Pain management for women in labour: an overview of systematic reviews.

@article{Jones2012PainMF,
  title={Pain management for women in labour: an overview of systematic reviews.},
  author={Leanne V Jones and Mohammad Shafie Othman and Therese Dowswell and Zarko Alfirevic and Simon Gates and Mary Newburn and Susan A. Jordan and Tina Lavender and James P. Neilson},
  journal={The Cochrane database of systematic reviews},
  year={2012},
  volume={3},
  pages={
          CD009234
        }
}
BACKGROUND The pain that women experience during labour is affected by multiple physiological and psychosocial factors and its intensity can vary greatly.  Most women in labour require pain relief. Pain management strategies include non-pharmacological interventions (that aim to help women cope with pain in labour) and pharmacological interventions (that aim to relieve the pain of labour). OBJECTIVES To summarise the evidence from Cochrane systematic reviews on the efficacy and safety of non… 

Hypnosis for pain management during labour and childbirth.

In this updated review, hypnosis interventions are compared with all control groups (main comparison) and also with specific control conditions: standard care, supportive counselling, and relaxation training (two RCTs), which showed evidence of considerable statistical heterogeneity.

Hypnosis for pain management during labour and childbirth.

There was some evidence of benefits for women in the hypnosis group compared with the control group for pain intensity, length of labour and maternal hospital stay, although these findings were based on single studies with small numbers of women.

Relaxation techniques for pain management in labour.

The effects of mind-body relaxation techniques for pain management in labour on maternal and neonatal well-being during and after labour were examined and found that relaxation compared to usual care provided lowered the intensity of pain.

Relaxation techniques for pain management in labour.

Relaxation and yoga may have a role with reducing pain, increasing satisfaction with pain relief and reducing the rate of assisted vaginal delivery and there is a need for further research.

Acupuncture or acupressure for pain management in labour.

Acupuncture and acupressure may have a role with reducing pain, increasing satisfaction with pain management and reduced use of pharmacological management in labour, however, there is a need for further research.

Acupuncture or acupressure for pain management during labour.

This review examined evidence about the use of acupuncture and acupressure for pain management in labour and found that acupuncture probably has little to no effect on assisted vaginal birth or caesarean section, and probably reduces theUse of pharmacological analgesia.

Massage, reflexology and other manual methods for pain management in labour.

Massage may have a role in reducing pain, and improving women's emotional experience of labour, and there is a need for further research.

Massage, reflexology and other manual methods for pain management in labour.

Low-quality evidence that massage provided a greater reduction in pain intensity than usual care during the first stage of labour is found, and the majority of trials had a high risk of performance bias and detection bias, and an unclear risk of reporting bias.

Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review

A qualitative evidence synthesis of women’s views and experiences of pharmacological (epidural, opioid analgesia) and non-pharmacological (relaxation, massage techniques) pain relief options is undertaken to understand what affects women's decisions and choices and to inform guidelines, policy, and practice.

Aromatherapy intervention on anxiety and pain during first stage labour in nulliparous women: a systematic review and meta-analysis

A systematic review and meta-analysis of RCTs regarding aromatherapy’s effects on labour pain and anxiety relief identified more credible evidence validating that aromather therapy could significantly decrease labour pain both in early active and late active phases.
...

References

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Biofeedback for pain management during labour.

There is insufficient evidence that biofeedback is effective for the management of pain during labour, and randomised controlled trials of any form of prenatal classes which included bio feedback, in any modality, in women with low-risk pregnancies showed that this approach is unproven.

Relaxation techniques for pain management in labour.

Relaxation and yoga may have a role with reducing pain, increasing satisfaction with pain relief and reducing the rate of assisted vaginal delivery and there is a need for further research.

Acupuncture or acupressure for pain management in labour.

Acupuncture and acupressure may have a role with reducing pain, increasing satisfaction with pain management and reduced use of pharmacological management in labour, however, there is a need for further research.

Massage, reflexology and other manual methods for pain management in labour.

Massage may have a role in reducing pain, and improving women's emotional experience of labour, and there is a need for further research.

Hypnosis for pain relief in labour and childbirth: a systematic review.

The risk/benefit profile of hypnosis demonstrates a need for well-designed trials to confirm the effects of hypnotherapy in childbirth.

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Flurane derivatives were found to offer better pain relief than nitrous oxide in first stage of labour as measured by a lower pain intensity score, and this findings should be considered with caution because of the questionable design of the included cross-over trials.

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According to the data, it seems clear that the use of epidural analgesia is considered to be an effective method of pain relief during labour and childbirth from the perspective of women giving birth.

Aromatherapy for pain management in labour.

There is a lack of studies evaluating the role of aromatherapy for pain management in labour, and further research is needed before recommendations can be made for clinical practice.

Inhaled analgesia for pain management in labour.

The effects of all modalities of inhaled analgesia on the mother and the newborn for mothers who planned to have a vaginal delivery were examined and substantial heterogeneity was found in the analyses of pain intensity and in the analysis of pain relief.

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Non-opioid drugs (sedatives) were found to offer better pain relief and better satisfaction with the childbirth experience and women having non-operative drugs (NSAIDs or antihistamines) were less likely to be satisfied with pain relief compared with women having opioids.
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