The physiological basis

To manage pain during labor and delivery, women may use nonpharmacological techniques to decrease pains. These nonpharmacological interventions to reduce pain during labor can be categorized into cognitive (guided imagery), sensory (aromatherapy, massage), and behavioral (patterned breathing) techniques (Brown, Douglas, & Flood, 2001). Some of the known effective nonpharmacological techniques in pain management during labor are aromatherapy, effleurage, water bath therapy, and intradermal water blocks (Klossner, 2006).

The physiological basis for use of aromatherapy is unclear but it reduces anxiety levels, promotes relaxation, and increases emotional satisfaction among women in labor. These resulting psychological changes in the body serve as a diversion to focus the mother’s attention to these instead of the pain (Murray ; Huelsmann, 2009). In an uncontrolled study conducted regarding the effectiveness of aromatherapy, results showed positive responses from women in labor who received arometherapy (lavender essential oil) during labor (Simkin ; Bolding, 2004).

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The physiological basis for use of water bath therapy is that it promotes good perfusion in the uterus, reduces blood pressure, lessens painful contractions, and increases emotional satisfaction among women in labor (Murray ; Huelsmann, 2009). A random clinical trial (RCT) on the effectiveness of water bath therapy in reducing labor pains showed that fewer women received epidural analgesia in the treatment group (received water bath therapy) compared to the control group (did not receive water bath therapy).

Other systematic reviews of RCTs and cohort studies reveal effectiveness of water bath therapy. The findings of these research publications suggest that water bath therapy with the correct water temperature, length of time for bath, and safety procedures, is effective as a pain relief procedure during labor (Simkin ; Bolding, 2004). Touch and massage, also known as effleurage, with light circular movements using the fingertips on the abdomen is found to be effective in relieving labor pains.

This method is based on the theory that the nerve endings going to the brain receive and entertain first this stimuli, ligh touch, hence the pathway for pain stimuli or sensation is blocked (Klossner, 2006). A recent RCT conducted showed that touch and massage significantly lowered both pain and anxiety levels of women who receive the massage therapy during different phases of labor compared to the control group (Simkin ; Bolding, 2004).

The physiological basis for the use of intradermal water blocks for management of labor pains is the hypothesis that the pain caused by injection blocks the pain stimulus pathway from other parts of the body, the abdomen and lower back in the case of women in labor (Murray ; Huelsmann, 2009). In line with this, four RCTs revealed that intradermal water blocks are very effective in reducing pain levels during labor among the treatment groups who received this nonpharmacological intervention in comparison to those who did not receive it (Simkin ; Bolding, 2004).


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