The Effect of Emotional Freedom Technique (EFT) Applied to Pregnant Women Before Cesarean Delivery on Surgical Fear and Intra-operative Vital Signs

Surgical interventions are often performed to secure people's lives. Although these applications are routine procedures for health professionals, exposure to a medical or surgical intervention in the operating room environment is a stress factor as it is unusual for most patients . Studies show that patients waiting for surgical intervention experience intense fear, anxiety, and anxiety in the preoperative period and that this is a situation that is often ignored .

Studies indicate that younger patients have higher anxiety levels than older patients and female patients have higher anxiety levels than male patients. Again, the results of some studies examining the factors causing anxiety and fear suggest that obstetric surgeries may cause more anxiety in individuals than some other surgeries .

Cesarean section (C/S) delivery represents one of the most common surgical interventions, which has increased significantly in many parts of the world in recent years .Cesarean section (C/S) rates are increasing worldwide, making C/S the most common intraperitoneal surgical intervention . According to Turkish population and health survey 2018 data, the cesarean section rate in our country is 52%, which is unfortunately much higher than the cesarean section rate recommended by WHO (World Health Organization). Again, one in three women in the United States gives birth by cesarean section, making C/S one of the most common surgical procedures in the country. The fact that caesarean section rates have increased so much in all countries of the world, developed and developing alike, should support efforts to reduce this method of delivery and promote normal delivery methods, but should also aim to minimize the side effects of this surgical procedure and the accompanying anesthesia and focus equally on postoperative maternal and fetal health outcomes.

The anxiety and fear experienced by pregnant women before these surgical interventions, the frequency of which has increased considerably in all countries of the world, are often ignored for various reasons, as in other surgeries. However, in addition to the fear and anxiety caused by surgical intervention in pregnant women before this intervention, the problems that may occur in the baby to be born are an additional cause of fear and anxiety. The results of the studies suggest that preoperative emotional states and fears of the patients should be determined and appropriate interventions should be made, since the preoperative emotional states and fears of the patients will affect compliance with the surgical process.

In C/S operations, spinal anesthesia technique is preferred in the first place due to its ease of application.Although spinal anesthesia provides significant benefits compared to general anesthesia, it often leads to hypotension with an incidence of up to 60% to 70% due to sympathetic nervous system blockade . Hypotension after spinal anesthesia is a common complication that can have adverse effects on the well-being of both the laboring woman and the fetus . Prolonged hypotension leads to cardiovascular problems and additional organ damage. At the same time, decreased placental blood flow in utero leads to fetal hypoxia, acidosis, and thus affected fetal health and lower Apgar scores. Since intraoperative hypotension is associated with increased patient morbidity, it is very important to maintain hemodynamics in cesarean section operations, especially in the perinatal period before fetal delivery.