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Observational Study
. 2023 Jan;45(1):3-10.
doi: 10.1055/s-0042-1759629. Epub 2023 Mar 6.

Nonpharmacological Methods to Reduce Pain During Active Labor in A Real-life Setting

Clarissa Bernardes de Oliveira Silva  1 , Karine Mendonça Davi Rodrigues  1 , Camila Zoldan  1 , Roseli Mieko Yamamoto Nomura  2 , Edward Araujo Júnior  2 , Alberto Borges Peixoto  1   3
Affiliations
Observational Study

Nonpharmacological Methods to Reduce Pain During Active Labor in A Real-life Setting

Clarissa Bernardes de Oliveira Silva et al. Rev Bras Ginecol Obstet. 2023 Jan.

Abstract
in English, Portuguese

Objective: To evaluate the association between pain intensity in the active phase of the first stage of labor with the use or not of nonpharmacological methods for pain relief in a real-life scenario.

Methods: This was an observational cross-sectional study. The variables analyzed were obtained by a questionnaire with the mothers (up to 48 hours postpartum) to investigate the intensity of pain during labor using the visual analog scale (VAS). The nonpharmacological pain relief methods routinely used in obstetric practice were evaluated by consulting medical records. The patients were separated into two groups: Group I - patients who did not use nonpharmacological methods for pain relief and Group II -patients who used these methods.

Results: A total of 439 women who underwent vaginal delivery were included; 386 (87.9%) used at least 1 nonpharmacological method and 53 (12.1%) did not. The women who did not use nonpharmacological methods had significantly lower gestational age (37.2 versus 39.6 weeks, p < 0.001) and shorter duration of labor (24 versus 114 min, p < 0.001) than those who used the methods. There was no statistically significant difference in the pain scale score using the VAS between the group that used nonpharmacological methods and the group that did not (median 10 [minimum 2-maximum 10] versus 10 [minimum 6-maximum 10] p = 0.334).

Conclusion: In a real-life setting, there was no difference in labor pain intensity between the patients who used nonpharmacological methods and those who did not use them during the active phase of labor.

Objetivo: Avaliar a associação da intensidade da dor na fase ativa da dilatação do parto em mulheres de acordo com a utilização ou não de métodos não farmacológicos para alívio da dor em cenário de vida real. MéTODOS: Trata-se de um estudo observacional de corte transversal. As variáveis analisadas foram obtidas através de questionário com as puérperas (até 48 horas pós-parto) investigando a intensidade da dor no parto pela escala visual analógica (EVA). As medidas não farmacológicas de alívio da dor, utilizadas rotineiramente na prática obstétrica, foram avaliadas pela consulta aos prontuários. As pacientes foram separadas em dois grupos: Grupo I – pacientes que não utilizaram medidas não farmacológicas para alívio da dor e Grupo II - pacientes que utilizaram estas medidas.

Resultados: Foram incluídas 439 mulheres que tiveram parto vaginal, sendo que 386 (87,9%) utilizaram, pelo menos, uma medida não farmacológica e 53 (12,1%) não utilizaram. As mulheres que não utilizaram as medidas não farmacológicas apresentaram idade gestacional significativamente menor (37,2 versus 39,6 semanas, p < 0,001) e menor duração do trabalho de parto (24 versus 114 minutos, p < 0,001) quando comparadas às que utilizaram as medidas. Não houve diferença estatisticamente significativa na pontuação da escala da dor pela EVA de acordo com a categorização pelo uso ou não de métodos não farmacológicos (mediana 10 [mínimo 2–máximo 10] versus 10 (mínimo 6–máximo 10), p = 0,334]. CONCLUSãO: Em cenário de vida real, as pacientes submetidas aos métodos não farmacológicos não apresentaram diferença em relação à intensidade da dor quando comparadas às que não os utilizaram durante a fase ativa do trabalho de parto.

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Conflict of interest statement

The authors have no conflict of interests to declare.

Figures

Fig. 1
Fig. 1
Flowchart of patient inclusion in the study.
Fig. 2
Fig. 2
Prevalence of use of nonpharmacological methods for pain relief during the active phase of the first stage of labor in patients who underwent vaginal delivery.
See this image and copyright information in PMC

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