Methods of relieving pain in labor - massage

Massage

Touch and massage

Touch, in the form of hand holding, stroking, caressing, embracing, or patting, communicates caring, reassurance, or love. The definition of medical massage is “the intentional and systematic manipulation of the soft tissues of the body to enhance health and healing”. It is very popular among patients in general and frequently recommended by doctors for a variety of maladies ranging from fatigue, tension, emotional distress, and mental illness, to musculo-skeletal injury, chronic and acute pain, and other conditions. Although in different cultures the attitude to touch by other people varies, touch has been used all over the world to soothe and reassure the laboring woman, relieve her pain, support her position, reduce muscle spasm, and other purposes. In most modern hospital, never mind how well equipped, the touch by loved ones still has an important role in making woman’s experience with giving birth more satisfying.

As with other alternative methods of relieving pain in labor, there is not enough research on the subject. Most women involved in the trials indicate that the touch or massage helps them cope with labor, eased their pain, and helped them feel comforted, reassured, accepted, and encouraged.

In one of the more recent trials from Taiwan partners of the laboring women were taught a particular technique of massage. During the first stage, before the cervix dilated to 3-4 cm the women were given massage of the abdomen, sacrum, shoulder and back for 30 minutes. The patients were encouraged to select their favourite type and site for massage, depending on what felt most useful and comfortable at the time. The same 30-minute massage was repeated in when the cervix was dilated to 5–7 cm and 8–10 cm. When asked after labor about their experiences, 87% of the experimental group reported that massage was of more than moderate helpfulness during labour. On the other hand, their satisfaction with the childbirth experience and partner satisfaction with the childbirth attendance experience were not significantly different.

Overall, the effects of touch and massage in labor just have not been sufficiently studied in order to make solid conclusions about their benefits and risks. And though it may be helpful for women in labor, so far there is no indication that massage has significant and consistent effect on pain of childbirth.

References:

1. Simkin PP, O’Hara M. Nonpharmacologic relief of pain during labor: Systematic reviews of five methods Am J Obstet Gynecol 2002; 186:S131-59.

2. Chang M.-Y., Wang S.-Y., Chen C.-H. Effects of massage on pain and anxiety during labour: a randomized controlled trial in Taiwan. Journal of Advanced Nursing 2000; 38(1), 68–73.

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Dr. Eugene Smetannikov is a practicing anesthesiologist with the interest in obstetric anesthesia. He is the author of the most comprehensive book on the subject, The Truth About Labor Epidural