Support Needs of Indian women in Early Labour

The study was conducted in four selected hospitals in the Southern part of India with an aim to determine the support needs of women in early labour as perceived by women. A descriptive design was used to determine the support needs of women in early labour. Following ethical approval, sixty women between 29-40 weeks of gestation with singleton pregnancy were interviewed in early labour, using a validated Labour Support Need Assessment Tool to gather data on background information and perception of women related to need and support needs (physical, emotional and informational support). Results indicated that women perceived all types of support such as physical, emotional and informational as significant factors in their care during labour, regardless of their parity and gestation. The major findings of the study suggested that there was a slightly higher need for support among women for informational (90.33%) and emotional support (88.78%) compared to physical support (80.19%). For primigravid women, and multiparous women who were experiencing labour for the first time (previous birth by caesarean section), the ‘need for support’ was greater than for women who had previous experience of labour. Early labour is the time when most women use their own coping skills and seek support. Determining the quantity and quality of support women need at this phase of labour can help care providers to provide the best comprehensive care to women in early labour. The findings of the study provide a guide on what women feel is helpful in early labour. DOI : 10.14302/issn.2381-862X.jwrh-15-672 Corresponding author: Sunita Panda, 48, Adamstown Park, Adamstown, Lucan. Co. Dublin. Ireland, Phone: 00353 877 815593, spanda@tcd.ie


Introduction
Giving birth is the most special and memorable moment in a woman's life. Women always remember their childbirth experience, and often find it very positive and enjoyable. However, some women find childbirth frightening and are quite anxious about it.
Understanding women's needs during this crucial period is one of the first steps to help and support women to achieve the most satisfying experience.
Different aspects of labour support, either to improve birth outcomes or to make labour a more satisfying experience for women and their families have been studied in the world literature. Smith's work on developing a labour satisfaction questionnaire has found high correlation between 'professional support in labour' and maternal satisfaction. 1 Integration of Reva Rubin's framework and social support theory has formed a foundation for intrapartum nursing with main focus on psychological milieu, support in labour to improve birth outcomes, enhancement of self-value and strengthening the transition to motherhood. Social support, on the other hand, mainly focuses on strengthening interpersonal transaction through emotional, physical and informational support. 2 Women's views on supportive behaviours of nurses have been categorised as emotional, informational and tangible support and findings have suggested that, regardless of the pain management used, nurses supporting childbearing women must not only be competent but also use a high degree of interpersonal skills in providing nursing care. 3 Similar findings from women's perspectives suggest professional competency and monitoring of women's condition during labour as other helpful behaviours. 4 Women following normal childbirth have described such helpful coping measures as performing roles of emotional support providers, comforters, information/advice providers, professional technical skill providers and advocates.
Unhelpful nursing actions were also described, such as failure to provide emotional support, comfort, information and advice, and technical duties. 5 (Fig 1).
Data analysis was done manually. Data related to sample characteristics were described using frequency and percentage distribution, and data related to women's perception of needs and need for physical, emotional and informational support were described using mean, mean percentage distribution of scores and standard deviation.
For each of the needs, and need for support, the mean score and standard deviation was obtained. The mean score was obtained by dividing obtained maximum score by the total number of women (n=60). The mean percentage distribution of score was obtained by dividing mean score by the maximum assigned score for each area multiplied by 100.

Results:
Results are presented under sample characteristics, labour support needs (physical, emotional and informational) and support needs among primigravid and multigravid women.
Of the 60 women who participated in the study, Do you want to talk to somebody during labour?
Would you like the nurse to be with you to talk to and reassure you during labour?
Do you want to know your labour progress?
Would you like the nurse to discuss with you about your labour progress?

Fig 1: Examples of questions in LSNAT (Labour Support Need Assessment Tool):
Freely

Conclusion
Making labour a memorable and positive experience for women is the goal of every organisation.
The study findings conclude that women in labour have support needs related to physical, emotional and informational support regardless of their parity.
However, the support needs perceived by women experiencing labour for the first time were found to be greater than those who had already experienced labour before. Support needs in the informational and emotional category were more than those in the physical category, which does suggest that the presence of an experienced and empathic care provider is of vital importance. Care providers not only have a role to provide physical comfort to the woman to help her cope with labour pain but also to provide emotional support and necessary information during the process of labour.
Care guidelines based on evidence and documented needs of women in labour will ultimately make labour

Acknowledgement
This was a self-funded study as part of the

Conflict of interest
The author reports no conflicts of interest. The author alone is responsible for the content and writing of the manuscript.

Affiliations
The researcher, Sunita Panda was a Master's student in the Manipal Academy of Higher Education, Manipal, Karnataka, India at the time of the conduct of this research.

Ethics
The study was conducted as part of fulfilment of a Master's Degree in Maternity Nursing. Permission was obtained from the head of the institutions and ethical committees of the primary institution and the selected study sites, and informed verbal consent was obtained from the participants of the study prior to data collection.