Labor Analgesia: A Systematic Review and Meta-Analysis of Non-Pharmacological Complementary and Alternative Approaches to Pain during First Stage of Labor.
Study Goal
The researchers aimed to evaluate the efficacy of non-invasive, non-pharmacological techniques, including massage, in reducing first-stage labor pain intensity.
Results Summary
The meta-analysis found significant evidence supporting the use of massage as a complementary method for labor analgesia, though its impact varied compared to other techniques.
Population
Women in the first stage of labor.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
massage | decrease | subjective pain intensity | women in first stage of labor | - | showed impact | #1 |
birth balls | decrease | subjective pain intensity | women in first stage of labor | - | showed impact | #2 |
mind-body interventions | decrease | subjective pain intensity | women in first stage of labor | - | showed impact | #3 |
heat application | decrease | subjective pain intensity | women in first stage of labor | - | showed impact | #4 |
music therapy | decrease | subjective pain intensity | women in first stage of labor | - | showed impact | #5 |
dance therapy | decrease | subjective pain intensity | women in first stage of labor | - | showed impact | #6 |
acupressure | decrease | subjective pain intensity | women in first stage of labor | - | showed impact | #7 |
transcutaneous electrical nerve stimulation (TENS) | decrease | subjective pain intensity | women in first stage of labor | - | showed impact | #8 |
non-pharmacological, non-invasive, or minimally invasive intrapartum analgesic techniques alternative and/or complementary to pharmacological analgesia | decrease | labor analgesia | women in first stage of labor | - | found significant evidence in support of the use | #9 |
the aim of the study was to conduct a meta-analysis to evaluate the efficacy of non-invasive and non-pharmacological techniques on labor first-stage pain intensity. Literature databases were searched from inception to May 2021, and research was expanded through the screening of previous systematic reviews. Inclusion criteria were: (1) population: women in first stage of labor; (2) intervention: non-pharmacological, non-invasive, or minimally invasive intrapartum analgesic techniques alternative and/or complementary to pharmacological analgesia; (3) comparison: routine intrapartum care or placebos; (4) outcomes: subjective pain intensity; and (5) study design: randomized controlled trial. Risk of bias of included studies was investigated, data analysis was performed using R version 3.5.1. Effect size was calculated as difference between the control and experimental groups at posttreatment in terms of mean pain score. A total of 63 studies were included, for a total of 6146 patients (3468 in the experimental groups and 2678 in the control groups). Techniques included were massage (n = 11), birth balls (n = 5) mind-body interventions (n = 8), heat application (n = 12), music therapy (n = 9), dance therapy (n = 2), acupressure (n = 16), and transcutaneous electrical nerve stimulation (TENS) (n = 8). The present review found significant evidence in support of the use of complementary and alternative medicine for labor analgesia, and different methods showed different impact. However, more high-quality trials are needed.