Common Fears Related To Pregnancy, Labor, and Delivery and Coping Mechanisms Among Primigravida Mothers
Common Fears Related To Pregnancy, Labor, and Delivery and Coping Mechanisms Among Primigravida Mothers
Common Fears Related To Pregnancy, Labor, and Delivery and Coping Mechanisms Among Primigravida Mothers
Chapter 1
INTRODUCTION
Over the years, a lot of mothers say that their first childbirth was an extraordinary
experience. This made the researchers wonder of the things they went through. For
primigravida mothers who have not experienced labor and delivery but about to, they
face fears and anxiety with regards to the unknown possibilities that may happen to them
or to their baby. Because of such fears, they find ways to cope with and manage the
stress. Discovering the common fears of this phenomena and what coping mechanisms
they use will help the primigravida mothers to be prepared for childbirth.
Before delivery, many things come to mind to the worrying mother. Fear of
deformed babies, use of invasive procedures such as episiotomy and anesthesia
administration, fear of a long labor, fear that she might not make it. Anxieties like these
increase especially when there is a friend or relative who would tell of their undesirable
birthing experience.
Labor experiences among primigravida mothers are somehow different from
multiparous mothers. To a multiparous mother, labor may not be that painful and
traumatic because they already know the feeling and have been to it. They got that
strength and confidence and would perceive labor pain and discomfort as normal and
natural since they have already experience labor and childbirth. In the case of
primigravida mothers, everything that a mother will feel is new. When contraction
increases, it gradually surges the burden of the mother, so the apprehension is greatly
increased which may lead to panic and disorientation during delivery.
In normal situations, primigravida mothers should be educated about labor and
delivery. Knowledge and facts about labor will help them prepare and understand the
process of childbirth. Family should be supportive especially the partner or husband.
Because in this moment, women began to demand attention and assurance that everything
will be alright.
This research intends to find out the common fears and coping mechanisms
among primigravida mothers related to pregnancy, labor, and delivery. The researchers
also wanted to find ways on how to alleviate discomforts and aim to identify the different
responses by the means of studying their experiences.
Theoretical framework
This study will be anchored on the theory of Roy Adaptation Model
which explains that human system has the capacity to adjust effectively to changes in the
environment and affects the environment. Promote survival, growth, reproduction &
mastery.
Conceptual framework
Basing on the theory of Callista Roy, the following are the concepts in the study:
A quantitative descriptive design will be conducted in Bago City Health Office,
Bago City to determine common fears related to pregnancy, labor, and delivery and
coping mechanisms among primigravida mothers admitted this year of 2014.
Common fears
Pregnancy
Labor
Delivery
Coping mechanisms
Physical
Emotional
Psychological
Spiritual
Social
The purpose of this study is to determine the common fears related to pregnancy,
labor and delivery and coping mechanisms among primigravida mothers admitted at
Bago City Health Office, Bago City of year 2014.
Definition of terms
Coping mechanism. Are any efforts directed to stress management (Stuart & Lardia,
2005). Operationally, it refers to how the mother manages stress.
Delivery. Is the expulsion of the fetus through the cervix and birth canal with assistance
of rhythmic muscle contractions (Dorland, 2007). Operationally, it refers to the situation
where the mother is in the process of giving birth.
Fear. It is cause by physical or psychological exposure to a threatening situation (Stuart,
2005). Operationally, it refers to the emotion the mother is experiencing during
childbirth.
Labor. It is the periodic contractions of the uterus (Dorland, 2007). Operationally, it
refers to the situation where the mother is experiencing episodes of uterine contractions.
Pregnancy. Is the state of carrying a developing embryo or fetus within the female body
(Dorland, 2007). Operationally, it refers to the condition of a woman bearing a
developing embryo or fetus.
Primigravida. It refers to a woman pregnant for the first time (Elsevier, 2009).
Operationally, it refers to the mother who will be sharing her experience about her first
labor.
Chapter 2
REVIEW OF RELATED LITERATURE
Review of related literature discusses the foreign and local related concepts and studies.
Also a synthesis is made to summarize the related concepts and studies of the research.
Related Concepts
Foreign
An article by Shelley Albini in (2010) on fears state that many are familiar with
the instinctual response of "fight or flight." As a basic survival instinct, when a person
senses a threat, real or perceived, their body throws out adrenalin so that they can either
run for safety or stay and fight. In fear, blood is sent away from the uterus and to the
extremities. Understanding what the body can do and trusting in the process can take one
quite far in allowing a peaceful birth. Knowledge is power. There is much written to
support the fact that the body's natural pain killers - endorphins - are available to birthing
women as they let go of fear. By understanding what their body can do given the chance,
many allow the natural process to occur without suffering.
As stated by Carol Nelson in (2008) the length of labor is extremely variable, with
the average length of active labor being 12 hours. Some labors are "harder" or "easier"
than others due to things like the position and size of the baby, shape and size of the
pelvis and a myriad of other physical, emotional and psychological factors that come into
play. Each woman has her own perceptions about labor as well. It is viewed by some as a
necessary evil, a means to an end that must be endured with the least amount of
discomfort possible. Others view it as a natural, spiritual, miraculous event that they want
to experience fully with minimal intervention.
An article by Expectant Mothers Guide in (2006) states that fear of childbirth is
common among moms-to-be. Most women have concerns about coping with pain,
childbirth-related injuries and the possibility of having a cesarean section. Some moms
have additional concerns due to previous life experiences such as sexual assault, having
undergone invasive fertility treatments, previous traumatic birth experience or pregnancy
loss.
An article by Bester & Nolte in (2011) stated that primigravida's experience of
childbirth is influenced by the knowledge and expectations they have of childbirth. Their
expectations of childbirth are based on the information they got from the antenatal clinic,
the nursing staff, her mother, friends and family. From this research it is clear that the
respondents had insufficient knowledge of childbirth and the handling of pain during
childbirth. This insufficient knowledge can mainly be attributed to the poor attendance of
antenatal preparation classes, inadequate professional counseling and the mother of the
primigravida as the primary source of information on childbirth. The group participating
in this research is therefore not adequately prepared for childbirth to have realistic
expectations.
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Local
An article by Yao in (2010) state that motherhood is a fulfilling experience, many
pregnant women in the Philippines still suffer from pregnancy-related illness and even
death. According to the World Health Organization (WHO), the major direct causes of
maternal morbidity and mortality include hemorrhage, infection, high blood pressure,
unsafe abortion and obstructed labor. The Philippine government, together with nongovernment organizations, private sectors and civil society should take a concerted effort
to promote cost-effective interventions that will minimize maternal mortality. "No
woman should die due to pregnancy and its other related complications. In our society,
the mothers are the primary caregiver of children. A mother's death is more than a family
tragedy -it costs social and economic investment for the community and nation as well.
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Pregnant women should have access to affordable health services throughout their
pregnancy and childbirth."
According to Parr in (2010) The birth of a child marks the culmination of a
significantly long period of all sorts of emotions. We experience a whole gamut of major
physical changes and adjustments, which are quite often challenging and demanding.
The experience of giving birth can be a rather stressful experience for women, so this
may account for why some do not cry after delivery. They may be more concerned about
the responsibilities that come with having a child, and not cry with tears of joy.
Therefore, the absence of crying could also just be the bodys reaction to extreme pain
and fatigue. Some mothers just need to take a short break after giving birth.
According to Basas (2013) religiosity is something that has been part of the
Filipino culture. It embodies the interaction between the pre-Christian religious faiths and
the Christian values in attitudes, gestures or behaviors that are highly conditioned by the
environment, ritual practices of the locality and Christian traditions which altogether
permeated into the Filipino religious culture. Filipinos believed that religion is part of
human existence and man cannot simply escape the faith that is dictated by God.
According to Lunt (2010) Filipinos were faced with numerous calamities and
disasters throughout the years, they still managed to maintain positive outlook for the
coming year. Compared to other countries with much more factors for optimism, such as
Germany, hopes run high among the Filipinos. Filipinos reason out that they should just
endure such events and phenomena since it is beyond their control and it has always been
likewise.
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Related Studies
Foreign
A study by Warchief in (2010) of fears of mothers is anxiety / anxiety is a
concern, difficulty, uncertainty / fear of loss resulting from actual or perceived threat and
can cause a person to feel frightened, worried for no apparent reason, difficulty
concentrating, tension, tiredness, restlessness and sleep disturbance. The survey results
revealed that as many (50.0%) respondents experienced anxiety were, (36.4%)
respondents experienced mild anxiety and as many (13.6%) respondents experienced
severe anxiety.
According to the study by the University of Skvde in (2012) womens
experiences of being involved in decisions and the relationship to professional and social
support during their first labor can be conceptualized as one main theme: "Most
important for first time mothers during labor is to be respected for their needs, to feel
involved in the care, and support from their partner". This theme contained three
categories: "To be respected for their needs", "To be involved in the care" and "Support
from the partner". A safe and calm environment positively influenced the womens sense
of support, and the ability to have her partner physically present positively influenced the
sense of support.
A study conducted by Suddha (2009) explored and assessed the different levels of
strees and its manifestation and different stressors in women with PIH in response to
stress. The research approach for the first phase of the study were correlational and
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a good indication that these mothers are psychologically healthy and could possibly cope
up better with motherhood.
According to RAJIV in (2007) women in labor not only have discomfort, they
also have signs of pain such as facial tenseness, flushing or paleness of the face, and
hands are fist, rapid breathing or rapid pulse rate. Other signs and symptoms of onset of
labor are lightening, increase in level of activity, uterine contractions, ripening of the
cervix involve uterine cervical changes. More women especially primigravida women,
dont know the signs of true labor. All women response to labor also may be reflect in the
vital signs and blood pressure, fear, anxiety and fatigue can cause alteration in baseline
findings.
A study by Bhure in (2008) reveals that in qualitative analysis of data obtained
from semi-structured interviews of 100 primigravida attending antenatal care and
previous painful experiences, knowledge and expectation of labour pain, attitude towards
labour pain. Many were highly motivated to deal with labour pain, although some were
anxious, and a few women expressed fear. None of the patients knew about adverse
effects of labour pain and why it should be relieved. The fact that some informants in this
study considered pain a positive feature of labour and that a few opposed the idea of
relieving labour pain, may reflect traditional social values, according to which labour
pain is welcomed, and successful bonding is seen to depend on the experience of pain in
labour.
A study by Linthoingambi Chanu in (2013) stress is common during pregnancy.
But too much of stress can make pregnant women uncomfortable. Research has shown
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that pregnant women undergo psychological, physical and social changes during
pregnancy. Stress can make trouble sleeping, headaches, lose appetite or overeat. High
levels of stress that continue for a long time may cause health problems, like high blood
pressure and heart disease. During pregnancy this type of stress can increase the chances
of having a premature baby or a low-birth weight baby, may lower baby's IQ, etc.
A study conducted by Panthumas (2012) investigated the predictive factors of the
self-care behaviours among Thai teenagers with primigravida pregnancy. The samples of
206 primigravida teenagers attending ANC clinics of six hospitals in the North-Eastern
region of Thailand were included. Data collection was done through self administeredquestionnaire.
The results of the yielded that these teenage pimigravida mothers needed
education on self-care since the majority of the respondents of the study attained the
secondary level of education. They proposed that their local centers should provide health
teaching that may provide them a better of knowledge on self-care during pregnancy.
A study conducted by Sadawarte in (2007) analysed the knowledge and
expectations of pain of labour and knowledge of labour analgesia methods among
primigravida women attending an antenatal care clinic in a teaching hospital in a rural
part of central India. The results of this study were aimed to be utilized to improve the
analgesic care of women.
The results were showed that patients were poorly informed about pain of labour.
Many women appeared highly motivated concerning their ability to cope with labour. All
the patients expected pain, many of them expected pain to be severe but had no concept
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of duration of the pain, and knew very little concerning methods available for pain relief
in labour.
They concluded that women attending antenatal care clinic in teaching hospital in
rural part of central India were poorly prepared for the experience of delivery. Antenatal
programmes should incorporate education concerning pain of labour and methods
available to alleviate pain.
A research by Bharathi in (2010) during labour, the woman experiences some
degree of stress as her system responds to the physical changes that prepare her to give
birth. Nearly every woman in labour experiences some degree of discomfort. Perception
of pain is highly unique and differs from one individual to another though the intensity of
pain stimuli is same. An appreciation of each womans unique experience of pain is
possible when perinatal nurses understand the physiological basis of pain, physiological
responses to pain, and psychosocial factors influencing pain perception.
A study conducted by Duman in (2012) aimed at determining the effect of sociodemographic and obstetric factors during pregnancy period on depression levels of the
pregnant women was a descriptive research. The results found out in the study that most
of the women experienced depression (75.0 %). However; a statistically significant
difference was found between mean depression scores and family type, number of the
pregnancy, spontaneous abortion, desired pregnancy and harmony between spouses. They
conclude that there was a positive correlation between some socio-demographic and
obstetric factors and depression during pregnancy.
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The basis of childbirth preparation is the belief that pain during childbirth is a
vicious cycle. As fear and massage, and positioning are also widely used ways of
handling the discomfort.
A study by Adin, Leena in Karnataka,Bangalore (2007) labour process more
painful situation of the every primigravida women. They will have stress and anxiety
during the labour & some will have knowledge of their past experience about the labour
and studies have proven if women have support from the family members and partner, the
labour becomes shorter. Planned teaching programme prior to the labour is one of the
most effective teaching strategies which can be used for improving the coping strategies
for the primigravida women during birth process. Objectives of the study:1. To identify
the coping strategies adopted by the primigravida women in the experimental group after
planned teaching on birth process. 2. To identify the coping strategies of women in the
control group during the birth process. 3. To compare the coping strategies adopted by the
primigravida women between experimental and control group. 4. To find out the
association between the copings strategies adopted by the primigravida in the
experimental and control group with the selected demographic variables. Methods Posttest control group design was used for the study. Interpretation and conclusion finding of
the study showed that the planned teaching for primigravida women was effective with
the positive coping strategies during birth process which was evident in post-test scores.
Hence planned teaching was an effective method for providing the information and
improving their confidence and knowledge and reduce stress and anxiety which made
primigravida with positive ability to cope with during labour.
Local
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A study by NCRFW in (2010) state that three of the four women interviewed
chose the modern day approach of giving birth in a hospital setting, while the fourth
woman opted for a home birth with the guidance of a lay mid-wife and other female
family members. One woman stated that she remained silent throughout her labor and
delivery, and also endured the pain naturally, while the others received the epidural.
These women stated that although they chose the modern day approach, they still carried
on some of the Filipino traditions.
A research by Bono, Pastrano, Ladonga, Ramirez, Laureano, Sellote and Navotas
in (2010) states that pain interventions, especially non-invasive interventions, are crucial
for primigravida mothers in enduring labour. The application of visual biofeedback with
the use of mirrors during labour shortens the duration of the second stage of labour
reduces its time span. The reduction in time span during labour means that primigravida
mothers will endure less. The pain they experience during labour may affect their
perception of their labour experience.
According to Ysmael, Elizon, Bejoc, Gonzaga and Caneda in (2010) music
therapy during labour for primigravida mothers are also found to be beneficial in
hastening the second stage of labour. The playing fast music during this stage of labour
hastened the time duration compared to those who used normal and paced music. The
hastening of the time duration during the second stage of labour means that woman has
less to endure. This could possibly affect the perception and interpretation by women of
their labour experience.
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A study conducted by James Abas et.al. in (2007) pregnancy and childbirth are a
happy and joyous time for some women , but for others the experience can be one of
anxiety , fear, and confusion. Due to the fact that our society holds pregnancy and
motherhood in high regard, many women suffer in silence when their experiences is
anything less than sublime, fearing they will be negatively judged. Some women may
feel very anxious. This is postpartum anxiety, and/or panic, and it is characterized by
intense anxiety and/ or fear etc.
Synthesis
Primigravida refers to a woman pregnant for the first time (Elsevier, 2009). All
the experience that they will encounter is new to them. According to the studies most
primigravida mothers, experienced anxiety and fear. Lack of knowledge regarding labor
process was one of the factors that contributes to the anxiety and fears among
primigravida mothers.
The related studies included in this review lead the researchers to conduct a
research about the Common Fears during childbirth and the various Coping Mechanisms
utilized by Primigravida Mothers. The studies are very useful for the researchers in
conducting the study, gathering of relevant information, and proper interpreting of data
that are to be collected. It will also serve as a guide in gathering relevant data from the
selected respondents specifically from primigravida mothers who are admitted at Bago
City Health Office, Bago City of year 2014.
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Chapter 3
METHODOLOGY
Methodology deals with the research design used the subject and respondents of
the study, the instrument used for gathering data, the analytical procedures and the
statistical tools employed.
Research Design
Quantitative research is the investigation of phenomena that lend themselves to
precise measurement and quantification, often involving a vigorous and controlled design
(Polit & Beck, 2004).
Descriptive research studies are that have as their main objective the accurate
portrayal of the characteristics of persons, situations, or groups, and /or the frequency
with which certain phenomena occur (Polit & Beck, 2004).
In this study purposive method a non-probability sampling will be used. A type of
data collection in which the researchers will choose a respondents for the study in their
own convenience.
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1. Primigravida
2. Admitted at Bago City Health Office, Bacolod City
3. Live anywhere in Negros Occidental
4. 16-25 years of age
Research instrument
The research instrument to be use will be the interview schedule. A formal
instrument, used in structured self-report studies that specify the wording of all questions
to be asked of respondents (Polit & Beck, 2004).
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Statistical Treatment
In analyzing the data according to the research design, appropriate tools were
employed depending on the nature of specific questions.
For specific question number 1, on what is the demographic profile of the
primigravida mothers admitted at Bago City Health Office, Bago City year 2014 in terms
of personal variables such as: age, educational achievement, occupation, and civil status,
necessitated the use of frequency and percentage distribution.
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For specific question number 2, on what are the common fears related to
childbirth among primigravida mothers admitted at Bago City Health Office, Bago City
year 2014, necessitated the use of frequency, and percentage. The frequency is a
symmetric arrangement of numeric from the lowest to the highest together with a count
(or percentage) of the number of times each value was obtained (Polit & Beck, 2010)
For specific question number 3, on what are the coping mechanism employed by
the primigravida mothers admitted at Bago City Health Office, Bago City year 2014,
necessitated the use of frequency, and percentage.
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Chapter 4
PRESENTATION, ANALYSIS, AND INTERPRETATION OF DATA
This chapter presents, analysis and interprets the data gathered in the relation to
the statement of the problem. It further addresses the main purpose of the study which is
to determine the common fears related to pregnancy, labor, and delivery, and the coping
mechanisms among primigravida mothers.
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limited knowledge regarding the care of the child and it may not be easy to continue
studying in view of the fact that they already have responsibilities to handle. This data
supports the study of Panthumas (2012) which states that teenage pimigravida mothers
needed education on self-care since the majority of the respondents of the study attained
the secondary level of education.
As of occupation, Table 1.1 shows that the highest is unemployed with 26 or 87 %
and lowest are sales agent and security guard with 1or 3%. It implies that 87% of the
respondents were dependent to their parents since most of them were unemployed for the
reason that they were unable to finish their studies which will give them better
opportunities to find job.
As of civil status, Table 1.1 shows that the highest is married with 15 or 50% and
the lowest is separated with 1 or 3%. This implies that majority or 50% of the mothers
have partner which serve as a support system in meeting the needs of the family. This
entail that those respondent with a married status have better way of living than those
who were single parent. This data supports the study of Sauls in (2004) and Adin, Leena
in Karnataka,Bangalore (2007) states that if women have support from the family
members and partner, the labour becomes shorter. The presence of support system and
understanding the needs of these young adolescents is crucial for them to in order to
endure pregnancy, labor and delivery.
Age
Freq.
Educational Freq.
Attainment
Occupation Freq.
Civil
Status
Freq.
27
16
17
13
18
10
19
20
20
21
10
22
23
24
25
23
Total
30
100
Elem.
Undergrad.
Elem. Grad.
None
26
87
Single
14
47
Vendor
Married
15
50
Separated
30
100
10
Sales Agent
High School
Undergrad.
13
Security
Guard
High School
Grad.
11
37
27
10
30
100
30
100
College
Undergrad.
College Grad.
Frequency
Percentage (%)
28
Miscarriage
17
28
Morning sickness
10
17
10
17
10
Total
60
100
Stress
Birth defects
Premature labor
complications
Frequency
Percentage (%)
29
Stillbirth
17
16
Forcep delivery
Meconium aspirations
12
12
11
11
Premature birth
pain
12
12
11
11
15
14
104
100
30
Fears
Frequency
Percentage (%)
Pain
10
Having cesarean
18
21
Dying
20
23
Episiotomy
Compications
health of the baby
12
14
Total
86
100
31
Physical
Frequency
Percentage (%)
Walking
25
57
Breathing exercises
16
36
Grooming
Total
44
100
Table 3.2 Emotional Coping Mechanisms to fears related to Pregnancy, Labor and
Delivery
The table 3.2 shows that the highest is crying with 11 or 37% and the lowest is
shouting with 9 or 30%. The result shows that majority of the mothers cry whenever they
are facing problems because they feel the need of expressing their emotions. This
expression of emotions can be sometimes interpreted as a sign of weakness and
incapability of solving their own problems. This data supports an article by Parr (2010)
relates that crying or not crying could be a normal reaction of the person when they are
experiencing pain and fatigue. It entirely depends to the individual whether they are
going to cry at stressful moments.
Emotional
Frequency
Percentage
Crying
11
37
Shouting
30
Displacement
10
33
Total
30
100
32
Table 3.3 Psychological Coping Mechanisms to fears related to Pregnancy, Labor and
Delivery
The table 3.3 shows that the highest is visualization of positive outcomes with 20
or 42% and the lowest is diversion of attention with 10 or 21%. This implicates that
mothers has an optimistic outlook of their pregnancy. This method of coping shows that
the mothers have accepted their pregnancy and most of their concerns about the future. In
this study, primigravida mothers try to visualize the positive outcome of their pregnancy.
This optimistic behavior is a way for the mothers to give themselves a sense of selfassurance and strengthening their morale during challenging moments of pregnancy. This
data supports the article of Lunt (2010) which states that Filipinos are maintain a positive
outlook when faced with problems as exemplified by their optimism even at times of
hardship such as typhoons, earthquakes and other natural calamities.
Psychological
Frequency
Percentage
Visualization of positive
20
42
Diversion of attention
10
21
Talking to others
18
37
Total
48
100
outcomes
Table 3.4 Social Coping Mechanism to fears related to Pregnancy, Labor and Delivery
The table 3.4 shows that the highest is seeking medical advice with 23 or 44% and
the lowest is expressing fears to others with 14 or 27%. The result implies that mothers
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seek the advice of medical. It shows that mothers express their concern of the well being
of both themselves and their unborn child. This data supports the study of Sadawarte
(2007) states that providing education among primigravida mothers is a way for them to
have a sense of preparedness during childbirth. This sense of preparedness can help in the
positive coping of the primigravida mother.
Social
Frequency
Percentage
14
27
Recreational activities
15
29
23
44
Total
52
100
Table 3.5 Spiritual Coping Mechanism to fears related to Pregnancy, Labor and Delivery
The table 3.5 shows that the highest is praying with 25 or 42% and the lowest is
reading the Bible with 13 or 22. The results implicate that most of the mothers seek the
help of God whenever they experience challenges in the duration of their pregnancy. It
shows that these mothers maintain their faith in God and they express hope concerning
their pregnancy. In this study, primigravida mothers pray as a way for them relieve
themselves from the stress and fears that they are experiencing. This data supports the
article of Basas (2013) which states that most Filipinos maintain their religious beliefs
and help or guidance to God whenever they are faced with problems that they may be
beyond their capability.
Spiritual
Frequency
Percentage
34
Praying
25
42
13
22
Attending mass
21
36
Total
59
100
35
Frequency
Percentage (%)
25
57
11
37
20
42
22
44
25
42
Physical
Walking
Emotional
Crying
Psychological
Visualization of positive
outcomes
Social
Seeking medical advices
Spiritual
Praying
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Chapter 5
SUMMARY OF FINDINGS, CONCLUSIONS, AND RECOMMENDATIONS
Summary of Findings
The following are the findings of the study from the data presented, analyze, and
interpreted:
1. Demographic profile of the respondents as to age is 25 years old as the highest with
23%; as to educational attainment, the highest is high school graduate with 37%; as to
occupation, jobless or unemployed with 87%; and as to civil status, 50% of the
respondents were married.
2. The most common fears of the young primigravida mothers as to pregnancy is
miscarriage which concerns 28%; as to labor is stillbirth which concerns 16%; and as to
delivery is death which concerns 23% of the mothers.
3. Most of the coping mechanisms utilized by the primigravida mothers chose walking
for their physical coping mechanism which corresponds with 57%; crying for their
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Conclusions
On the basis of summary of findings, the research drew up these conclusions:
Most of the respondents had their first pregnancy at the age of 25 years old,
finished high school, are unemployed, and are married. They are at the right age for
pregnancy but they have no adequate knowledge, since they only finished at the high
school level, they have the least opportunities for getting employed. They have a partner
in life but not enough to support the familys needs due to unemployment.
The common fears stated by the primigravida mothers are related to the loss of
life of either the mother or the child such as miscarriage, stillbirth, and death of the
mother. The primigravida mothers are afraid that if they experience such scenario, they
may be discouraged to conceive again since the life of both the mother and the child are
at risk.
The common coping mechanisms of the primigravida mothers, to alleviate the
fears and anxiety that they are experiencing, are walking, crying, visualization of positive
outcomes, seeking of medical advice, and praying. These coping mechanisms serve as an
outlet to handle the stress and worries of the possible outcomes of their pregnancy.
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Recommendations
For College of Nursing
1. This study recommends to take into account the learning of their research and integrate
it in discussion especially in NCM subjects. They should teach the Nursing students
the common coping mechanisms of primigravida mothers to enable students to
understand and help primigravida mothers alleviate the fears and anxiety that they are
experiencing
For General Health Professionals
1. Health teaching regarding pregnancy and family planning such as; distributing
pamphlets in vernacular language for easy and simple understanding during prenatal
check-ups with the content comprising of ways on how to take care of self and the
baby during pregnancy.
2. Give supplementary knowledge to primigravida mothers that can help them anticipate
possible circumstances that they may experience.
For Nursing Students
1. Update themselves to improve and effectively apply their knowledge, skills, and
attitude in rendering quality nursing care to primigravida mothers.
2. They should be aware of the challenges that primigravida mothers are experiencing in
order to apply appropriate and adequate interventions that would be therapeutic for
both mother and child.
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REFERENCES
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Suddha, A., Baby, N., Ratna, P., Puri, R., &Metgud, M. (2009). Stress, Coping Strategies,
Quality of Life and Lived Experiences of Women with Pregnancy-Induced
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APPENDIX A
Letter to the Chief Nurse
University of St. La Salle
Bacolod City
College of Nursing
July 8, 2014
Nona Obando, RN
Chief Nurse
Bago City Health Office
Madam:
Greetings!
In line with the course requirements in Nursing Research 2, we the Group 2B, BSN-4B
students of the University of St. La Salle, College of Nursing would like to ask for your
approval to allow our group to conduct our study on the proposed research entitled Common
Fears related to Pregnancy, Labor, and Delivery, and Coping Mechanisms among
Primigravida Mothers. The group is going to interview selected respondents who are
primigravida patients who seek prenatal consultation at Bago City Health Office. We will be
choosing 30 primigravida patients whose ages range from 16-25 years old. The data obtained
from this pilot study will be for research purposes only and will be kept confidential and will
augment our knowledge how to conduct research study.
We are hoping for your positive response and consideration regarding this matter. Thank you
and God bless.
In St. La Salle,
Christy Jane N. Rasimo
Group Leader
Noted By:
Merle L. Salvani RN, MN,PhD
Nursing Research 2 RLE Facilitator
College of Nursing, University of St. La Salle
45
APPENDIX B
Interview Schedule
University of St. La Salle
College of Nursing
Palangga na Responde,
Kami ang Group 2B BSN4B sang University of St. La Salle, maga conduct sang
research parte sa mga masami nga gina-kahadlokan sang mga una nga nangin iloy parte
sa pagbusong, pagpasakit, kag pagbata kag ang mga pama-agi para mabatuan ang
kahadlok. Ginapangayo namun ang inyo kooperasyon sa pagsabat sang mga masunod nga
pamangkot. Makasigurado kamu nga ang ini nga dokumento iga-tago namun para sa inyo
proteksyon.
Respectfully yours,
Christy Jane N. Rasimo
Leader, Group 2B of BSN4B
________________________________________________________________________
I. Demographic Profile of Respondent
Instruction: Palihog isulat sang nagakadapat nga personal nga impormasyon ukon check
sang mga kahon na magasanto sa inyo mga sabat.
Ngalan (Optional):
1. Age (Edad):
___________________________________________
_______
__________________
Single
Married
Separated
46
1.7 __ Complications
(Mga komplikasyon)
1.8 __ Not knowing how
to care of the baby (Indi kabalo
kung paano mag atipan lapsag)
2) Labor (Pagpasakit)
2.1 __ Loss of sexual
enjoyment (Pagdula sang
kalipayan samtang gapakiglawas)
2.2 __ Stillbirth (Mapatay
ang lapsag sa sulod palang sang
tiyan)
2.3 __ Forceps delivery
(Pagbata gamit ang mga forceps)
2.4 __ Meconium
complications (Mga
47
III. Coping Mechanisms related to fears during pregnancy, labor, and delivery.
Instruction: Palihog marka sang mga pilili-an nga gaka angay sa imo.
Ano ang imo mga gina himo para mabatu-an ang kahadlok nga gina batyag gikan sa pag
busong, pagpasakit, kag pagbata?
1) Physical
1.1 __ Walking (Pag lakat-lakat)
48
2) Emotional
2.1 __ Crying (Ga hibi)
2.2 __ Shouting (Pag-singgit)
2.3 __ Displacement (Ga pa-utwas sa mga butang sa palibot)
3) Psychological
3.1 __ Visualization of positive outcomes (Positibo nga pagtan-aw sang
resulta)
3.2 __ Diversion of attention (Pagbaling sang atensyon)
3.3 __ Talking to others (Pag isturya sa iban nga tawo)
4) Social
4.1 __ Expressing fears to others (Pagpahibalo sang ginabatyag sa iban)
4.2 __ Recreational activities (Kalingawan nga mga aktibidades)
4.3 __ Seeking medical advices (Pagpakonsulta sa eksperto/doktor)
49
5) Spiritual
5.1 __ Praying (Pagpangamuyo)
5.2 __ Reading the Bible (Pagbasa sang Bibliya)
5.3 __ Attending mass (Pagsimba)
_____________________
Pirma sang Nagresponde
50
APPENDIX C
Good and Scates Evaluation Form
NA
it.
2. The questionnaire has a face appeal such that the
NA
NA
NA
NA
51
NA
NA
NA
NA
52
APPENDIX D
Chronbachs Alpha Reliability Index
Where:
N the number of questions
APPENDIX E
Schedule of Activities
NOVEMBER
2013
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
10
11
12
13
14
15
16
21
22
23
Making of
Chapter 1
28
Finalizing
Chapter 1
29
30
17
18
19
Making of
Chapter 1
20
24
Making of
Chapter 1
25
Making of
Chapter 1
26
Making of
Chapter 1
27
Chapter 1
presentation;
Making of
Chapter 2
DECEMBER
2013
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Revision of
Chapter 1
10
Making of
Chapter 2
11
Making of
Chapter 2
12
Finalizing
Chapter 1& 2
13
14
Chapter 2
presentation;
Making of
Chapter 3
Making of
Chapter 3
Making of
Chapter 3
17
Making of
Chapter 3
18
19
20
21
Submission of
Chapters 1,2 & 3
25
26
27
28
15
16
Finalizing
Chapters 1,2& 3
22
23
24
29
30
31
JANUARY
2014
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
10
11
12
13
14
15
16
17
18
21
22
Submission of
Chapters 1,2 & 3
23
24
25
28
Revision of
Chapters 1,2& 3
29
30
Revision of
Chapters 1,2& 3
31
Revision of
Chapters 1,2& 3
Finalizing
research study;
Submission of
research study
19
26
Revision of
Chapters 1,2& 3
20
27
Printing of hard
copy
FEBRUARY
2014
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
1
10
11
Mock defense
12
13
14
15
Revision of
research study
Revision of
research study
Revision of
research study
Revision of
research study
Finalizing
research study
16
17
18
19
20
21
23
24
25
26
27
28
JUNE 2014
22
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
10
11
12
13
14
15
Giving of the
Good & Scates
16
17
18
Collation of the
Good & Scates
19
20
21
22
23
24
25
26
27
28
29
Giving of letter
to BacCHD for
pilot study
30
Friday
Saturday
Pilot study
JULY 2014
Sunday
Monday
Tuesday
Wednesday
Thursday
13
Giving of letter
to BCHO for
approval
14
10
11
12
17
18
19
Analysis and
Interpretation of
Data
25
26
Field work
15
16
Gathering of
Data
20
21
22
23
24
27
28
29
30
31
Presentation of
Chapter 4
Presentation of
Chapter 5
AUGUST 2014
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
SEPTEMBER
2014
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
OCTOBER
2014
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
APPENDIX F
Budget Estimate
Month
Cost
November
Printing of research study
Internet usage
P _____
P _____
December
Printing of research study
Internet usage
P _____
P _____
January
Printing of research study
Materials used for the research study
Internet usage
P _____
P _____
P _____
February
Printing of research study
P _____
P _____
P _____
April
Printing of interview schedule
Photocopy of interview schedule
P _____
P _____
May
Statistician
Book binding
Printing the hard copy
Internet usage
Total Cost
P _____
P _____
P _____
P _____
P _____
APPENDIX G
Coding Manual
Question
no.
Variable
no.
Variable description
Demographic data
1.1 Age
Code
Choices
16
17
18
19
20
21
22
23
24
10
25
1.2 Educational
Attainment
1.3. Occupation
Common fears
Elementary undergraduate
Elementary graduate
College undergraduate
College graduate
None
Vendor
Sales agent
Security guard
Single
Married
Separated
2.2 Pregnancy
Miscarriage
Morning sickness
Stress
Birth defects
Premature labor
Complications
Others
2.3 Labor
Stillbirth
Forcep delivery
Meconium aspirations
Premature death
Pain
10
Prolonged labor
11
12
Others
2.3 Delivery
Pain
Having a cesarean
Dying
Episiotomy
Complications
Others
Walking
Breathing exercise
Grooming
Others
Coping mechanisms
3.1 Physical
3.2 Emotional
3.3 Psychological
3.4 Social
Crying
Shouting
Displacement
Others
Diversion of attention
Talking to others
Others
Recreational activities
Others
3.5 Spiritual
Praying
Attending mass
Others