The impact of the use of active imagery on labor and delivery

Abstract

This clinical investigation assessed the impact of the use of active imagery during labor and delivery to: assist in pain control, facilitate the physiological processes of labor, reduce anxiety, and improve feelings of control and self worth in the parents. Multiple designs including descriptive, Wilcoxon signed-rank test, and ANOVA using the General Linear Model were employed. After approval by monitoring authorities and informed consent, multipara couples responded to the State Trait Anxiety Inventory, the Pregnancy Attitude Index or Levenson's Locus of Control Scales, and the Adjective Checklist. Gender differences in the late third trimester were assessed. Experimental group couples were taught active imagery, given an audiotape for daily practice, and used imagery in labor and delivery. After delivery, tests were readministered, subjective comments recorded, and vividness of imagery assessed in the imagery group mothers. In the 15 couples studied, all were Internally controlled. Men felt more Internally controlled, women more manipulation by Powerful Others. There were no differences on the STAI or ACL. After delivery, no change was found on the STAI, or in Internal control. The eight couples in the Control group and women had greater control by Powerful Others. Control by Chance increased in the Control group, particularly the women. On the ACL, the Experimental group had significant change in Favorable scores with more feelings of internal control, confidence and less need for support and sympathy compared to the Control group. There was no significant difference in time in labor from 7-10 cm. However, Experimental group mothers had shorter labor periods in the hospital. They required less medication, and their babies had higher one minute Apgar scores and significantly higher arterial oxygen concentration in umbilical cord blood gas analysis. Subjectively, mothers voiced greater feelings of control after using imagery, adopting the procedure and generalizing it to other life situations. This study provided an initial look at men's feelings during their wives' pregnancies. The use of active imagery resulted in greater feelings of control and self worth, shorter total labor periods and improved neonatal outcome in this group. Imagery offers a potential for improvement in the birth process which merits further study.