Labour Pain

  • Acupuncture significantly reduces duration of labour and reduces the need for augmentation of labour with contraction-stimulating drugs. A study randomised 100 women with spontaneous rupture of membranes at term to either acupuncture or no acupuncture.Treatment was individualised on the basis of traditional Chinese medical diagnosis and used three points per patient from a pool of nine possible choices. Treatment principles applied were to increase energy, soften the cervix and open the Conception vessel. Although time from membrane rupture to delivery did not differ significantly between the groups, length of active labour was significantly reduced in the acupuncture group by a mean difference of 1.7 hours.    In addition, significantly fewer patients in the acupuncture group required oxytocin (used to stimulate contractions) for longer than two hours. Medical induction of labour was eventually necessary in 15 acupuncture patients and 20 controls. When induction was carried out, women assigned to acupuncture completed the active phase of labour in half the time compared to controls, a statistically significant difference.   Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin. A randomized controlled trial. Acta Obstet Gynecol Scand. 2006; 85(11):1348-53.
  • In a study investigating the efficacy of electro-acupuncture (EA) for relief of labour pain, 36 pregnant women were randomly divided into an EA group and a control group. Two rounds of EA were carried out, one at the beginning of the active phase of labour and one at 7-8cm of cervical dilation. The EA group exhibited lower pain intensity and better relaxation during labour than the control group.  In addition, the peripheral blood test showed a significant increase in the concentration of the pain-relieving substances beta-endorphin and 5-hydroxytryptamine in the acupuncture group at the end of the first stage of labour. Hegu L.I.-4 and Sanyinjiao SP-6 were stimulated bilaterally for 20 minutes at a frequency of 2–100 Hz and current of 14–30 mA (a tolerable level) with a dense/disperse waveform.   Electro-acupuncture in relieving labor pain. Evidence Based Complementary Alternative Medicine. 2007 Mar; 4(1): 125-30.
  • A meta-analysis of three trials (496 women all together) into the use of acupuncture to relieve labour pain suggests that women receiving acupuncture required less analgesia, including the need for epidural analgesic and a reduced need for augmentation with oxytocin.Complementary and alternative therapies for pain management in labour. Cochrane Database of Systematic Reviews 2006 Issue 4.
  • A Norwegian study has shown that women who receive acupuncture during labour have a significantly reduced rate of epidural anaesthesia.Nesheim BI, Kinge R. (2006) Performance of acupuncture as labour analgesia in the clinical setting. Acta Obstetrics and Gynecology Scandinavia; 85(4):441-3.
  • A randomised, un-blinded, controlled study carried out at the Department of Obstetrics and Gynecology, Ulleval University Hospital, Oslo, Norway, has indicated that acupuncture is effective in controlling labour pain.Of the 106 women in labour who received acupuncture, only 11% required Meperidine analgesia, compared to 37% and 29% in two control groups. The use of other analgesics was also lower in the acupuncture group. Patient satisfaction was high: 89 of 103 patients asked said they would want acupuncture during another labour.Clin J Pain. 2003 May-Jun;19(3):187-91.
  • Obstetricians from Norway have said that acupuncture is the analgesic method of choice for reducing labour pain, whether supplemented by pharmacological painkillers or not. 210 mothers in spontaneous labour were randomly assigned to receive either real acupuncture or false acupuncture. The results were tested by assessing their request for pharmacological pain-relief, and on their perception of pain felt on a Visual Analogue Score. The researchers found that acupuncture not only reduced labour pain, it also reduced delivery time. It was particularly useful for women who wanted non-pharmacological pain-relief to avoid the side effects.Acta Obstet Gynecol Scand 2002 Oct; 81(10): 943-8.
  • A study carried out at Orebro University Hospital, Sweden, has found that women who received acupuncture during labour were less likely to ask for an epidural to relieve pain (12% compared to 22%) and felt more relaxed than women who did not receive acupuncture.46 women were randomised to receive acupuncture during labour, and reported at least once an hour how much pain they were experiencing and how relaxed they felt. Results were compared to 44 women who did not receive acupuncture. The women in both groups had constant access to other methods of pain relief, including epidurals, nerve blocks and warm rice bags.   Midwives, who had gone through a 4-day course on the use of acupuncture during labour administered acupuncture treatments, which were individualised according to the type of pain experienced. The women who received acupuncture were half as likely to request an epidural during labour, were less likely to ask for other types of pain relief, such as nerve stimulation therapy or a warm rice bag, and reported feeling more relaxed compared to the women in untreated group. The treatment had no significant effect on how much pain the women said they were feeling. The acupuncture appeared to have no effect on the length of labour.  British Journal of Obstetrics and Gynaecology 2002;109:637-644.
  • A study was conducted to see if acupuncture can influence cervical ripening, induce labour and reduce the need for induction. 45 women were randomly assigned to an acupuncture or a control group on their due date. In the acupuncture group, women were needled at Hegu L.I.-4 and Sanyinjiao SP-6 bilaterally every other day, until they either gave birth or, if the due date was exceeded by 10 days, were induced.In the acupuncture group the time from the first positive fibonectin test to delivery was 2.3 days (compared to 4.2 days in the control group), the time from due date to delivery was 5 days on average (7.9 in the control), and only 20% of women in the acupuncture group needed to be induced (35% in the control). There was no difference in duration of labour between the two groups.  Wien Klin Wochenschr, 2001;113:942-6.
  • In a study carried out in Sweden, the analgesic effect of acupuncture during childbirth was assessed by comparing the need for other pain treatments such as epidural analgesia, nitrous oxide/oxygen etc.Out of 90 women given acupuncture (acupuncture group) 52 (58%) managed their deliveries without further pain treatment, compared to 13 (14%) out of 90 women not given acupuncture (control group). The groups were similar with respect to age, pariety, duration of delivery, use of oxytocine and incidence of Caesarean section.   Acupuncture treatment was found to have no major side effects, and 85 women (94%) given acupuncture reported that they would consider acupuncture for future deliveries.   The authors concluded that acupuncture reduces the need for other methods of analgesia in childbirth.  Acupunct Electrother Res, 23(1):19-26 1998.
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