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Type: Journal article
Title: Complementary and alternative therapies for pain management in labour
Author: Smith, C.
Collins, C.
Cyna, A.
Crowther, C.
Citation: Cochrane Database of Systematic Reviews, 2003; 2003(2):D003521-1-D003521-20
Publisher: John Wiley & Sons
Issue Date: 2003
ISSN: 1469-493X
Editor: Smith, C.
Statement of
CA Smith, CT Collins, AM Cyna, CA Crowther
Abstract: <h4>Background</h4>Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of alternative and complementary therapies for pain management in labour.<h4>Objectives</h4>To examine the effectiveness of complementary and alternative therapies for pain management in labour on maternal and perinatal morbidity.<h4>Search strategy</h4>We searched the Cochrane Pregnancy and Childbirth Group trials register (July 2002), the Cochrane Controlled Trials Register (The Cochrane Library Issue 2, 2002), MEDLINE (1966 to July 2002), EMBASE (1980 to July 2002) and CINAHL (1980 to July 2002).<h4>Selection criteria</h4>The inclusion criteria included published and unpublished randomised controlled trials comparing complementary and alternative therapies with placebo, no treatment or pharmacological forms of pain management in labour. All women whether primiparous or multiparous, and in spontaneous or induced labour, in the first and second stage of labour were included.<h4>Data collection and analysis</h4>Meta-analysis was performed using relative risks for dichotomous outcomes and weighted mean differences for continuous outcomes. The outcome measures were maternal satisfaction, use of pharmacological pain relief and maternal and neonatal adverse outcomes.<h4>Main results</h4>Seven trials involving 366 women and using different modalities of pain management were included in this review. The trials included one involving acupuncture (n = 100), one involving audio-analgesia (n = 25), one involving aromatherapy (n = 22), three trials of hypnosis (n = 189) and one trial of music (n = 30). The trial of acupuncture decreased the need for pain relief (relative risk (RR) 0.56, 95% confidence interval (CI) 0.39 to 0.81). Women receiving hypnosis were more satisfied with their pain management in labour compared with controls (RR 2.33, 95% CI 1.55 to 4.71). No differences were seen for women receiving aromatherapy, music or audio analgesia.<h4>Reviewer's conclusions</h4>Acupuncture and hypnosis may be beneficial for the management of pain during labour. However, few complementary therapies have been subjected to proper scientific study and the number of women studied is small.
Keywords: Humans
Complementary Therapies
Acupuncture Analgesia
Music Therapy
Analgesia, Obstetrical
Obstetric Labor Complications
Pain Management
Rights: © 2006 The Cochrane Collaboration
DOI: 10.1002/14651858.CD003521
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Appears in Collections:Aurora harvest
Obstetrics and Gynaecology publications

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