A study to assess the impact of early and late ambulation on maternal outcome of mothers with caesarean birth in a selected hospital in mangalore

Caesarean section is a life-saving procedure and with the advances in anaesthetic services and improved surgical techniques, the morbidity and mortality of this procedure have come down considerably. Caesarean section is associated with risks of post-operative adhesions, wound infections and also poses a barrier to breast-feeding initiation. In a developing country like India, it is important to look at the interventions that will make a difference and facilitation of the early ambulation may help to overcome the challenges and barriers facing post caesarean women. Objectives of the study were: • To determine the impact of early ambulation on maternal outcome of mothers with caesarean birth (group I). • To determine the impact of late ambulation on maternal outcome of mothers with caesarean birth (group II). • To compare the maternal outcome among group I and group II. • To determine the association between maternal outcome on the second postnatal day and selected variables in group I and group II. Methods: An evaluatory approach with a quasi experimental time series design was used for the study. Sample consisted of 50 mothers with caesarean birth who met the inclusion criteria and they were randomly assigned to group I and group II (n=25 in each group). Mothers in group I were ambulated 10 hours after caesarean birth and mothers in group II walked after 24 hours of delivery. . The tool used was a practice questionnaire and an observation checklist. Data was analysed using descriptive statistics, unpaired‘t’ test and Fisher’s exact test. Results: The mean breast feeding, rooming in and maternal feelings of wellbeing scores in group I (14) was higher than the mean breast feeding, rooming in and maternal feelings of wellbeing scores in group II (8.44) on the second postnatal day. The mean lochia scores in group I (268) was lower than the mean lochia scores in group II (248) on the second postnatal day. The computed ‘t’ value showed a significant difference in the maternal outcome of mothers with caesarean birth in group I and group II. There was no significant association between the maternal outcome of mothers with caesarean birth and selected variables such as parity, education, income, type of operation and time of ambulation after surgery in group I (p=2.04, p=0.21, p=2.12, p=0.15, p=0.65; p<0.05) and group II (p=0.051, p=0.12, p=0.08, p=8.48; p<0.05). Interpretation: The result shows that early ambulation is an effective method in improving the maternal outcome of mothers with caesarean birth. Conclusion: Early ambulation is a simple and a cost- free method that can be promoted by nurses’ to be used by mothers after the caesarean birth.