THE EFFECT OF LISTENING TO SURAH ABESE (VERSES 19-20) DURING CHILDBIRTH ON VAGINAL BIRTH SELF-EFFICACY, BIRTH BELIEFS, AND PAIN PERCEPTION

This study is a randomized controlled clinical trial planned to examine the effect of listening to verses 19-20 of Surah Abasa during labor on women's self-efficacy regarding vaginal birth, childbirth beliefs, and pain perception.

Childbirth is an important and unforgettable process in a woman's life, with both physiological and psychological dimensions. During this process, a woman's level of self-efficacy regarding childbirth directly affects the quality of the birth experience. It is stated that women with high self-efficacy manage the labor process more easily, perceive less pain, and cope more effectively with complications. In contrast, a low level of self-efficacy may cause childbirth to be perceived as more difficult and stressful. It is stated that there is an inverse relationship between self-efficacy and labor pain; that is, as self-efficacy increases, pain perception decreases.

Non-pharmacological methods play an important role in the management of labor pain. Current health policies and guidelines recommend the use of methods such as music, massage, movement, changes in position, and similar approaches during labor. Spiritual and religious approaches, which are among these methods, have also attracted attention in recent years. Spiritual care can increase a woman's ability to cope with stress, provide psychological relaxation, and positively affect the childbirth experience. In particular, listening to prayers and religious content has contributed to reductions in pain, anxiety, and stress levels in some studies.

Although there are various studies in the literature examining the effects of listening to the Qur'an, prayers, or surahs, no study has been found that examines the effect of listening to a specific verse during labor on childbirth self-efficacy and childbirth beliefs. Based on this gap, the study aims to scientifically evaluate the effect of verses 19-20 of Surah Abasa, which is believed to facilitate childbirth in Muslim societies.

This study will be conducted in the Maternity Unit of Hitit University Erol Olçok Training and Research Hospital in Çorum province.

The hypotheses of the study are; H1: Listening to verses 19-20 of Surah Abasa during labor reduces the duration of the active phase.

H2: Listening to verses 19-20 of Surah Abasa during labor reduces the duration of the second stage of labor.

H3: Listening to verses 19-20 of Surah Abasa during labor reduces pain perception.

H4: Listening to verses 19-20 of Surah Abasa during labor increases the Vaginal Birth Self-Efficacy Scale score.

H5: Listening to verses 19-20 of Surah Abasa during labor increases the Birth Beliefs Scale score.

• LISTENING TO VERSES 19-20 OF SURAH ABESE (Other): In this study, verses 19-20 of the Surah Abasa will be uploaded to a music player and played through headphones to pregnant women who have completed the participation requirements and voluntarily agreed to participate, once every hour from the active phase of labor (5 cm cervical dilation) until the end of labor.

Primary outcomes

• Visual Analog Skala (VAS) [1 week]: VAS was developed by Bond and Pilowsky in 1966 , and its Turkish adaptation was carried out by Aslan and Öztürk in 2014. The Visual Analog Scale is a unidimensional scale commonly used to measure pain intensity. It is a measurement tool that allows individuals to subjectively describe their pain. VAS is a ruler measuring 0-10 cm (0-100 mm) from the starting point to the endpoint. This measurement tool can be used horizontally or vertically. The scale starts with "no pain" (0) and ends with "the most severe pain imaginable" (10). Pain scores obtained from the scale indicate 'mild pain' between 0-3, 'moderate pain' between 3-6, and 'very severe pain' between 6-10.

Secondary outcomes

• Vaginal Birth Self-Efficacy Scale [1 week]: This scale is used to measure women's perceptions of self-efficacy regarding performing vaginal birth and coping with this process. The scale can be administered to all pregnant women from the 14th week of pregnancy (the beginning of the second trimester) until delivery. The scale consists of 9 items, and for each item, there is an eleven-point Likert-type scale ranging from 0- disagree to 10- agree. The possible score range on the scale is 0-90. Higher scores indicate that the pregnant woman's self-efficacy belief regarding vaginal birth has increased.
• Birth Beliefs Scale [1 week]: The scale is a five-point Likert-type scale consisting of 11 items and two subdimensions. The items are presented in a mixed order and measure belief in the natural process of childbirth (DSI) and belief in the medical process of childbirth (MSI). The scale includes 5 items measuring belief in the natural process of childbirth and 6 items measuring belief in the medical process of childbirth. The minimum score that can be obtained for belief in the medical process is 6, while the maximum score is 30; for belief in the natural process, the minimum score is 5 and the maximum score is 25. The arithmetic mean is calculated by dividing the total score of the items belonging to each subdimension by the number of items in that subdimension. The subdimension with the higher numerical value resulting from the arithmetic mean represents the woman's childbirth belief. The arithmetic mean of each subdimension on the scale is evaluated within itself, and there are no items requiring reverse coding

Sex: Female, ages: 19 Years to 35 Years

Inclusion Criteria:

* Being in the first pregnancy,
* Agreeing to participate in the study on the specified dates and volunteering,
* Maternal age >18,
* Maternal age ≤ 35,
* Understanding and speaking Turkish,
* >37 weeks of gestation,
* ≤42 weeks of gestation,
* Cephalic presentation and singleton pregnancy,
* Cervical dilation of 5 cm or more,
* No visual impairment, hearing impairment, or communication problems,
* Being Muslim

Exclusion Criteria:

* Pregnant woman admitted to the Delivery Unit with 10 cm dilation,
* Pregnant woman who has received epidural anesthesia,
* Having a psychiatric disorder