Non-pharmacological techniques to reduce pain and anxiety among parturients undergoing vaginal delivery: a systematic review
DOI:
https://doi.org/10.33448/rsd-v11i5.27921Keywords:
Anxiety; Natural childbirth; Complementary therapies.Abstract
Objective: To analyze the main non-pharmacological techniques to reduce anxiety among parturients undergoing vaginal delivery. Methodology: This is a systematic review carried out using the PRISMA method, in the electronic databases PubMed, Scopus and Web of Science, using the following descriptors: “pregnancy”, “parturition”, “natural childbirth”, “anxiety”, “therapeutics” and “complementary therapies”. Full articles, available in Portuguese, English or Spanish, published between January 2016 and December 2021 and providing a detailed description of interventions to reduce anxiety in women undergoing vaginal delivery were included. Results: 11 articles made up the final sample of this study, with the highest frequency of publication in 2016 (n: 04) and greater production from Iran (n: 04) and Brazil (n: 03). All studies used the methodology of a randomized controlled clinical trial, characterizing the studies as presenting a strong level of evidence (II). The most used non-pharmacological techniques to reduce anxiety were: aromatherapy (n: 04), hydrotherapy with hot shower and perineal exercises with a ball (n: 02), music therapy (n: 02), breathing techniques (n: 02) and massage (n: 01). The periods of these interventions ranged from 10 minutes to 2 hours, most often lasting 30 minutes. Conclusion: Six non-pharmacological techniques were found to reduce anxiety in parturients undergoing vaginal delivery, with different effect sizes, especially aromatherapy and music therapy.
References
Adib-Hajbaghery, M., Abasi, A. & Rajabi-Beheshtabad, R. (2014). Whole body massage for reducing anxiety and stabilizing vital signs of patients in cardiac care unit. Med J Islam Repub Iran. 28, 47.
Alder, J., Urech, C., Fink, N., Bitzer, J. & Hoesli, I. (2011). Response to induced relaxation during pregnancy: comparison of women with high versus low levels of anxiety. J. Clin. Psychol. Med. Settings. 18, 13-21.
Almeida., C. F. S., Graepp-Fontoura, I., Tavares, H. S. A., Lima, L. N. F., Santos, F. S., Neto, M. S., et al. (2021). Métodos alternativos para alívio da dor no parto normal: revisão sistemática. Research, Society and Development. 10(1), e45910111725.
Amanak, K. (2020). The effect of the sound of the ney (reed flute) on women in labour in Bursa, Turkey. J Pak Med Assoc. 70(11), 1934-1937.
Anarado, A., Ali, E., Nwonu, E., Chinweuba, A. & Ogbolu, Y. (2015). Knowledge and willingness of prenatal women in Enugu Southeastern Nigeria to use in labour non-pharmacological pain reliefs. Afr. Health Sci. 15(2), 568-575.
Asadi, N., Maharlouei, N., Khalili, A., Darabi, Y., Davoodi, S., Shahraki, H. R. et al. (2015). Effects of LI-4 and SP-6 acupuncture on labor pain, cortisol level and duration of labor. J. Acupunct. Meridian Stud. 8(5), 249-254.
Barbieri, M., Henrique, A. J., Chors, F. M., Maia, N. D. L. & Gabrielloni, M. C. (2013). Warm shower aspersion, perineal exercises with Swiss ball and pain in labor. Acta Paulista de Enfermagem. 26(5), 478–484.
Boaviagem, A., Melo Junior, E., Lubambo, L., Sousa, P., Aragão, C., Albuquerque, et al. (2017). The effectiveness of breathing patterns to control maternal anxiety during the first period of labor: a randomized controlled clinical trial. Complementary Ther. Clin. Pract. 26, 30-35.
Bodnar, R. J. (2014). Endogenous opiates and behavior: 2013. Peptides. 62, 67–136.
Brasil. Ministério da Saúde (MS). (1998). Lei no 9.610, de 19 de fevereiro de 1998, que altera, atualiza e consolida a legislação sobre direitos autorais e dá outras providências. Diário Oficial da União. Brasília: Ministério da Saúde. Recuperado de http://www.planalto.gov.br/ccivil_03/leis/l9610.htm
Chang, M. Y., Chen, C. H. & Huang, K. F. (2008). Effects of music therapy on psychological health of women during pregnancy. J. Clin. Nurs. 17(19), 2580-2587.
Cicek, S. & Basar, F. (2017). The effects of breathing techniques training on the duration of labor and anxiety levels of pregnant women. Complement Ther Clin Pract. 29, 213-219.
Ciobanu, D., Deac, A. & Lozinca, I. (2010). Comparative study regarding the ınfluence of pain management on labor deployment. Ovidius Univ. Ann. Ser. Phys. Educ. Sport/Scı. Mov. Health, 2, 883-892.
Cluett, E. R., Burns, E. & Cuthbert, A. (2018). Immersion in water in labour and birth. Cochrane Database of Systematic Reviews.
Dengsangluri & Salunkhe, J. A. (2015). Effect of breathing exercise in reduction of pain during first stage of labour among primigravidas. Int. J. Health Sci. Res. 5(6), 390-398.
Ersanlı, C. & Kömürcü, N. (2016). Effects of musical therapy and labor education at first pregnancy with induction. J Samsun Health Sci. 1, 18- 39.
Esmaelzadeh, S. S., Torkashvand, S., Rahimzadeh, K. M., Lotfi, R., Akbari, K. M. & Khosravi, N. (2016). Effect of aromatherapy with Boswellia Carteri on anxiety in first stage of labor in nulliparous women. Complementary Medicine Journal. 5(4), 1314–1323.
García, J., Ventura, M. I., Requena, M., Parrón, T. & Alarcón, R. (2018). Effects of prenatal music stimulation on state/trait anxiety in full-term pregnancy and its influence on childbirth: a randomized controlled trial. J. Matern.-Fetal Neonat. Med. 31(8), 1058-1065.
Hamdamian, S., Nazarpour, S., Simbar, M., Hajian, S., Mojab, F. & Talebi, A. (2018). Effects of aromatherapy with Rosa damascena on nulliparous women's pain and anxiety of labor during first stage of labor. J. Integr. Med. 16(2), 120-125.
Heidari-Fard, S., Amir Ali-Akbari, S., Rafiei, A., Mojab, F., Shakeri, N. & Simbar, M. (2017). Investigating the effect of chamomile essential oil on reducing anxiety in nulliparous women during the first stage of childbirth. Int J Biol Pharm Allied Sci. 6(5), 828-842.
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. Int. J. Nurs. Pract. 24(3), e12642.
Holm, L. & Fitzmaurice, L. (2008). Emergency department waiting room stress: can music or aromatherapy improve anxiety scores? Pediatr Emerg Care. 24(12), 836-838.
Jahdi, F., Mehrabadi, M., Mortazavi, F. & Haghani, H. (2016). The effect of slow-stroke back message on the anxiety levels of Iranian women on the first postpartum day. Iran Red Crescent Med. J. 18(8), e34270.
Karkal, E., Kharde, S. & Dhumale, H. (2017). Effectiveness of music therapy in reducing pain and anxiety among primigravid women during active phase of first stage of labour. Int J Nurs Educ. 9, 57-60.
Kaviani, M., Maghbool, S., Azima, S. & Hosein, M. (2014). Comparison of the effect of aromatherapy with Jasminum officinale and Salvia officinale on pain severity and labor outcome in nulliparous women. Iran J Nurs Midwifery Res. 19(6), 666–672.
Kheirkhah, M., Pour, N. S., Nisani, L. & Haghani, H. (2014). Comparing the effects of aromatherapy with rose oils and warm foot bath on anxiety in the first stage of labor in nulliparous women. Iran Red Crescent Med J. 16(9), 1-5.
Köksal, Ö. & Tascı Duran, E. (2013). Cultural approach for labor pain. J. Dokuz Eylül Üniv. Sch. Nurs. 6(3), 144-148.
Lamadah, S. M. & Nomani, I. (2016). The effect of aromatherapy massage using lavender oil on the level of pain and anxiety during labour among primigravida women. Am J Nurs Sci. 5(2), 37–44.
Lemos, A., Lubambo, L., Aragão, C., Sousa, P., Albuquerque, S., Melo Junior, E., et al. (2017). The effectiveness of breathing patterns to control maternal anxiety during the first period of labor: a randomized controlled clinical trial. Complem. Ther. Clin. Pract. 26, 30-35.
Meftahi, N., Bervis, S., Taghizadeh, S.H. & Ghafarinejad, F. (2014). The Effect of Lying in Prone Position on Blood Pressure and Heart Rate with and without Massage. JRSR. 1(2), 40–43.
Mete, S., Ertuğrul, M. & Uludağ, E. (2015). The childbirth education program awareness in childbirth. J Dokuz Eylül Üniv. Fac. Nurs. 8(2), 131-141.
Moher, D., Shamseer, L., Clarke, M.; Ghersi, D., Liberati, A., Petticrew, M., et al (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst. Rev. 4(1), 1-9.
Nascimento, J. W. A., Santos, R. S., Santos, T. M. R., Silva, A. L. B., Rodrigues, L. D. C., Silva, V. W., et al. (2021). Complications associated with intimate partner violence in pregnant women: a systematic review. Int. J. Dev. Res. 11(7), 48924-48928.
Nikfarjam, M., Bahmani, M. & Heidari-Soureshjani, S. (2016). Phytotherapy for anxiety in Iran: a review of the most important anti-anxiety medicinal plants. J Chem Pharm Sci. 9(3), 1235-1241.
Nilsson, C., Hessman, E., Sjöblom, H., Dencker, A., Jangsten, E., Mollberg, M., et al. (2018). Definitions, measurements and prevalence of fear of childbirth: a systematic review. BMC Pregnancy Childbirth. 18(1), 28.
Ozgoli, G., Torkashvand, S., Salehi Moghaddam, F., Borumandnia, N., Mojab, F. & Minooee, S. (2016). Comparison of peppermint and clove essential oil aroma on pain intensity and anxiety at first stage of labor. Iranian Journal of Obstetrics, Gynecology and Infertility. 19(21), 1–11.
Pati, D. & Lorusso, L. N. (2018). How to Write a Systematic Review of the Literature. HERD. 11(1), 15-30.
Räisänen, S., Lehto, S. M., Nielsen, H. S., Gissler, M., Kramer, M. R. & Heinonen, S. (2014). Risk factors for and perinatal outcomes of major depression during pregnancy: a population-based analysis during 2002-2010 in Finland. BMJ Open. 4(11), e004883.
Salehi, F., Pourasghar, M., Khalilian, A. & Shahhosseini, Z. (2016). Comparison of group cognitive behavioral therapy and interactive lectures in reducing anxiety during pregnancy: a quasi experimental trial. Medicine (Baltimore). 95(43), e5224.
Stillwell, S., Fineout-Overholt, E., Melnyk, B. M. & Wiliamson, K. M. (2010). Evidence– based practice: step by step. Am J Nurs; 110(5), 41-47.
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. Nurs. Midwifery Stud. 2(1), 115-119.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2022 José William Araújo do Nascimento; Mariana Rodrigues Buarque de Vasconcelos; Julyana da Silva de Oliveira; Jéssica Lucas de Santana; Jaqueline Maria da Silva; Joana Gabriela Farias Lourenço dos Santos; Gerson Waltrudes da Silva Neto; Igor Henrique Mendes Ribeiro de Miranda
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.