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Research: SMITH and colleagues,
Listed in Issue 94
Abstract
SMITH and colleagues, Department of Obstetrics and Gynaecology, The University of Adelaide, Women's and Children's Hospital, 72 King William Road, North Adelaide, Australia, caroline.anne.smith@adelaide.edu.au, have reviewed (44 references) complementary and alternative therapies for pain management in labour.
Background
Many women would like to avoid pharmacological and invasive pain relief approaches in labour. This review examines the evidence supporting the use of complementary and alternative therapies for pain management and effects on maternal and perinatal morbidity.
Methodology
Databases searched were the Cochrane Pregnancy and Childbirth Group trials register, the Cochrane Controlled Trials Register, MEDLINE, EMBASE, and CINAHL. Inclusion criteria included published and unpublished randomized controlled trials comparing complementary and alternative therapies with placebo, no treatment or pharmacological treatment in labour. Meta-analysis was performed using relative risks for dichotomous outcomes, ad weighted mean differences for continuous outcomes. The outcome measures were maternal satisfaction, use of analgesic medication, and maternal and neonatal adverse outcomes.
Results
7 trials using different modalities of pain control and involving a total of 366 women were included in the study. One trial studied acupuncture (100 women), one involved audio-analgesia (25 women), one involved aromatherapy (22 women), 3 trials studied hypnosis (189 women), and one trial involved music (30 women). The acupuncture reduced the need for analgesic medication (relative risk 0.56). Women receiving hypnosis were more satisfied with their pain management (relative risk 2.33). No differences could be seen for aromatherapy, audio analgesia, or music.
Conclusion
Acupuncture and hypnosis may be beneficial for the management of labour pain. However few complementary therapies have been properly investigated for their use in labour pain management.
References
Smith CA, Collins CT, Cyna AM, Crowther CA. Complementary and alternative therapies for pain management in labour. The Cochrane Database of Systematic Reviews 2003 (2): CD003521, 2003.
