Effectiveness of birth ball exercise and structured antenatal counseling on labor pain, anxiety, and maternal satisfaction among primigravida women: A quasi-experimental study

Abdominal surgery can temporarily impair respiratory mechanics, intensify pain with movement, and reduce physical activity at a time when patients need to regain independent function. Atelectasis, secretion retention, pneumonia, respiratory failure, venous thromboembolism, loss of muscle strength, and delayed discharge are among the clinically important concerns associated with the postoperative period. Nurse-led deep breathing and early mobilisation are practical, low-cost components of contemporary recovery pathways because nurses are continuously involved in assessment, education, symptom relief, coaching, and reassessment. This review examines the effectiveness of these interventions for postoperative recovery, pain-related activity limitation, and prevention of respiratory complications among adults undergoing abdominal surgery. A focused narrative review was developed from key systematic reviews, randomised trials, perioperative guidelines, and clinical practice recommendations available through October 2026. Evidence was considered in relation to physiological rationale, intervention design, implementation, patient safety, and relevant clinical outcomes. A recent systematic review and meta-analysis reported that breathing exercises were associated with fewer postoperative pulmonary complications across the included trials, while early mobilisation also showed a potentially beneficial effect; however, the certainty of some estimates, intervention heterogeneity, and the contribution of multicomponent care require careful interpretation. Earlier reviews found inconsistent or low-certainty evidence for individual respiratory devices and techniques, illustrating why no single exercise should be treated as a universal substitute for comprehensive care. The most defensible clinical approach is a tailored bundle combining preoperative explanation when feasible, upright positioning, supported slow deep breaths, effective cough when indicated, timely multimodal analgesia, graded mobilisation, and regular review of physiological tolerance. Nurses should document participation and patient response, identify barriers early, and escalate new respiratory symptoms, haemodynamic instability, or unexpected functional decline. The available evidence supports integrating these interventions into enhanced recovery pathways, while recognising that the magnitude of benefit for pain scores, length of stay, and complications varies according to patient risk, surgical procedure, protocol adherence, and co-interventions. Further pragmatic trials should define optimal dose, timing, fidelity, and patient-centred outcome measures for nurse-led combined protocols.