The value of CAM for pain relief during labor

Professor Michel Tournaire and Dr. Anne Theau-Yonneau have reviewed the literature.

Few publications report a statistically significant reduction in labor pain? Here’s what we know about pain relief and other outcomes. I’ll summarize the more familiar options.

Acupressure

• In one study, total labor time was significantly shorter in the SP6 acupressure group vs the control group.

Acupuncture

• Beneficial effects are uncertain.
• Set-up time is prolonged.
• Need more studies.

Aromatherapy

• Massage around the lower back with jasmine, juniper, geranium, clary sage, rose and lavender have been reported to provide subjective benefit in labor.

Biofeedback

• Contradictory results.
• Its value requires strong support from caregivers.

Herbal therapy

• Labor pain can be treated with motherwort.
• In one study, raspberry leaf taken from 32 weeks of gestation until labor did not shorten the first stage of labor (cervical dilatation) but did the second (descent of the baby), and also lowered the rate of forceps deliveries.

Homeopathy

• No differences between homeopathy and control groups in a study of 40 women.

Hypnosis

• Few studies.
• Seems to reduce fear, tension, and pain during labor and raise the pain threshold.
• Reduces the need for chemical analgesia.
• Patients have a greater sense of control over painful contractions.
• Considered helpful during labor and delivery.

Massage

• Two studies reported opposite results.

Mind-body interventions

• There are many of them.
• “Appears to be applicable to the acute situation of delivery.”

Sterile water blocks

• May be an alternative for women who want to avoid epidural analgesia.

Transcutaneous electrical nerve stimulation

• No effect of TENS on pain, and no difference in use of other pain treatments.

Therapeutic touch

• Some evidence that anxiety and pain are reduced.

Yoga

• Professionals who use this technique for delivery claim yoga shortens labor, decreases pain, and reduces the need for pain medicine.
• No scientific confirmation of these assertions.

Music therapy

• Contradictory study results.

The bottom line?
Applying regional anesthesia (aka epidural) is the most efficient way to reduce labor pain — with 85% to 95% of women reporting complete relief of pain during the 2 phases of delivery: cervical dilatation and descent of the baby. Failure of this approach is rare and usually due to technical problems, as when the epidural space cannot be reached with the catheter.

“Those seeking alternatives are not necessarily dissatisfied with conventional medicine, but attempt to supplement rather than replace traditional care,” say the authors.

2/1/08 19:14 JR