Effect of Pronurturance Plus on Labor Outcomes of Women at Risk to Postpartum Hemorrhage

Background: Postpartum hemorrhage is still the leading cause of death of birthing mothers
in the world today. Pronurturance plus evidence-based practice which includes early skin-to-skin
contact and breastfeeding has a significant positive effect to improve the labor outcomes and
decrease the occurrence of postpartum hemorrhage. Aim: was to study the effect of pronurturance
plus on labor outcomes of women at risk to postpartum hemorrhage. A Quasi-experimental
research study carried out at the Delivery Room and Postpartum Department in one of the
Hospital that affiliated to the Ministry of Health, Fayoum, Egypt. Sample: A purposive sample
of 90 laboring women at risk for postpartum hemorrhage was divided into the study and control
groups (45 for each). The control group received routine hospital care and the study group
received the pronurturance plus practice. Seven women were excluded from the study group due
to that some babies failed to initiate breastfeeding after delivery and some mothers didn‟t
complete the duration of skin to skin contact. Finally, the sample size reached 45 & 38 women in
the control and study groups respectively. Four tools were used: 1) Laboring women‟s‟
demographic data assessment tool,2)Risk factors‟ to postpartum hemorrhage assessment tool 3)
Labor outcomes assessment tool, and 4) Women‟s‟ satisfaction assessment tool. The results:
There were statistically significant differences between the study and the control groups with
regard to the labor outcomes in third and fourth stage of labor. The study group exhibited less
duration of 3
rd
stage of labor, efficient uterine contraction, less amount of blood loss, less
occurrence of primary postpartum hemorrhage, and high satisfaction level regarding to the apply
of pronurturance plus. Conclusion: The pronurturance plus practice had a positive effect in
improving labor outcomes and reducing the occurrence of primary postpartum hemorrhage
among women at risk to postpartum hemorrhage. Recommendations: The practice of
pronurturance plus should be a part of routine 3
rd
and 4
th
stage care for all birthing women
regardless of their level of risk.