When it comes to complementary medicine, the scientific results for what to use to assist with a safe and natural labour, are very hit and miss. The reason for this, is that complementary medicine usually treats individuals and research studies look at large groups. So it’s hard to say for sure what single therapies work best on their own in large studies. Unfortunately small studies aren’t able to give enough weight to the result either – a constant problem with complementary medicine research and evidence based medicine.
However, with a rise in the rates of intervention in labour, particularly in Australia and other developed countries, more information is desperate.
So earlier this month, there was a new Australian study published looking into the effect of an integrative antenatal education programme to assist pregnant women through labour. The integrative part is the bit I like best. They looked at six different techniques including; acupressure, visualisation and relaxation, breathing, massage, yoga techniques and facilitated partner support.
They were looking to see what effect these therapies combined would have on the rate of epidural use, onset of labour, augmentation (added methods to bring on labour like manual membrane rupture or oxytocin medication), mode of birth and newborn outcomes.
They found that the implementation of these techniques together significantly reduced epidural use and caesarean section.
Other findings – although not significant, they also found that there was a reduced rate of augmentation, length of second stage labour, perineal trauma and resuscitation of the newborn.
For full disclosure – there were no differences found in spontaneous onset of labour, pethidine use, rate of postpartum haemorrhage, major perineal trauma or admission to intensive care unit. However, these may have been more physical or functional concerns associated with existing conditions and not able to be assisted with complementary methods.
Something they noted, is that the study did include a high number of ‘relatively wealthy, well educated women’ but it was also followed up with the discussion point that the highest rates of epidural use and caesarean section are amongst this same population.
Any complementary therapies that can help reduce epidural use and caesarean section numbers are a worthwhile investment in my opinion so it’s some exciting news. Not so much for the people already using these therapies because you’re already benefiting. But it will mean more women and families could be directed towards this style of protocol.
I do recommend all of these therapies with all of the pregnant women I see. Usually prior to 36 weeks because I find it can take some practice for some of the visualisation, yoga and breathing techniques. The great thing is, all of these therapies are safe. Safe pregnancies with healthy mums and bubs is the most ideal outcome.
For a link to the original article, click here.
Details of the techniques if you’re interested…
The protocol started prior to 36 weeks in combination with their usual hospital care and included:
- Visualisation – four guided visualisations rehearsed through the courses and given to participants on a CD to practice at home
- Yoga postures – five postures and movements practiced to encourage relaxation, physiological position for labour, opening of the pelvis and downward descent of the baby
- Breathing techniques – four breathing techniques were introduced: soft sleep breaths for relaxation between contractions; blissful belly breaths (BBs) which were used during contractions for pain relief; Cleansing Calming Breaths used following contractions during the transition period of labour; and the gentle birthing breath (GB) which was for use during the second stage of labour and encouraged descent of the baby avoiding active pushing and protection of the pelvic floor
- Massage – two techniques were shown to partners: the endorphin massage used between contractions, which is a soft technique and encourages endorphin release; and the stronger massage which is used during contractions for pain relief and focuses on squeezing the buttock, especially the piriformis muscle, to interrupt pain perception
- Acupressure – the use of six main points for use during labour selected from a previously published protocol. These focus on hormone release for labour progression, augmentation of contractions, pain relief, nausea and positioning of baby. For a free booklet on these acupuncture points and how to use them, head to Debra Bett’s website here.
- Facilitated partner support – used concept of working with pain and instructs partners to advocate for the labouring woman, promoting her oxytocin levels and minimising her stress with actions and techniques which are supportive for the birthing woman, and gives time for facilitated discussion and rehearsal by couples during the course.