The effects of video lecture on expulsive efforts of women receiving epidural analgesia for labor and delivery

INTERVENTION: [first step study][second step study] We hand the questionnaire to midwives.Within 24 hours after delivery, midwives assess the parturients' pushing and attitude to pushing subjectively. [second step study] 1. We measure the diameter of internal juglar vein with ultrasound at just before pushing and during pushing. 2. We measure the circumference of the abdomen at the height of umbilicus at just before pushing and during pushing. 3. We measure R‐R interval of electrocardiograph at just before pushing and during pushing. 4. We measure the lowest heart rate at just before pushing and during pushing. [second step study] We assess the effects of the educational video which we make for the purpose of demonstrating expulsive effort such as posture, breathing, and following the midwives' lead on the parturients' pushing and attitude to pushing and parturient progress. We divide parturients planninng epidural analgesia for labor and delivery and receiving the childbirth class in our hospital into the following two groups.Parturients of group A watch the educational video in addition to ordinary explanation about epidural analgesia. Parturients of group B watch non‐educational video in addition to ordinary explanation about epidural analgesia. Moreover, we emphasize the importance of effective expulsive efforts to the parturients of group A. CONDITION: Pregnant women requesting labor pain epidural PRIMARY OUTCOME: Expulsive efforts assessed by midwives on the day of delivery INCLUSION CRITERIA: [first step study] 1. parturients planninng the vaginal delivery in our hospital 2. age>20 3. parturients written informed consent [second step study] 1. parturients planninng epidural analgesia for labor and delivery and receiving the childbirth class in our hospital 2. age>20 3. parturients written informed consent