The role of psychoprophylactic preparation of pregnant women for childbirth

Authors of the article: obstetrician-gynecologist (head) of the maternity department Kupchina A.N., assistant of the department of obstetrics and gynecology of the educational institution "BSMU" Pinchuk T.V.

The role of psychoprophylactic preparation of pregnant women for childbirth

Creating comfortable conditions for the patient while providing medical care is a priority direction of modern medicine. In this regard, pregnancy, childbirth and the postpartum period are a very popular area. For every woman and married couple as a whole, this is a new, unlike anything else stage of life, which is unknown and very responsible. Already during the period of pregnancy planning, young couples actively turn to the obstetrician-gynecologist for advice and recommendations, the main goal of which is to create conditions for a physiological and smooth course of pregnancy. When pregnancy occurs, expectant parents face a new goal and desire - to make the birth process safe, predictable and comfortable. There are several components to solving this issue: the competence of doctors, the equipment of the clinic and... psychoprophylactic preparation of a pregnant woman for childbirth.

For the first time, the method of psychoprophylactic preparation of pregnant women was proposed by the famous domestic psychiatrist and psychotherapist K.I. Platonov and developed by his student, Russian obstetrician-gynecologist I.3. Velvovsky in the 40s of the XX century. The essence of the method was to relieve labor pain by eliminating a woman’s fear of childbirth. For this reason, the method was called the “system of psychoprophylactic pain relief for childbirth.” In world literature, the system of I.Z. Velvovsky is called a system of psychoprophylactic preparation of pregnant women for childbirth, and not a system of psychoprophylactic pain relief for childbirth, and this largely reflects its essence, because the system of psychoprophylactic pain relief for childbirth is aimed not only at reducing pain during childbirth, but also leads to a deeper impact on the course of prenatal, birth and postpartum periods.

There is convincing evidence, based on scientific research, that emotional stress, fear, and anxiety in a pregnant woman before childbirth worsen outcomes for both mother and child. Quite frequent complications of childbirth, such as labor anomalies and, as a consequence, fetal hypoxia, are caused by psycho-emotional factors that directly depend on the preparation of the pregnant woman for childbirth. Taking this fact into account, it is necessary to emphasize the particular importance of psychoprophylactic preparation of pregnant women at the prenatal stage.

Conducting psychoprophylactic preparation for childbirth allows a woman to adapt and understand her role in the pregnancy process, develop theoretical and practical skills of behavior during childbirth, and prepare the father of the unborn child to participate in childbirth. The undeniable advantage of psychoprophylactic preparation for childbirth is that it can be applied to all pregnant women without exception and has no contraindications.

The psycho-emotional stability of the expectant mother, the absence of fear and anxiety before childbirth contribute to the formation of a dominant pregnancy and the normal physiological course of the birth process, improving obstetric and perinatal outcomes. According to WHO, only 10% of women in labor need the use of stimulants and painkillers; the remaining 90% of women are able to safely give birth to a healthy child on their own.

Psychoprophylactic preparation and caesarean section

The issue of reducing the proportion of births by cesarean section in the pregnant population is one of the pressing problems of modern obstetrics. There is convincing scientific evidence that psychoprophylactic preparation for childbirth helps to reduce the number of surgical interventions in the natural process of childbirth. For this reason, it should be considered as a tool for reducing the percentage of cesarean sections and, as a consequence, the incidence of complications associated with surgical delivery.

Partner birth

This type of psychoprophylactic preparation for childbirth involves joint marital preparation and the participation of both parents in childbirth. Partner birth is a promising and actively developing direction in modern obstetrics. A 2013 meta-analysis, combining 22 studies and including more than 15,000 couples expecting a child, objectively demonstrated the positive qualities of this partner support for women in childbirth. At the same time, there were significantly fewer cases of surgical delivery, the use of drugs for pain relief during labor, and neonatal complications.

Non-drug pain relief for childbirth

The fear of pain during childbirth is perhaps the main fear for an expectant mother. Already from the threshold of the emergency department of the maternity hospital, some women in labor find themselves hostage to uncontrollable fear, anxiety, worries and, as a result, debilitating pain. Pain is determined not only by the damaging (nociceptive) stimulus, but also depends on a number of factors against which the action occurs (environment, memory, mood). It is known that through the efforts of the will of the person himself, by switching his attention to other activities, it is possible to reduce and even suppress the sensation of pain. In the same way, the pain of a woman in labor depends on the characteristics of her personality, on the emotional background, the environment in which she is located and can be controlled! Currently, various methods of non-drug pain relief for childbirth are widely used: relaxation, massage, acupuncture, music therapy, water birth. In terms of improving the environment for a woman in labor, partner childbirth and childbirth with an individual choice of a doctor have proven themselves to be excellent, when a comfortable and familiar psychological atmosphere minimizes the patient’s fears and worries and, as a result, minimizes the severity of pain during childbirth. Theoretical knowledge of women in labor, understanding of basic concepts in childbirth, for example, what labor pains are, why they are needed and how to “survive” them.

Based on the data presented in our article, it is obvious that psychoprophylactic preparation of pregnant women is an important link in the system of modern obstetric care. Such a psychoprophylactic effect on a pregnant woman not only provides pain relief during childbirth, but also has a beneficial effect on the entire generative cycle: it is not so often necessary to resort to surgical obstetric care, the duration of labor is reduced, hypoxia of newborns is less common, and the frequency of obstetric injuries and labor anomalies is reduced.