Effectiveness of Nursing Intervention Package of Kegel Exercise and Prone Positioning in Optimizing Postpartum Outcomes

Arfi Yamin, Dr. K Latha

Abstract: Introduction: A significant amount of effort is devoted to managing pain during labour and delivery, with postpartum pain receiving less attention. The study was conducted to evaluate the effectiveness of Kegel Exercise and Prone positioning on the afterpain and uterine involution among postnatal mothers. Methodology: the study was conducted in Narayan Medical College and Hospital and Sadar Hospital, Sasaram, Bihar. A true experimental pre-test posttest design was used on 60 postnatal mothers who fulfilled the inclusion criteria using lottery method after explaining the study and obtaining informed consent from the participants out of which 30 were in experimental group and 30 were in control group. Pretest was conducted to on day1 of the postnatal period on afterpain using modified numerical rating scale and the uterine involution was assessed using Objective clinical uterine involution scale. Nursing interventions of combined Kegel exercise and prone positioning was administered to the experimental group on day1 to day 3 of the postnatal period and normal hospital routine maintained in the control group. The posttest was done using the same tool for both the group. Result: The pretest level of after pain among the post-natal mother in the pretest experimental group 13(43.33%) of the mothers had moderate pain and 17(56.67%) of the mothers had severe pain. In the posttest experimental group 26(86.67%) of the mothers had mild pain and 4(13.33%) of the mothers had moderate pain and no mother had Severe pain. In the pretest control group, 14(46.67%) of the mothers had moderate pain and 16(53.33%) of the mothers had severe pain. In the posttest control Group, 4(13.33%) of the mothers had mild pain and 11(36.67%) of the mothers had moderate pain and 15(50%) of the mothers had severe pain. The pretest experimental group 8(26.67%) of the mothers had slow involution with poor contour and 11(36.67%) of the mothers had slow involution with good contour, 11(36.67%) of the mothers had Fair involution with poor contour and no mother had good involution. In the posttest experimental group 6(20%) of the mothers had Fair involution with poor contour and 12(40%) of the mothers had fair involution with good contour, 7(23.33%) of the mothers had good involution with poor contour, 5(16.67%) of the mothers had good involution with good contour and no mother had slow involution. In the pretest control Group, 5(16.67%) of the mothers had slow involution with poor contour and 12(40%) of the mothers had slow involution with good contour, 13(43.33%) of the mothers had Fair involution with poor contour and no mother had good involution. In the posttest control Group, 7(23.33%) of the mothers had slow involution with poor contour and 11(36.67%) of the mothers had slow involution with good contour, 9(30%) of the mothers had Fair involution with poor contour, 3(10%) had fair involution with good contour and no mother had good involution. there was a significant association of the posttest afterpain levels among the postnatal mothers and the amount of oxytocin used in the second stage of labour at p<0.05 (?2=10.143, p=0.038). Discussion: On conducting paired t-test p=0.0001, df=118 and t=6.4216 between pretest and posttest values of afterpain and p=0.0001, df=118 and t= -5.28268 between pretest and posttest values of uterine involution which is statistically extremely significant at p<0.05. proving Kegel exercise and prone positioning has a very good effectiveness in reducing afterpain and enhancing uterine involution among postnatal mothers. The study result concludes that nursing intervention like Kegel exercise and prone positioning has great impact and is effective in reducing the postnatal after pain and works as a catalyst in enhancing the involution of the uterus making the postnatal period pleasant.

Keywords: Postnatal Care, Afterpain, Uterine Involution, Kegel Exercises, Prone Position, Nursing Care, Intervention Studies, Pelvic Floor, Puerperal Disorders, Treatment Outcome