2.4 Data collection
Maternal and fetal outcomes were evaluated within the first hour after
birth. Pain and maternal satisfaction about the type of pushing were
measured with a 10-point visual analog scale (VAS), 0 being absence of
pain/mild pain and low satisfaction, and 10 meaning moderate to severe
pain and high satisfaction, respectively [14].
Anxiety levels were assessed with the Brazilian version of the
State-Trait Anxiety Inventory (STAI) [15], already adapted and
validated for women in labor [16]. It contains 19 statements, each
with four agreement levels, scored from 1 to 4, with 1 indicating the
lowest level of anxiety and 4 the maximal level. This score was reversed
for the items that are present with anxiety (items 1, 2, 4, 7, 9, 10,
14, 15, 18, 19). With a total score of 19 to 76 points, mild anxiety (19
to 36 points), moderate anxiety (37 to 56 points) and severe anxiety (57
to 76 points) were categorized.
To assess maternal fatigue the Maternal Perception of Childbirth Fatigue
Questionnaire (MCFQ) was used, consisting of 15 questions, with four
agreement levels each, scored from 0 to 4, 0 being an indicative
response of a minimum degree of fatigue and 4 a maximum degree, being
categorized as low fatigue (15-50 points) and high fatigue (51-75
points) [17].
Data about episiotomy, perineal lacerations, instrumental delivery
(forceps or vacuum), postpartum hemorrhage (24 hours after delivery) and
neonatal data such as the presence of hypoxic-ischemic encephalopathy,
the 5th minute Apgar and the newborn’s admission to
intensive care were collected in medical records. The positions adopted
by women in labor have not been reported or established.