A Comprehensive Study of the Dynamic Interaction Between Normal Labor Pain and Maternal Anxiety Levels: A Multivariable Approach to Analyzing Psychophysiological Influences and Subjective Perceptions

Hidayat  Wijayanegara; Teni Nurlatifah  H. R.; Roni  Rowawi; Yanti  Herawati

Authors

Hidayat Wijayanegara STIKes Dharma Husada Bandung, Indonesia
Teni Nurlatifah H. R. STIKes Dharma Husada, Bandung, Indonesia
Roni Rowawi STIKes Dharma Husada, Bandung, Indonesia
Yanti Herawati STIKes Dharma Husada, Bandung, Indonesia

Keywords:

Labor Pain, Anxiety.

Abstract

Normal labor is a complex physical and emotional experience for a mother, with pain being a major element in this process. The interaction between labor pain and maternal anxiety levels is an aspect that requires in-depth understanding, given its influence on the psychophysical well-being of both mother and baby. Although the scientific literature has highlighted the importance of pain and anxiety management during labor, comprehensive studies that consider the psychophysiological and subjective perceptual influences on this dynamic interaction are limited. Therefore, this study aimed to explore the relationship between pain in normal labor and maternal anxiety levels through a multivariable approach. This research method uses a quantitative approach with an analytic observational research type. The research design was conducted prospectively. This research method involves maternal respondents who experience normal labor, with data collection through measuring anxiety levels using standardized questionnaires and psychophysiological analysis using objectively measured parameters. In addition, a multivariable approach was used to analyze the complexity of the interaction between the variables involved. The sample size was 100 laboring mothers, randomly selected from the population of mothers who met the inclusion criteria. The population was mothers giving birth at TPMB Midwife Delima in Bandung City. Using cluster sampling, only 40 pomegranate midwives (10 sub-districts) were taken from a total of 127 pomegranate midwives from 30 sub-districts. The results showed that the average level of pain during labor reached 6.8 with an average duration of 8 hours. The average maternal anxiety level reached 55 on a scale of 0-100. A significant correlation was found between pain and anxiety (r = 0.68, p < 0.05), while psychophysiological influences such as frequency of uterine contractions and blood pressure also played a role in the experience of pain. Social support was also shown to influence anxiety levels (p = 0.005). These findings illustrate the complexity of interactions between psychophysiological and social aspects in the context of normal labor, providing a basis for the development of more targeted intervention strategies in the management of maternal pain and anxiety. The conclusion of this study shows that there is a significant relationship between pain in normal labor and maternal anxiety levels. Psychophysiological influences, such as frequency of uterine contractions and blood pressure, as well as social support, play an important role in determining the mother's experience during labor. Therefore, increased attention to pain management and provision of adequate social support may be key to reducing maternal anxiety levels. A suggestion for health practitioners is to strengthen efforts to integrate holistic pain management strategies and enhance aspects of social support during normal labor, in the hope of improving the mother's overall emotional and physical well-being.

References

Abbas, J., Aqeel, M., Abbas, J., Shaher, B., Jaffar, A., Sundas, J., & Zhang, W. (2019). The moderating role of social support for marital adjustment, depression, anxiety, and stress: Evidence from Pakistani working and nonworking women. Journal of affective disorders, 244, 231-238.

Difarissa, R. R. (2016). Hubungan Tingkat Kecemasan dan Lamanya Partus Kala I Fase Aktif pada Primigravida di Pontianak. Jurnal Mahasiswa PSPD FK Universitas Tanjungpura, 3(1).

Idriani. (2008). Studi Fenomenologi: Pengalaman Ibu Primipara dengan Keluarga Inti dalam Merawat Bayi Baru Lahir di Jakarta Pusat. Thesis Program Pascasarjana FIK.

Jalal, M., Dolatian, M., Mahmoodi, Z., & Aliyari, R. (2017). The relationship between psychological factors and maternal social support to breastfeeding process. Electronic physician, 9(1), 3561.

Jijimole, M., Abdul, J. A., Vijayaraghavan, R., & Susila, C. (2018). Comparison of the effectiveness of reflexotherapy with skilled birth attendant on labor outcomes in terms of psychophysiological variables among primigravid women–A pilot study. National Journal of Physiology, Pharmacy and Pharmacology, 8(8), 1179-1187.

Kuswandi, L. (2014). Gentle hypnobirthing a gentle way to give birth. Jakarta: Puspa Swara.

Lee, L., Dy, J., & Azzam, H. (2016). Management of spontaneous labour at term in healthy women. Journal of Obstetrics and Gynaecology Canada, 38(9), 843-865.

Lowdermilk, D. L., Cashion, K., Perry, S. E., Alden, K. R., & Olshansky, E. (2019). Maternity and Women's Health Care E-Book. Elsevier Health Sciences.

Nisa, S. M. K., Murti, B., & Qadrijati, I. (2018). Path analysis on the psychosocial factors affecting anxiety and delivery pain. In Mid-International Conference on Public Health 2018 (pp. 173-173). Sebelas Maret University.

Oakley, A. (2018). Social support and motherhood (reissue): The natural history of a research project. Policy Press.

Palupi, P. (2020). Studi Fenomenologi: Pengalaman Primipara Saat Mengalami Depresi Postpartum. Jurnal Persatuan Perawat Nasional Indonesia (JPPNI), 4(2), 81-90.

Prasetyaningrum, S. (2017). Faktor-faktor psikologis yang mempengaruhi postpartum blues. Psympathic: Jurnal Ilmiah Psikologi, 4(2), 205-218.

Rahayuningsih, F. B. (2021). Peningkatan Kualitas Hidup Ibu Nifas. Nas Media Pustaka.

Rahmawati, A. F., & Ambarwati, W. N. (2018). Pengalaman Pertama Ibu Melahirkan Secara Normal Didampingi Suami (Doctoral dissertation, Universitas Muhammadiyah Surakarta).

Reid, K. M., & Taylor, M. G. (2015). Social support, stress, and maternal postpartum depression: A comparison of supportive relationships. Social Science Research, 54, 246-262.

Sachs‐Ericsson, N. J., Sheffler, J. L., Stanley, I. H., Piazza, J. R., & Preacher, K. J. (2017). When emotional pain becomes physical: adverse childhood experiences, pain, and the role of mood and anxiety disorders. Journal of clinical psychology, 73(10), 1403-1428.

Sarason, I. G., Sarason, B. R., Brock, D. M., & Pierce, G. R. (2013). Social support: Current status, current issues. Stress and emotion, 3-27.

Satriani, G., & ST, S. (2021). Asuhan Kebidanan Pasca Persalinan dan Menyusui. Ahlimedia Book.

Sternbach, R. A. (2013). Pain: A psychophysiological analysis. Academic Press.

Sunarsih, S., & Tuti Puspita, S. (2019). Nyeri persalinan dan tingkat kecemasan pada ibu inpartu kala I fase aktif. Holistik: Jurnal Kesehatan, 13(4), 327-332.

Whitburn, L. Y., Jones, L. E., Davey, M. A., & McDonald, S. (2019). The nature of labour pain: An updated review of the literature. Women and Birth, 32(1), 28-38.