Non-pharmacological methods for pain relief during labor: Experience report and an integrative review

Authors

DOI:

https://doi.org/10.33448/rsd-v10i7.16446

Keywords:

Labor; Labor pain; Physical therapy specialty; Revision.

Abstract

Introduction: Pain during labor can be modulated by non-pharmacological agents, however, its mechanisms are not fully elucidated. The purposes of this study were to identify scientifical productions in the literature regarding non-pharmacological methods for pain relief during labor in association with an experience report. Methods: It is an integrative review conducted through access to VHL, Embase and MEDLINE databases using the keywords, respectively, from DECS, Emtree e MESH in 2021 february. Full articles in English, Portuguese or Spanish from original researches were included in the time cut from 2015 to 2020, and which presented non-pharmacological methods for pain relief during labor. In addition, this work aimed to describe an undergraduate experience in the Physical Therapy course in a public maternity of a city in the countryside of Rio Grande do Sul (Brazil). Results: Twenty articles highlighting the issue were found which applied massage, walking, vertical positions, breathing exercise technique, pelvic exercise, musicotherapy, birth ball, warm aspersion or immersion, kinesio taping and tanscutaneous electrical stimulation (TENS). Extension program involved 13 parturients who were assisted by, in an isolated and combined manner, with therapeutic methods; in addition, we encouraged freedom of movement and vocalization. Conclusion: These methods bring to the conclusion that may be comfort measures in the assistance according to the integrative review. Further studies are required in order to qualify and strengthen physiotherapeutic approach in labor.

Author Biographies

Caroline Tibola, Universidade Federal do Pampa

Graduada em Fisioterapia pela Universidade Federal do Pampa (UNIPAMPA) – Campus Uruguaiana-RS

Grupo de Estudos e Pesquisa em Fisioterapia e Saúde Pélvica (GEPEFISP) – UNIPAMPA

Mariana Maydana Rivero, Universidade Federal do Pampa

Graduanda em Fisioterapia pela Universidade Federal do Pampa (UNIPAMPA) – Campus Uruguaiana-RS

Grupo de Estudos e Pesquisa em Fisioterapia e Saúde Pélvica (GEPEFISP) – UNIPAMPA

Amanda Fernandes Pacheco, Universidade Federal do Pampa

Graduada em Fisioterapia pela Universidade Federal do Pampa (UNIPAMPA) – Campus Uruguaiana-RS

Grupo de Estudos e Pesquisa em Fisioterapia e Saúde Pélvica (GEPEFISP) – UNIPAMPA

Inaê de Oliveira Marcelo, Universidade Federal do Pampa

Graduada em Fisioterapia pela Universidade Federal do Pampa (UNIPAMPA) – Campus Uruguaiana-RS

Grupo de Pesquisa em Neuromecânica Aplicada (GNAP) – UNIPAMPA

Sara Lima Pereira Correa, Universidade Federal do Pampa

Graduada em Fisioterapia pela Universidade Federal do Pampa (UNIPAMPA) – Campus Uruguaiana-RS

Grupo de Estudos e Pesquisa em Fisioterapia e Saúde Pélvica (GEPEFISP) – UNIPAMPA

Juliana Möbs Canova, Universidade Federal do Pampa

Graduada em Fisioterapia pela Universidade Federal do Pampa (UNIPAMPA) – Campus Uruguaiana-RS

Grupo de Estudos e Pesquisa em Fisioterapia e Saúde Pélvica (GEPEFISP) – UNIPAMPA

Ruthy Cristina Silva Morais, Universidade Federal do Pampa

Graduada em Fisioterapia pela Universidade Federal do Pampa (UNIPAMPA) – Campus Uruguaiana-RS

Grupo de Estudos e Pesquisa em Fisioterapia e Saúde Pélvica (GEPEFISP) – UNIPAMPA

Pietra de Vargas Minuzzi, Universidade Federal do Pampa

Graduada em Fisioterapia pela Universidade Federal do Pampa (UNIPAMPA) – Campus Uruguaiana-RS

Grupo de Estudos e Pesquisa em Fisioterapia e Saúde Pélvica (GEPEFISP) – UNIPAMPA

Fabiana Vargas-Ferreira, Universidade Federal de Minas Gerais

Doutora em Epidemiologia pela Universidade Federal de Pelotas (UFPEL).

Professora da Faculdade de Odontologia, Departamento de Odontologia Social e Preventiva e da Pós-Graduação da Universidade Federal de Minas Gerais (UFMG)

Grupo de Estudos e Pesquisa em Fisioterapia e Saúde Pélvica (GEPEFISP) – UNIPAMPA

Fernanda Vargas Ferreira, Universidade Federal do Pampa

Doutora e Pós-Doutora em Ciências da Saúde: Ginecologia e Obstetrícia pela Universidade Federal do Rio Grande do Sul (UFRGS)

Professora Adjunta do Curso de Fisioterapia na Universidade Federal do Pampa (UNIPAMPA) – Campus Uruguaiana-RS

Líder do Grupo de Estudos e Pesquisa em Fisioterapia e Saúde Pélvica (GEPEFISP) – UNIPAMPA

References

Abedi, P; Rastegar, H;Valiani, M; Saadati, N. (2017). The Effect of Auriculotherapy on Labor Pain, Length of Active Phase and Episiotomy Rate Among Reproductive Aged Women. J Family Reprod Health. Dec;11(4):185-190. PMC6168759.

Alimoradi, Z; Kazemi, F; Gorji, M; Valiani, M. Effects of ear and body acupressure on labor pain and duration of labor active phase: A randomized controlled trial. (2020). Complement Ther Med. Jun; 51:102413. https://doi: 10.1016/j.ctim.2020.102413.

Angelo, P. H. M et al. Recursos não farmacológicos: atuação da fisioterapia no trabalho de parto, uma revisão sistemática. (2016). Fisioterapia Brasil;17(3):285-292. https://doi.org/10.33233/fb.v17i3.489.

Araújo, A. E., Delgado, A., Boaviagem, A., Lemos, A. (2018). Prescription of breathing orientations given by the healthcare team during labor: A cross-sectional study. Mundo Da Saude, 42(3), 628–641. https://doi.org/10.15343/0104-7809.20184203628641.

Baldisserotto, M. L., Theme Filha, M. M., Da Gama, S. G. N. (2016). Good practices according to WHO’s recommendation for normal labor and birth and women’s assessment of the care received: The “birth in Brazil” national research study, 2011/2012. Reproductive Health, 13(Suppl 3). https://doi.org/10.1186/s12978-016-0233-x.

Bavaresco, G. Z., de Souza, R. S. O., Almeica, B., Sabatino, J. H., Dias, M. (2011). O fisioterapeuta como profissional de suporte à parturiente. Ciencia e Saude Coletiva, 16(7), 3259–3266. https://doi.org/10.1590/S1413-81232011000800025.

Boaviagem, A et al. (2017). The effectiveness of breathing patterns to control maternal anxiety during the first period of labor: A randomized controlled clinical trial. Complement Ther Clin Pract. 2017 Feb; 26:30-35. https://doi: 10.1016/j.ctcp.2016.11.004.

Borges, C. (2017). Labor Pain: Perception of the Parturient and Midwife Evaluation. American Journal of Nursing Science, 6(2), 80. https://doi.org/10.11648/j.ajns.20170602.12 ISSN 1980-5756.

Botelho, L. L. R; Cunha, C.C. A.; Macedo, M. (2011). O método da revisão integrativa nos estudos organizacionais. Gestão e Sociedade· Belo Horizonte, v.5, n. 11, p. 121-136.

Brasil. Ministério da Saúde. Política nacional de práticas integrativas e complementares no SUS - PNPIC-SUS: atitude de ampliação de acesso. Brasília: Ministério da Saúde, 2006. (Série B. Textos Básicos de Saúde).

Campanelli, S., Lopes Tort, A., Lobão-Soares, B. (2020). Pranayamas and their neurophysiological effects. International Journal of Yoga, 13(3), 183. https://doi.org/10.4103/ijoy.ijoy_91_19.

Carvalho, V. F., Kerber, N. P. da C., de Azambuja, E. P., Bueno, F. F., da Silveira, R. S., de Barros, A. M. (2014). Rights of parturients: Adolescents’ knowledge and that of their companion. Saude e Sociedade, 23(2), 572–581. https://doi.org/10.1590/S0104-12902014000200017.

Cavalcanti, A.C.V, Henrique, A. J, Brasil, C. M, Gabrielloni, M. C, Barbieri, M. Terapias complementares no trabalho de parto: ensaio clínico randomizado. Rev Gaúcha Enferm. 2019;40:e20190026. 80. https://doi.org/10.1590/1983-1447.2019.20190026.

Czech, I; Fuchs, P; Lorek, M; Tobolska-Lorek, D; Drosdzol-Cop, A; Sikora, J. Pharmacological and Non-Pharmacological Methods of Labour Pain Relief—Establishment of Effectiveness and Comparison. (2018). Int J Environ Res Public Health. Dec 9;15(12):2792. https://doi.org/ 10.3390/ijerph15122792.

Desseauve, D., Fradet, L., Lacouture, P., Pierre, F. (2017). Position for labor and birth: State of knowledge and biomechanical perspectives. In European Journal of Obstetrics and Gynecology and Reproductive Biology (Vol. 208, pp. 46–54). Elsevier Ireland Ltd. https://doi.org/10.1016/j.ejogrb.2016.11.006.

El-Refaye, G., El Nahas, E., Ghareeb, H. (2016). Effect of kinesio taping therapy combined with breathing exercises on childbirth duration and labor pain: a randomized controlled trial. Bulletin of Faculty of Physical Therapy, 21(1), 23. https://doi.org/10.4103/1110-6611.188026.

Benfield, R.D; Hortobágyi, T; Tanner, C. J; Swanson, M; Heitkemper, M.M; Newton, E. R. (2010). The Effects of Hydrotherapy on Anxiety, Pain, Neuroendocrine Responses, and Contraction Dynamics During Labor. Bone, 23(1), 1–7. https://doi.org/10.1177/1099800410361535.

Dehcheshmeh, F. S; Rafiei, H. Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage. Complement Ther Clin Pract Nov;21(4):229-32. https://doi.org/ 10.1016/j.ctcp.2015.09.002.

Félix, H. C. R., Corrêa, C. C., Matias, T. G. da C., Parreira, B. D. M., Paschoini, M. C., Ruiz, M. T. (2019). The signs of alert and labor: Knowledge among pregnant women. Revista Brasileira de Saude Materno Infantil, 19(2), 335–341. https://doi.org/10.1590/1806-93042019000200005.

Ferroli-fabricio, A. M., Mascarenhas, L. R. (n.d.). Por mais Fisioterapeutas nas Maternidades.

Silva Gallo R.B., Santana L.S., Jorge Ferreira C.H., Marcolin A.C., PoliNeto O.B., Duarte G., Quintana S.M. (2013). Massage reduced severity of pain during labour: A randomised trial. Journal of Physiotherapy. 59:2 (109-116). https://doi.org/ 10.1016/S1836-9553(13)70163-2.

Gallo, R. B. S., Santana, L. S., Marcolin, A. C., Quintana, S. M. (2014). Swiss ball to relieve pain of primiparous in active labor. Revista Dor, 15(4), 253–255. https://doi.org/10.5935/1806-0013.20140054.

Gallo, R., Santana, L., Marcolin, A., G. D. J. (2018). Sequential application of non-pharmacological interventions reduces the severity of labour pain, delays use of pharmacological analgesia, and improves some obstetric outcomes: a randomised trial. J Physiother. Jan;64(1):33-40. https://doi.org/ 10.1016/j.jphys.2017.11.014.

Gokyildiz Surucu, S., Ozturk, M., Avcibay Vurgec, B., Alan, S., Akbas, M. (2018). The effect of music on pain and anxiety of women during labour on first time pregnancy: A study from Turkey. Complementary Therapies in Clinical Practice, 30, 96–102. https://doi.org/10.1016/j.ctcp.2017.12.015.

Gönenç, İ. M., Dikmen, H. A. (2020). Effects of Dance and Music on Pain and Fear During Childbirth. JOGNN - Journal of Obstetric, Gynecologic, and Neonatal Nursing, 49(2), 144–153. https://doi.org/10.1016/j.jogn.2019.12.005.

Gönenç, I. M., Terzioǧlu, F. (2020). Effects of massage and acupressure on relieving labor pain, reducing labor time, and increasing delivery satisfaction. Journal of Nursing Research, 28(1), 1–9. https://doi.org/10.1097/jnr.0000000000000344.

Henrique, A. J., Gabrielloni, M. C., Rodney, P., Barbieri, M. (2018). Non-pharmacological interventions during childbirth for pain relief, anxiety, and neuroendocrine stress parameters: A randomized controlled trial. International Journal of Nursing Practice, 24(3), 1–8. https://doi.org/10.1111/ijn.12642.

Kiapour, A., Joukar, A., Elgafy, H., Erbulut, D. U., Agarwal, A. K., & Goel, V. K. (2020). Biomechanics of the sacroiliac joint: Anatomy, function, biomechanics, sexual dimorphism, and causes of pain. International Journal of Spine Surgery, 14, S3–S13. https://doi.org/10.14444/6077.

Lemos, A., Dean, E., & de Andrade, A. D. (2011). The Valsalva maneuver duration during labor expulsive stage: Repercussions on the maternal and neonatal birth condition. Revista Brasileira de Fisioterapia, 15(1), 66–72. https://doi.org/10.1590/S1413-35552011000100012.

Lunde, S. J., Vuust, P., Garza-Villarreal, E. A., & Vase, L. (2019). Music-induced analgesia: How does music relieve pain? Pain, 160(5), 989–993. https://doi.org/10.1097/j.pain.0000000000001452.

Makvandi, S; Mirzaiinajmabadi, K; Tehranian, N; Esmily, H; Mirteimoori, M. The Effect of Normal Physiologic Childbirth on Labor Pain Relief: an Interventional Study in Mother-Friendly Hospitals. (2018). Maedica (Bucur). Dec; 13(4): 286–293. https://doi: 10.26574/maedica.2018.13.4.286

Olza, I., Leahy-Warren, P., Benyamini, Y., Kazmierczak, M., Karlsdottir, S. I., Spyridou, A., Crespo-Mirasol, E., Takács, L., Hall, P. J., Murphy, M., Jonsdottir, S. S., Downe, S., & Nieuwenhuijze, M. J. (2018). Women’s psychological experiences of physiological childbirth: A meta-synthesis. BMJ Open, 8(10), 1–11. https://doi.org/10.1136/bmjopen-2017-020347.

Pawale, M. P; Salunkhe, J.A. Effectiveness of back massage on pain relief during first stage oflabor in primi mothers admitted at a Tertiary care center. (2020). J Family Med Prim Care. 9(12): 5933–5938. https://doi.org/ 10.4103/jfmpc.jfmpc_1189_20: 10.4103/jfmpc.jfmpc_1189_20.

Priddis, H., Dahlen, H., Schmied, V. (2012). What are the facilitators, inhibitors, and implications of birth positioning? A review of the literature. Women and Birth, 25(3), 100–106. https://doi.org/10.1016/j.wombi.2011.05.001.

Regaya, L. Ben, Fatnassi, R., Khlifi, A., Fékih, M., Kebaili, S., Soltan, K., Khairi, H., Hidar, S. (2010). Intérêt de la déambulation au cours du travail obstétrical: étude prospective randomisée de 200 cas. Journal de Gynecologie Obstetrique et Biologie de La Reproduction, 39(8), 656–662. https://doi.org/10.1016/j.jgyn.2010.06.007.

Santana, L. C.; Gallo, R. B. S; Ferreira, C. H. J.; Duarte, G., Quintana, S. M.Q; Marcolin, A.C. Transcutaneous electrical nerve stimulation (TENS) reduces pain and postpones the need for pharmacological analgesia during labour: a randomised trial. (2016). J Physiother Jan;62(1):29-34. https://doi.org/ 10.1016/j.jphys.2015.11.002.

Silva, Gallo, R. B., Santana, L. S., Jorge Ferreira, C. H., Marcolin, A. C., PoliNeto, O. B., Duarte, G., Quintana, S. M. (2013). Massage reduced severity of pain during labour: A randomised trial. In Journal of Physiotherapy (Vol. 59, Issue 2, pp. 109–116). https://doi.org/10.1016/S1836-9553(13)70163-2.

Shahoei, R; Shahghebi, S; Rezaei, M; Naqshbandi, S. (2017). The effect of transcutaneous electrical nerve stimulation on the severity of labor pain among nulliparous women: A clinical trial. Complement Ther Clin Pract.Aug;28:176-180. https://doi: 10.1016/j.ctcp.2017.05.004.

Smith, C. A., Levett, K. M., Collins, C. T., Dahlen, H. G., Ee, C. C., Suganuma, M. (2018). Massage, reflexology and other manual methods for pain management in labour. In Cochrane Database of Systematic Reviews (Vol. 2018, Issue 3). John Wiley and Sons Ltd. https://doi.org/10.1002/14651858.CD009290.pub3.

Surucu, S.G; Ozturk, M; Vurgec, B.A, Alan, S, Akbas, M. The effect of music on pain and anxiety of women in labor during their first pregnancy: A study from Turkey. (2018). Complementary Therapies in Clinical Practice (2018), doi: 10.1016/j.ctcp.2017.12.015.

Taavoni, S, Sheikhan, F, Abdolahian, S, Ghavi, F. Birth ball or heat therapy? A randomized controlled trial to compare the effectiveness of birth ball usage with sacrum-perineal heat therapy in labor pain management. (2016). Complementary Therapies in Clinical Practice 24 99e102. https://doi.org/ 10.1016/j.ctcp.2016.04.001.

Thomson, G., Feeley, C., Moran, V. H., Downe, S., Oladapo, O. T. (2019). Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: A qualitative systematic review. Reproductive Health, 16(1). https://doi.org/10.1186/s12978-019-0735-4.

Vakilian, K., Keramat, A. (2013). The Effect of the Breathing Technique With and Without Aromatherapy on the Length of the Active Phase and Second Stage of Labor. In Nursing and Midwifery Studies (Vol. 1, Issue 3, pp. 115–119). https://doi.org/10.5812/nms.9886.

WHO. (2018). WHO recommendations: Intrapartum care for a positive childbirth experience. Transforming care of women and babies for improved health and well-being Executive summary. WHO Recommendations: Intrapartum Care for a Positive Childbirth Experience., 1–8. https://apps.who.int/iris/bitstream/handle/10665/272447/WHO-RHR-18.12-eng.pdf.

Yazdkhasti, M; Pirak, A. (2016) The effect of aromatherapy with lavender essence on severity of labor pain and duration of labor in primiparous women. Complement Ther Clin Pract. Nov; 25:81-86. https://doi.org/ 10.1016/j.ctcp.2016.08.008.

Yazdkhasti, M; Hanjani, SM; TourzanI, ZM. (2018). The Effect of Localized Heat and Cold Therapy on Pain Intensity, Duration of Phases of Labor, and Birth Outcomes Among Primiparous Females: A Randomized, Controlled Trial. Shiraz E-Med J.; 19(8):e65501.

Zaky, HN. (2016). Effect of pelvic rocking exercise using sitting position on birth ball during the first stage of labor on its progress. IOSR Journal of Nursing and Health Science, 05(04), 19–27. https://doi.org/10.9790/1959-0504031927.

Published

03/07/2021

How to Cite

TIBOLA, C. .; RIVERO, M. M.; PACHECO, A. F. .; MARCELO, I. de O. .; CORREA, S. L. P.; CANOVA, J. M. .; MORAIS, R. C. S. .; MINUZZI, P. de V. .; VARGAS-FERREIRA, F. .; FERREIRA, F. V. . Non-pharmacological methods for pain relief during labor: Experience report and an integrative review . Research, Society and Development, [S. l.], v. 10, n. 7, p. e18310716446, 2021. DOI: 10.33448/rsd-v10i7.16446. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/16446. Acesso em: 25 apr. 2024.

Issue

Section

Health Sciences