The development of maternity nursing care model for antepartum intrapartum and postpartum mothers in the delivery room, Chiangkhan hospital.

Abstract

Effective maternal care during the antepartum, intrapartum, and postpartum periods is essential for ensuring the safety of both mothers and newborns. According to the statistics of Chiang Khan Hospital from 2021 to 2023, several complications were identified, including 2-3 cases of delivery on the waiting bed per year, neonatal asphyxia rates ranging from 8.41% to 33.11%, postpartum hemorrhage rates of 2.54% to 6.15%, and referral rates of mothers in the first stage of labor who delivered normal labor at the referral hospital ranging from 21.42% to 31.25%. This study aimed to develop a maternal care model for the antepartum, intrapartum, and postpartum periods in the delivery room at Chiang Khan Hospital. This action research employed purposive sampling. The sample consisted of 68 mothers who delivered vaginally and 22 healthcare personnel working in the maternal care unit between October 2024 and August 2025. Research instruments included the developed maternal care model, data recording forms, a labor pain coping questionnaire, and a satisfaction questionnaire. Data were analyzed using frequency, percentage, mean, and standard deviation.

        Results The developed maternal care model comprised three phases: (1) the antepartum phase, utilizing Partograph for risk screening and educating mothers and relatives on slow deep breathing techniques and uterine massage; (2) the intrapartum phase, implementing the ATM (Assessment-Team preparation-Management) guidelines with fetal heart rate monitoring every 5-10 minutes; and (3) the postpartum phase, performing uterine massage every 15 minutes during the first two hours using an innovative loudspeaker reminder system. Following implementation, no cases of delivery on the waiting bed or neonatal asphyxia were observed. The referral rate decreased to 26.47%. The most frequently used labor pain coping method was slow deep breathing (80.88%). Maternal satisfaction was rated at the highest level for both the antepartum and intrapartum periods (Mean = 4.54, SD = 0.05) and the postpartum period (Mean = 4.59, SD = 0.04).

        Conclusion The developed maternal care model effectively reduced the incidence of complications, enhanced mothers' labor pain coping skills, and increased client satisfaction.