Impact of Early and Late Ambulation on Pain and Breastfeeding of Mothers with Caesarean Section in Selected Hospital in Panipat, Haryana

Abstract

Background of the Study: Caesarean section is a life-saving procedure and with the advances in
aesthetic services and improved surgical techniques, the morbidity and mortality of this procedure
have come down considerably. Numerous complications are associated in caesarean section, which
include post-operative pain, infection around the site, delayed healing of wound and difficulty in
starting breastfeeding. In developing countries like India, it is very essential to search for novel
interventions that will significantly help post caesarean women to overcome challenges and barriers
regarding early ambulation. Aim of the Study: To assess the impact of early and late ambulation on
maternal outcome of mothers with caesarean birth. Methodology: a quasi-experimental (time series)
research design was adopted in this study. Setting of the study was Civil Hospital, Panipat. Purposive
sampling technique was used to select samples. Data collection tool was numerical pain rating scale,
the latch breastfeeding assessment tool, involution of the uterus Performa. The mothers in group I
were made to sit on the bed after 10 h of delivery for 5 min. They were checked for headache,
uneasiness, and nausea. Those who did not exhibit the above symptoms were made to stand with
support for 2–3 min and then ambulated in the ward with support for 15 min for every 2 h. Mothers
with headache, nausea and uneasiness were given complete rest until 24 h of delivery. The mothers in
group II were checked for headache, uneasiness, and nausea. Mothers in this group were ambulated
only after 24 h of the surgery. The first, second and third data was collected when the mother was in
labour ward and after 24, 48 and 72 h of caesarean birth respectively using a practice questionnaire

and an observation checklist. Results: • Among subjects who had early ambulation, on the post-
operative first day, the mean pain score and Standard deviation score was 8.04±0.841. During second

day, the mean pain score and standard deviation score was 6.64±0.810 and on the third day, it was
3.96±1.060. The variance level on day 1, 2 and 3 were (0.707, 0.657 and 1.113). • Among subjects
who had early ambulation, on the post-operative first day, the mean breastfeeding score and Standard
deviation score was 0.40±0.50. During second day, the mean breastfeeding score and Standard
deviation score was 3.36±1.221; and on the third day, it was 6.96±1.338. The variance levels on day

1, 2 and 3 were 0.250, 1.490 and 1.790. • Among subjects who had late ambulation, on the post-
operative first day, the mean pain score and

Standard deviation score was 8.16±1.143. During
second day, the mean pain score and Standard
deviation score was 6.56±0.757 and on the third
day, it was 4.04±1.098. The variance levels on day
1, 2 and 3 were 1.307, 0.870 and 1.207. • Among

subjects who had late ambulation, on the post-
operative first day, the mean breastfeeding score

and Standard deviation score was 0.24±0.436.
During second day, the mean breastfeeding score
and Standard deviation score was 3.16±1.179 and
on the third day, it was 6.52±1.531. The variance
levels on day 1, 2 and 3 were 1.307, 0.870 and
1.207. Conclusion: Nurses working in the labour ward practice various measures’ procedures which assist postnatal mother after caesarean birth. One

of the simple and cost-free method that is recommended through this research was early ambulation.