International Journal of Health Sciences and Research

DOI: https://doi.org/10.52403/ijhsr.20210925
Vol.11; Issue: 9; September 2021
Website: www.ijhsr.org
Original Research Article ISSN: 2249-9571

Knowledge and Anxiety Level on Labour Process

among Primigravida Mothers in a Selected Hospital,
Kamrup (M), Guwahati, Assam: A Descriptive
Study
Lalchungnungi1, Rikynti Nongkynrih2
1
M.Sc Nursing 2nd Year, Department of Obstetrics and Gynaecology, Asian Institute of Nursing Education,
Guwahati, Assam.
2
Lecturer, Department of Obstetrics and Gynaecology, Asian Institute of Nursing Education, Guwahati, Assam.
Corresponding Author: Lalchungnungi

ABSTRACT

Introduction: Many Indian women are unaware about the changes that occur in their body during
pregnancy and labour, as a result many mothers suffer physiologically and psychologically, hence
education is needed for mother especially to primigravida mothers.
Aims and Objectives: The aim of the study is to assess the level of knowledge and level of anxiety
on labour process among primigravida mothers who are attending antenatal OPD at a selected
hospital.
Methods and materials: A descriptive survey research design was used and purposive sampling
technique was used for obtaining sample for the study. Study was undertaken on 100 sample
primigravida mothers at Maternity and Child welfare Hospital of Guwahati, Assam.
Results: The finding shows that majority i.e. 53% had inadequate knowledge, 44% had moderately
adequate knowledge and only three (3%) had adequate knowledge on labour process, majority of the
respondents i.e. 58% had moderate anxiety and 42% had severe anxiety. There was association
between the knowledge level and selected demographic variables such as age, education, trimester of
pregnancy and any prenatal counselling given. Also with anxiety and selected demographic variables
such as education, occupation and any types of prenatal counseling attend. There was moderate
negative correlation (-0.310) between knowledge and anxiety scores on labour process among primi
gravida mothers.
Conclusion: This study shows that primigravida mothers had lack of knowledge and moderate
anxiety on labour process. Therefore health personnel need to conduct the education programmes to
improve the level of understanding as to reduce the level of anxiety on labour process.

Keywords: Primigravida, labour process, anxiety, delivery, childbirth, pregnancy

INTRODUCTION that may be associated with pregnancy and

Pregnant women especially labour. [1]
primigravida have to be informed about the When a woman carry a child for the
process of labour and what is expected of first time she may be anxious about how
them in the labour room so also what they they are going to cope with themselves
should expect from their care givers during besides pregnancy is an important event in
labour. The fears of pregnant women about the life of a women, it requires special care
labour should be allayed to reduced anxiety from the time of conception to the postnatal
stage, every pregnancy is a distinctive

International Journal of Health Sciences and Research (www.ijhsr.org) 164

Vol.11; Issue: 9; September 2021
Lalchungnungi et.al. Knowledge and anxiety level on labour process among primigravida mothers in a selected
hospital, Kamrup (M), Guwahati, Assam: a descriptive study.

experience and each pregnancy the women suffer from acute complications resulting
experience will be new and adequately from pregnancy and childbirth. [5]
different.[2] Selvanayaki V. (2015) conducted a
During labour many women study to assess the knowledge on childbirth
encounter the problems of fear, pain of process among primigravida mothers in
contractions and pain as menacing but it Salem polyclinic, Salem, by using purposive
often associate it with a loss of control over sampling technique 50 primigravida
their bodies and emotions. When a woman mothers were selected and structured
is in labour, especially for the primigravida interview schedule were adopted for data
mothers, they be anxious about their ability collection. The overall mean knowledge
to with stand the pain of labour and scores on childbirth process (15.76 ± 4.17)
maintain control over herself. [3] shows that the primi mothers had poor
Unfortunately, Many Indian women knowledge. Mothers had poor knowledge on
who were illiterate were lack of knowledge first stage of labour (5.88 ± 2), second stage
about physiological changes during of labour (2.06 ± 1.2) and third stage of
pregnancy and during labour, especially at labour (0.94 ± 0.71), whereas average
the first time and so they suffers knowledge on signs and symptoms of onset
psychologically ultimately which in turn of true labour (2.94±1.37). The overall
affect their gynecological health of antenatal finding revealed that primimothers had poor
mother’s childbirth as pregnancy is a knowledge on childbirth process, therefore a
physical and emotional experience. health personnel need to conduct the
Considering the above facts it is necessary education programmes on various methods
to assess the knowledge regarding normal to increase the knowledge on childbirth
delivery among the primigravida mother to process which will ultimately help the
prevent possible complication and to reduce mothers to reduce their fear and anxiety
the maternal mortality ratio, and perinatal during labour process.4
mortality and morbidity is contributing to The investigator has come across
healthy mother. [4] antenatal mothers who are unaware of the
Worldwide, every three minute, a labour process, the complication during
woman lost their lives due to pregnancy and pregnancy and during childbirth and the
its related complications approximately 800 birth preparation As a midwife ,the main
women every day and in India, one mother role is to assess and provide their
dies every 10 minutes due to pregnancy- knowledge and also to provide health
related cause. Despite the availability of education thereby creating awareness
advanced medical technology, women regarding preparedness, labour process
continue to die in the process of child birth ,anxiety level and complication readiness
and the maternal morbidity and mortality for the better outcome.
has been remained same in the past three The investigator had undergone
decades .In India over 56,000 women dying through the previous study and only few
each year from pregnancy-related causes, studies have done regarding labour process
and it has among the highest number of and assessing anxiety level, besides from
maternal deaths anywhere in the world, the personal experiences the investigator felt
with. It is calculated that for every 100,000 the need and motivated of studying this
live births in India, 212 mothers will die. topic by assessing their knowledge and
Statistics of India show that India every 5 anxiety level with providing health
minute1 women dies due to which education so as to make them aware about it
complication related to pregnancy and child and prevent the possible complication which
birth. Every pregnancy carry a risk and 15% are preventable.
women often develop life threatening
complications and 50% of women also

International Journal of Health Sciences and Research (www.ijhsr.org) 165

Vol.11; Issue: 9; September 2021
Lalchungnungi et.al. Knowledge and anxiety level on labour process among primigravida mothers in a selected
hospital, Kamrup (M), Guwahati, Assam: a descriptive study.

OBJECTIVES: to participate in the study. The samples were

1. To assess the level of knowledge on also assured anonymity and confidentiality
labour process among primigravida of information provided by them. The
mothers in a selected hospital, Kamrup, collected data were analyzed in terms of
Guwahati Assam. objectives of the study using descriptive and
2. To assess the level of anxiety on labour inferential statistics.
process among primigravida mothers in
a selected hospital, Kamrup, Guwahati Statistical analysis:
Assam. The collected data were analysed on
3. To find out the correlation between the the basis of the objectives and data was
level of knowledge of the primigravida organized in the master sheet and tabulated
mothers with the level of anxiety on for statistical analysis. Demographic data
labour process in a selected hospital, were represented in terms of frequency and
Kamrup, Guwahati, Assam. percentage.
4. To find out the association between the Mean, standard deviations were used
knowledge and level of anxiety of the to assess the level of knowledge and anxiety
primigravida mother on labour process score. Karl Pearson’s correlation coefficient
with the selected demographic variables test was used to find out the correlation
in a selected hospital, Kamrup, between the level of knowledge of the
Guwahati, Assam. primigravida mothers with the level of
anxiety.
METHODS AND MATERIALS Chi square test was used to find out
A descriptive survey research design the association between the knowledge and
was used in this study to accomplish the level of anxiety of the primigravida mother
objectives. Purposive sampling technique with selected demographic data.
was used for obtaining adequate sample for
the study. Study was undertaken on 100 Description of the tool
sample primigravida mothers at Maternity Section A: Demographic data consist of
and Child Welfare Hospital, Dhirenpara Age in years, religion, education,
Guwahati, Assam. Semi structured occupation, income per month, trimester of
knowledge questionnaire and 4 point Likert pregnancy, type of family, type of
scale was used as tool for the study. pregnancy, duration of marriage, residence,
Respondent were selected on the basis of support system during the process for
inclusive and exclusive criteria. Ethical delivery, previous information regarding
permission was obtained before data labour, source of information, any prenatal
collection and permission was obtained counseling given, any types of prenatal
from the selected Hospital. The investigator counseling attend.
collected the list of primigravida mother
who are attending the antenatal OPD from Section B: Semi structured knowledge
the registration counter and has identified questionnaire. It consists of 30
the sample. A brief self introduction and questionnaires.
purpose of the study were explained to the
sample prior to data collection and keeping Section C: 4 point Likert scale was used to
in mind the ethical aspect of research. Data assess anxiety level. It consisted of 14 items
was collected after obtaining the informed with 7 positive statements and 7 negative
consent of the sample with their willingness statements.

International Journal of Health Sciences and Research (www.ijhsr.org) 166

Vol.11; Issue: 9; September 2021
Lalchungnungi et.al. Knowledge and anxiety level on labour process among primigravida mothers in a selected
hospital, Kamrup (M), Guwahati, Assam: a descriptive study.

RESULT
Table I: Frequency and percentage distribution of primigravida mothers according to demographic variables. n= 100
Demographic Variables Frequency (f) Percentage (%)
Age in years
≤25 56 56
26 – 35 43 43
>35 1 1
Religion
Hindu 61 61
Islam 39 39
Christian - -
Others - -
Education
Primary school 35 35
High school 31 31
Higher secondary school 13 13
Graduate 9 9
Others 12 12
Occupation
Business 18 18
Govt. Servant 1 1
Private 4 4
Others 77 77
Income per month
≤Rs.10001 48 48
Rs.10002 – 29972 32 32
Rs.29973 – 49961 16 16
Rs.49962 – 74755 3 3
Rs.74756 – 99930 1 1
Rs.99931 – 199861 - -
≥199862 - -
Trimester of pregnancy
≤3 months 18 18
4–6 42 42
≥7 40 40
Type of family
Nuclear family 59 59
Joint family 40 40
Extended family 1 1
Type of pregnancy
Unplanned pregnancy 4 4
Planned pregnancy 96 96
Duration of marriage
≤5 years 88 88
6 – 10 years 5 5
≥11 years 7 7
Residence
Urban 85 85
Rural 15 15
Support system during the process of preparation for delivery
Health personnel 76 76
Family 22 22
Relatives 1 1
Others 1 1
Previous information regarding labor
Yes 55 55
No 45 45
Source of information
Mass media 6 6
Health professionals 27 27
Elders and relatives 17 17
Friends and others 2 2
Newspapers 3 3
Others - -
No 45 45
Any prenatal counseling given
Yes 54 54
No 46 46
Any types of prenatal counseling attend
General care counseling 36 36

International Journal of Health Sciences and Research (www.ijhsr.org) 167

Vol.11; Issue: 9; September 2021
Lalchungnungi et.al. Knowledge and anxiety level on labour process among primigravida mothers in a selected
hospital, Kamrup (M), Guwahati, Assam: a descriptive study.

Demographic Variables Frequency (f) Percentage (%)

Dietary counseling 6 6
Breast feeding counseling - -
Family planning counseling 6 6
Genetic counseling - -
Childbirth: labour, delivery and postpartum care counseling 1 1
Women with HIV/AIDS counseling 3 3
Pregnancy and mental health counseling 2 2
Others - -
No 46 46
Yes 54 54
No 46 46
Any types of prenatal counseling attend
General care counseling 36 36
Dietary counseling 6 6
Breast feeding counseling - -
Family planning counseling 6 6
Genetic counseling - -
Childbirth: labour, delivery and postpartum care counseling 1 1
Women with HIV/AIDS counseling 3 3
Pregnancy and mental health counseling 2 2
Others - -
No 46 46

Table II : Frequency and percentage distribution of primigravida mothers according to level of knowledge on labour process .
n=100
Knowledge level Frequency(f) Percentage (%) Mean SD Range of score Total score
Inadequate 53 53% 9.35 3.89 3-20 30
≤9 ( score ≤ 33%)
Moderate 44 44%
10 – 18 (score34- 66%)
Adequate 3 3%
≥19 (≥67%)

The table II: depicts the percentage distribution of level of knowledge on labour
process among primigravida mothers. The results shows that 53(53%) had inadequate
knowledge, 44(44%) had moderately adequate knowledge and 3(3%) had adequate
knowledge on labour process the mean score of knowledge was 9.35±3.89 and SD was 3.89.

Table III: Frequency and percentage distribution of primigravida mothers according to level of anxiety on labour process. n=100
Anxiety level Frequency (f) Percentage (%) Mean SD Range of score Total score
Mild :- ≤18(≤32% score) 0 0% 35.52 3.17 27-43 56
Moderate:- 19 – 36 (33%-66% ) 58 58%
Severe:- ≥37(≥67%) 42 42%

The table III depicts the percentage distribution of level of anxiety on labour process
among primigravida mothers. The result shows that 58(58%) had moderate anxiety and
42(42%) had severe anxiety. The mean score of anxiety was 35.52±3.17and SD was 3.17.

Table IV: Association between level of knowledge on labour process among primigravida mothers with selected demographic
variables. n=100
Demograpic Variables Chi square Df P- value Remarks
1. Age in years 13.2 4 0.003 Significant at p<0.01
2. Religion 0.66 2 0.767 Not significant p>0.05
3.Education 20.0 8 0.003 Significant at p<0.05
4.Occupation 6.43 6 0.420 Not significant p>0.05
5.Income per month 8.50 8 0.432 Not significant p>0.05
6. Trimester of pregnancy 11.11 4 0.022 Significant at p<0.05
7. Type of family 3.47 4 0.683 Not significant p>0.05
8. Type of pregnancy 0.84 2 0.693 Not significant p>0.05
9. Duration of marriage 5.98 4 0.169 Not significant p>0.05
10. Residence 0.29 2 1.000 Not significant p>0.05
11. Support system during the process of preparation for delivery 8.82 6 0.202 Not significant p>0.05
12. Previous information regarding labour 2.14 2 0.370 Not significant p>0.05
13. Source of information 10.2 10 0.405 Not significant p>0.05
14. Any prenatal counselling given 5.68 2 0.045 Significant at p<0.05
15. Any types of prenatal counselling attend 12.4 12 0.473 Not significant p>0.05

International Journal of Health Sciences and Research (www.ijhsr.org) 168

Vol.11; Issue: 9; September 2021
Lalchungnungi et.al. Knowledge and anxiety level on labour process among primigravida mothers in a selected
hospital, Kamrup (M), Guwahati, Assam: a descriptive study.

The table IV: Shows the association education, trimester of pregnancy and
between level of knowledge on labour prenatal counselling given had shown
process among primigravida mothers with statistically significant association with
their demographic data. The table shows level of knowledge on labour process
that the demographic variable age had among primigravida mothers at p<0.05. The
shown statistically significant association other demographic variables had not shown
between level of knowledge on labour statistically significant association with
process among primigravida mothers at level of knowledge on labour process
p<0.01. The demographic variables age, among primigravida mothers.

Table V: Association of pretest level of anxiety on labour process among primigravida mothers with selected demographic variables.
n=100
DEMOGRAPIC VARIABLES Chi square Df P- value REMARKS
1. Age in years 5.19 2 0.051 Not significant p>0.05
2. Religion 0.97 1 0.407 Not significant p>0.05
3.Education 9.42 4 0.049 Significant at p<0.05
4.Occupation 7.31 3 0.042 Significant at p<0.05
5.Income per month 1.88 4 0.864 Not significant p>0.05
6. Trimester of pregnancy 3.46 2 0.189 Not significant p>0.05
7. Type of family 2.43 2 0.214 Not significant p>0.05
8. Type of pregnancy 1.86 1 0.307 Not significant p>0.05
9. Duration of marriage 1.63 2 0.406 Not significant p>0.05
10. Residence 1.70 1 0.260 Not significant p>0.05
11. Support system during the process of preparation for delivery 2.16 3 0.681 Not significant p>0.05
12. Previous information regarding labour 0.002 1 1.000 Not significant p>0.05
13. Source of information 2.54 5 0.822 Not significant p>0.05
14. Any prenatal counselling given 2.54 5 1.000 Not significant p>0.05
15. Any types of prenatal counselling attend 0.01 1 0.028 Significant at p<0.05

The table V shows the association as the level of knowledge were inadequate
between level of anxiety on labour process there were moderate level of anxiety.
among primigravida mothers with their
demographic variables. The table shows that DISCUSSION
the demographic variables education, The study reveals that out of 100
occupation and types of prenatal counselling antenatal mothers majority of the mothers
attend had shown statistically significant i.e. 53 (53%) fall under the category of
association with level of anxiety on labour inadequate knowledge, 44(44%) had
process among primigravida mothers at moderately adequate knowledge and 3(3%)
p<0.05 .The other demographic variables had adequate knowledge on labour process.
had not shown statistically significant This study is in contrast to a study findings
association with level of anxiety on labour of Pankot R, Patidar N, Devi NJ et al.
process among primi gravida mothers. (2018) knowledge regarding process of
normal labour among primigravida mothers
Table VI : Correlation between knowledge and anxiety scores in a selected hospital in Pune city in which
on labour process among primi gravida mothers. n=100
VARIABLES MEAN S.D ‘r’ value ‘P’ value the results shows 22% of mothers having
Knowledge 9.35 3.89 -0.310 0.002, S** poor knowledge about process of normal
Anxiety 35.52 3.17
labour, 74% of mothers were having
average knowledge regarding process of
Data from table VI reveals that the
normal labour, 4% of mothers are having
‘r’ value is -0.310 and ‘p’ value is 0.002
good knowledge about process of normal
which is significant at 0.05 level of
labour. [3]
significance. There is a moderate negative
The present study shows that out of
correlation between knowledge and level of
100 antenatal mothers majority of the
anxiety on labour process among
mothers i.e. 58(58%) were having moderate
primigravida mothers .It clearly infers that
anxiety on labour process, 42(42%) had

International Journal of Health Sciences and Research (www.ijhsr.org) 169

Vol.11; Issue: 9; September 2021
Lalchungnungi et.al. Knowledge and anxiety level on labour process among primigravida mothers in a selected
hospital, Kamrup (M), Guwahati, Assam: a descriptive study.

severe anxiety, this is supported by the Source of Funding: None

study conducted by Sapkota B, Mali S N et
al. (2019) a study on prenatal anxiety among REFERENCES
pregnant women visiting in antenatal care 1. Omotayo RS, Akintan AL, Akadiri O et al.
outpatient department at Paropakar Level of awareness of Primigravida about
maternity and women’s hospital in which Pregnancy and Antenatal Care at the Time
40.9% had minimal anxiety ,42.15 had mild of Booking in a South West Nigerian
to moderate anxiety and 16.9% had severe Tertiary Hospital. Clinic in surgery journal
[Internet] 2020 Jul 15;8(3):83-96[cited on
anxiety.[6] 2021 Jan 2].Available from URL
In present study there was http://www.clinicsinsurgery.com/pdfs_folde
correlation between knowledge and anxiety r/cis-v5-id2868.pdf.
on labour process. The calculated Karl 2. Walia N, Ramanadin V,Kiran. A descriptive
Pearson’s Correlation Value of r= -0.310 study to assess the level of knowledge
shows a moderate negative correlation related to labour process among
which was found to be statistically primigravida in selected Hospitals of Punjab
significant at p< 0.01.It clearly infers that and Haryana. Asian J. Nur. Edu. &
knowledge on labour process among Research [Internet ] 2014 July [cited on
primigravida mothers decreases their 2021 Jan 30] 4(3);273-275 .Available from
URL
anxiety level increases.
https://ajner.com/HTMLPaper.aspx?Journal
In the present study there was =Asian%20Journal%20of%20Nursing%20E
association between level of knowledge on ducation%20and%20Research;PID=2014-4-
labour process among primigravida mothers 3-2
with the selected demographic variables like 3. Punjot R, Patidar N, Devi NJ et al. A study
age, education, trimester of pregnancy, and to assess knowledge regarding the process
there was association between anxiety level of normal labor among primigravida
on labour process among primigravida mothers in selected hospitals of Pune city.
mothers with the selected demographic IJNH [ Internet] 2018 [cited on 2021 Jan30]
variables like types of prenatal counselling 4(2):66-71.Available from URL
attend. http://innovationalpublishers.com/Content/u
ploads/PDF/690645763_IJNH-06-AJ-2018-
24.pdf
CONCLUSION 4. Selvanayaki V. A study to assess the
The study conclude that as the knowledge on childbirth process among
knowledge were inadequate and moderate primigravida mother at Salem Polyclinic
level of anxiety was present among Tamilnadu. International Journal on Current
primigarvida mothers, it is recommended Research [Internet] 2015 July ;7 (7);18504-
that there should be more awareness 18506[cited on 2021 jan 2 ] .Available from
programmes related to child birth and URL
delivery process among antenatal mothers https://www.journalcra.com/article/study-
including the family members so as to assess-knowledge-childbirth-process-
support them throughout pregnancy and among-primigravida-mothers
during labour, the healthcare worker should 5. Mulik MS, Salunkhe J, Salunkhe AH. A
study to assess knowledge and effectiveness
educate the mothers properly whenever they of structured teaching programme on child
come for checked up which will increase birth process among primipara mothers.
their knowledge and will reduce the IJHSR [Internet] 2014;4(11):174-178:[cited
pregnancy related anxiety. on 2021 Feb 9] .Available from URL
https://www.ijhsr.org/IJHSR_Vol.4_Issue.1
Acknowledgement: None 1_Nov2014/25.pdf
6. Sapkota B , Mali S.N , Singh RD et al.
Conflict of Interest: None Prenatal Anxiety among Pregnant Women
Visiting in Antenatal Care Outpatient

International Journal of Health Sciences and Research (www.ijhsr.org) 170

Vol.11; Issue: 9; September 2021
Lalchungnungi et.al. Knowledge and anxiety level on labour process among primigravida mothers in a selected
hospital, Kamrup (M), Guwahati, Assam: a descriptive study.

Department at Paropakar Maternity and How to cite this article: Lalchungnungi,

Women's Hospital. IJHSR 2019 March; Nongkynrih R. Knowledge and anxiety level on
9(3)173-181[cited on 2021 Feb 6] Available labour process among primigravida mothers in a
from : URL selected hospital, Kamrup (M), Guwahati,
https://www.ijhsr.org/IJHSR_Vol.9_Issue.3 Assam: a descriptive study. Int J Health Sci Res.
_March2019/25.pdf 2021; 11(9): 164-171. DOI: https://doi.org/10.
52403/ijhsr.20210925

******

International Journal of Health Sciences and Research (www.ijhsr.org) 171

Vol.11; Issue: 9; September 2021