Efeitos da intervenção fisioterapêutica e educação em saúde por teleatendimento em gestantes em preparação para o parto sobre a ansiedade, satisfação e experiência de parto: ensaio clínico controlado randomizado

Abstract

Introduction: Preparing women for childbirth with prenatal preparation programs is part of the global recommendations to promote a healthy pregnancy, with greater autonomy during labor, avoiding physical discomfort and high levels of anxiety. The physiotherapeutic intervention in obstetric care values the responsibility of the pregnant woman in the process, through the active use of her own body. Objective: This study aimed to investigate the effects of a physiotherapeutic intervention by teleservice through a training that associates exercises and orientations in health education versus orientations in health education on preparation for childbirth, anxiety, perception, satisfaction and experience of the childbirth in pregnant women. Method: This is an observational, experimental, blinded randomized controlled clinical trial, conducted online. Primiparous women, with gestation between 24 and 30 weeks, were included. Interested pregnant women were randomly allocated into two groups: Group 1 - exercises and health education guidelines and Group 2 - health education guidelines. Eight sessions were held in both groups of up to 10 pregnant women, consisting of health guidelines on pregnancy, gestational physiology, childbirth, postpartum and, only in group 1, training with exercises aimed at sensory, functional discovery and training for the labor. Before and after the interventions, the Tilburg Pregnancy Distress Scale (TPDS) and the Childbirth Anticipation Questionnaire (QAP) were applied. After delivery, the participants were contacted and answered the Childbirth Experience Questionnaire (CEQ). Results: Forty-three pregnant women were included in the study. After randomization, 22 pregnant women were in group 1 and 21 in group 2. When the values of the negative and social affect subscales and the final TPDS score were analyzed, no statistically significant differences were observed between the groups before or after the remote intervention (p> 0.05). The same was observed when investigating the effects of interventions in the preparation for childbirth regarding the pregnant woman's expectation regarding labor, delivery and postpartum, through the QAP questionnaire (p>0.05). When analyzing women's experiences and satisfaction with childbirth, statistically significant differences were observed between the groups in the domains of self-ability (p=0.019) and perceived security (p=0.032), with higher values in Group 1. Conclusion: The intervention of preparation for childbirth with a protocol of physiotherapeutic exercises and health education, through teleservice, provides the pregnant woman with a positive childbirth experience in terms of her self-capacity at the time of childbirth and the feeling of security during childbirth.