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Nurse-Led Early Ambulation After Caesarean Birth: A Cluster Randomized Controlled Trial of Recovery and Well-being
Abin Varghese1, Shuchita Mundle, Manmohan Singh
1Author Affiliations: College of Nursing, AIIMS Nagpur, Maharashtra, India (Dr Varghese, Mr Singh, Mrs George, Ms Kapoor, Ms Languichungliu, Ms Sulaiman, Ms Swami, and Ms Poonia); and Department of Obstetrics and Gynaecology, AIIMS Nagpur, Maharashtra, India (Dr Mundle).
Purpose:
To evaluate the effectiveness of a structured, nurse-led early ambulation program on postoperative pain, uterine involution, gastrointestinal recovery, and psychological outcomes among women after cesarean delivery.
Methods:
A cluster-randomized controlled trial was conducted in a tertiary hospital in India among post-cesarean women assigned to either a structured early ambulation program or routine care by study week (10 clusters, 1:1 ratio). The intervention began 8-10 hours after surgery and continued for 4 days under nurse supervision. Primary outcome was pain intensity; secondary outcomes included uterine involution, constipation, psychological well-being, anxiety, obstetric recovery, and global health, assessed on postoperative days 1 and 4.
Results:
Sixty women were equally allocated. The intervention group showed greater pain reduction, faster uterine involution, fewer gastrointestinal symptoms, improved psychological well-being, and better perceived global health. Obstetric recovery scores were higher, and early ambulation independently predicted lower pain on day 4.
Conclusions:
A structured, nurse-delivered early ambulation program initiated within 10 hours post-cesarean reduced pain and promoted early recovery.
Implications For Practice And Research:
Early ambulation is a feasible, low-cost strategy that can be integrated into routine post-cesarean care.
Precis:
Early nurse-led ambulation improves physical and psychological recovery after cesarean birth.
