Purpose: The purpose of this systematic review is to compare the effectiveness between complementary and alternative therapies for pain management in women experiencing first and second stages of labor.
Methods: Recent studies were examined to investigate the effectiveness of complementary and alternative therapies for pain management in pregnant women in the first and second stages of labor. The outcomes were evaluated using the VAS scale where lower scores indicate a greater reduction in pain.
Results: Data was gathered using VAS scores reported from 1760 women in ten trials. Acupuncture intervention (n=546) showed a lower VAS score after use of electro-acupuncture (p<0.05). No differences were found in others comparing electro-acupuncture (adjusted mean difference 1.3 (95% CI -5.5 to 8.1)), manual acupuncture (adjusted mean difference 0.8 (95% CI -6.3 – 7.9)), and control group. Sham acupuncture (5.1 (95% CI = 4.4-5.8)) did not show differences (4.9 (95% CI = 4-5.8)). Warm showers compared to standard care (shower 7.10, control 8.85; p<0.001), heat packs compared to control (p<0.05), and ice packs compared to control (cold 6.5, control 9.25; p<0.0001) all showed a decrease in VAS scores (n=246). Trial using lavender massage/aromatherapy (n=60) showed a decrease in VAS scores (before 8.16, after 6.16; p=0.0001). Trials looking at herbals (n=236) and self-hypnosis (n=672) found no significant difference in VAS scores.
Conclusions: The data was inconclusive in regards to using non-pharmacotherapy interventions in reducing labor pain; however, some effective options have potential use as complementary therapy for existing, standard treatment. Additional trials are required to minimize bias through participant blinding.