான வலி 1-3
மிதமான வலி. 4-6
கடுமையான வலி 7-10
135
பகுதி IV
சுய திருப்தி அளவடு

ீ குறியீடு
நோக்கம் : இந்த அளவடு

ீ பிரசவ வலியினை குறைக்க செய்யும்
மூச்சுப் பயிற்சி எந்த அளவிற்கு உங்களுக்கு திருப்தி அளிக்கின்றது
என்பதை அளவிட உதவுகிறது
வரைமுறைகள் : ஆய்வாளர் ஆய்வில் பங்கேற்பாளரிடம் கேட்டு
அதற்கான பதிலைக் குறிப்பார்
வ. எண் அறிக்கைகள் மிகவும் மிதமான வெறும் அதிரு
திருப்தி திருப்தி திருப்தி
1 பயன்படுத்த மிகவும்
எளிதானது
2 வலியை குறைக்க
உதவுகிறது
3 தளர்வு
நடைமுறைகளை
ஊக்குவிக்கிறது
4 சமாளிக்கும் திறனை
பெருக்க உதவுகிறது
5 கவலைகளை குறைக்க
136
உதவுகிறது
6 உடல் பதற்றத்தினை
குறைக்க உதவுகிறது
7 பிராண வாயுவினை
மேம்படுத்த உதவுகிறது
8 உடல்
ஆரோக்கியத்தின் பக்க
விளைவுகளை
குறைக்கிறது
9 பிரசவ
செயல்முறைகளை
மேம்படுத்த உதவுகிறது
10 உடலின் ஆற்றல்
நிலையை
மேம்படுத்துகிறது
மதிப்பெண் : /40
மதிப்பெண் விளக்கம்.
வகை மதிப்பெண்.
குறைந்த திருப்தி <20
மிதமான திருப்தி 21-30
உயர் திருப்தி >30
137
பகுதி-IV
பிரசவ முடிவினை மதிப்பிடுதல்
நோக்கம்: லாமேஸ் சுவாச நுட்பத்திற்குப் பிறகு முதல்முறையாக
கர்ப்பமாகும் தாய்மார்களின் பிரசவ முடிவினை மதிப்பிடுவதற்கு இந்த
அளவுகோல் பயன்படுத்தப்படுகிறது
வரைமுறைகள்: ஆய்வாளர் தாயை மதிப்பிட்டு தகுந்த பதிலைக்
குறிப்பார்
1. எந்த வகையான மகப்பேறு முறை
அ. சுகப்பிரசவம்
ஆ. கருவி மூலம் நடைபெறும் சுகப்பிரசவம்
இ. அறுவை சிகிசட்சை மூலம் நடைபெறும் பிரசவம்
2. பிரசவத்தின் கால அளவு
அ 12 – 15 மணி
ஆ 16 – 18 மணி
இ 19 – 21 மணி
3. நச்சுக்கொடி வெளியேற்றுதலின் கால அளவு
அ. 5-15 நிமிடம்
ஆ. 16- 30 நிமிடம்
இ. 31 - 45 நிமிடம்
4. அப்கார் எண்ணிக்கை
அ. 0 – 3
138
ஆ 4 – 6
இ 7 - 10
139

"A Strong Intention, A Relaxed Body and An Open Mind Are The Main Ingredients For An Active Birth" - Janet Balaskas

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CHAPTER 1

Labour is an inevitable physiological process that most women experience a high

According to Rafal, S. Filip (2013) Pain is an unpleasant sensory and emotional

According to Gill Thomson (2019) Non-pharmacological pain relief methods

Abiy Todesse Angelo(2020) conducted a study in United Kingdom to determine the

Kavitha Devi (2021) conducted a study in CLR, Nehru Hospital PGIMER

According to Janine Kellbach (2017) Lamaze breathing techniques

According to Lamaze International (2021) The goal of Lamaze classes is to

H1 :There will be a significant difference in the level of pain perception after

 Lighter and more rapid breathing than level -1

 Even more shallow and more rapid breathing for 20seconds

In this study, labour pain refers to the pain experienced by primigravida

First stage of labour

The study assumes that

 The primigravida mothers may experience severe pain during labour

This study is delimited to

 Selected hospitals at Kanyakumari district

A conceptual framework is an analytical tool with several variations and contexts. It is in

HEALTH CARE NEEDS

Nurses attained the outcome of enhanced comfort with implementation of

HEALTH SEEKING BEHAVIOUR

B . Jayabharathi (2019) conducted a descriptive study to assess the perception of labour

Lydia Aziato (2017) conducted a descriptive study to assess the indepth

According to Sibel Oztiik (2019) conducted a descriptive study to assess and

2. STUDIES RELATED TO COMMON NON PHARMACOLOGICAL

Manju Mohan(2021) Conducted a quasi experimental study, to evaluate the effect

An experimental study was conducted to evaluate the effectiveness of back massage in

Minerva Thame (2020 ) conducted an experimental study to assess the effect of

An experimental study was conducted to evaluate the effectiveness of acupressure

Hatlin Sugi M (2021) conducted an experimental study, to assess the effectiveness

An experimental study was conducted to assess the effectiveness of Lamaze breathing

Varalakshmi(2019) conducted a quasi experimental study to assess the effectiveness

An experimental study was conducted by Parimalam Priya (2021) to evaluate the

In this study , the researcher intended to evaluate the effectiveness of Lamaze

SETTING OF THE STUDY

Setting refers to the area where the study is conducted .

The primigravida mothers who were

Denise F. Polit, 2017

SAMPLE SIZE CALCULATION

DISCRIPTION OF THE TOOL

Section B :Obstetrical variables

Section D : Self -satisfaction rating scale

Information on demographic variables were collected from the study sample

Section I b, Obstetrical variables

Section 1II:Self satisfaction scale Scoring interpretation

DATA COLLECTION PROCEDURE

PLAN FOR DATA ANALYSIS

Tool for data collection (English)

Purpose: This proforma is used to measure the obstetric variables .

QUALITY Aching Sore Exhausting

Annoying Intense Overwhelming

BEHAVIOUR & Happiness Muscular tension Crying out

PSYCHOSOCIAL Support sufficient Rely on support Support

Interact normal More focused Interact difficul

Anticipation Frustrated Discouraged

Some fear Fear ofunknown Fear to be alone

PATIENT RATING :no pain 0…1…. . 2…3…4…5…6…7…8…9…10 unbearable

S. no statements Highly Moderately Just satisfied Dissatisfie