Alternative & Complementary Therapy in Labour

MANIBA BHULA NURSING COLLEGE

Sub: Obstetrical & Gynaecological Nursing Topic: Alternative & Complementary Therapies in Labour

SUBMITTED TO:

SUBMITTED BY:

Ms. Kinjal Mistry

Ms. Hiral Mistry

Assistant Professor

Ist Year M.Sc Nursing

MBNC

MBNC SUBMITTED ON:

25-11-016

Trusted by over 1 million members

Try Scribd FREE for 30 days to access over 125 million titles without ads or interruptions! Start Free Trial Cancel Anytime.







ALTERNATIVE & COMPLEMENTARY THERAPY IN LABOUR 

Introduction:

It is the happiest moment for the mother when she conceives, but it becomes worst moment when labour pain starts & she suffers from anxiety & nervousness. There is recent development in treatment modalities which is very helpful to the mother during labour. It helps to reduce the pain, lowers her anxiety level & makes her ready for the process of labour. These treatments are other than pharmacological modalities & known as alternative & complementary therapies. 

Alternative therapies:

Alternative therapies are used instead of conventional or mainstream therapies for examples, the use of acupuncture/acupressure rather than analgesics to relieve pain. 

Complementary therapies:

Complementary therapies are those used in conjunction with conventional therapies for example meditation used as an adjunct to analgesics drugs. 

Different alternative & complementary complementary therapies:

There are various modalities which can be used as a alternative or complementary therapy in labour. They are as follows: 1. Hypnosis: 

 



The word hypnosis originates from the Greek “Hypnos” which means s leep. Hypnosis is not sleep but a state of attentive and focused concentration in which the patient can be relatively unaware, yet not completely blind to their surroundings. surroundings. Hypnotic focus on diminishing the awareness of pain as well as f ear and anxiety. Hypnosis advocates give several explanations of how the process works. One theory holds that when a woman feels fear during childbirth, her body releases stress hormones that trigger the body's "fight or flight" response. this causes muscles to tighten and interferes with the birthing process. By training the subconscious mind to expect a safe, gentle birth, they say, women can avoid going into the fight-or-flight state, allowing for a smoother birth. Self hypnosis can be taught at various hypnosis training centers on special childbirth classes that teach the technique of positive statements and concentrating on beautiful images of child.







2. Biofeedback: 





Biofeedback is a treatment that uses monitoring instruments to provide visual or acoustic feedback to patient’s physiological information of which they are normally unaware. It is a therapeutic technique that teaches you how to control physical responses such as breathing, muscle tension, hand temperature, heart rate, rate, blood blood pressure and brain activity that are not normally controlled voluntarily. It puts the patient in control and gives them a sense of self-reliance that is an important factor for laboring woman. For example childbirth classes or childbirth classes plus video session about coping with labour pain etc.

3. Yoga:









There are different aasans or positions which can be used during labour for the benefits. I.

Cat Pose

The cat pose makes you kneel on all fours and stretch. This helps t o push the baby down once your water breaks. You can also try lifting your leg up high to quicken the baby's movement.

II.

Dog Tail Wagging

Kneel on all fours and move your hip as if you are a dog wagging its tail. You can vary the pace of the tail wagging depending on the surge of pain you feel. It is a very soothing position.

III.

Child Pose

The child pose is named so because it is an extremely relaxing position. Your uterus contractions will come in spell. The period in between the contractions is for resting. Try this yoga position during the rest period.







IV.

Squat

Squatting is the most traditional position in which women gave birth. It naturally opens up the vaginal opening so that the baby can be born easily. Practice squatting before hand so that you can try this yoga position during labour.

4. Sophrology: 





The word Sophrology S ophrology derives from two Greek words, ‘sos’ harmony or serenity and ‘phren’ conscience or spirit. This technique derived from Indian yoga was introduced in Europe during the 1960s. Its purpose is to improve the control of body and spirit through three degrees of dynamic relaxation: concentration, contemplation and meditation. Applied to obstetrics, better control of the delivery process is expected. Patients individually report a high degree of satisfaction with this experience of relaxation during prenatal classes and delivery.







relaxation during the early stages of labour and as a stimulant to promote movement during later stages, when physical exertion is required for bearing down process. Phumdoung and Good 2003, in their study described music consistently provided significant relief from severe pain across 3 hours of labour and delayed the increase of affective pain for 1 hour, it also delayed increase in distress of pain for an hour and for some, relief was fairly substantial. 6. Acupuncture: Acupuncture is well known Chinese practice. In this one uses needles inserted at specific points to relieve pain. This therapy is found beneficial and relaxing during pregnancy. 







 

During labor, acupuncture can be used for pain relief, relie f, as a calming technique (which again will lessen pain) and to keep labor contractions going.

The placement of the needle will depend on which stage of labor patient is and kind of pain. Advisable to take this treatment with experienced certificate practitioners. The basic theory includes altering the body’s levels of chemical neurotransmitters and influencing the natural electrical currents or electromagnetic fields.

7. Acupressure therapy: 



Acupressure is a descendant of Chinese manipulative therapy in which points are stimulated by pressure, using hands, fingers and thumbs. Acupressure might increase blood flow to the uterus, influence hormonal responses, and stimulate uterine contractions.









8. Homeopathy: 





There are homeopathic drugs that may help to lessen the pain of natural child birth. These are pills with no side effects to be said that have to be taken at regular intervals throught out the labour. Though homeopathy is not recognized as a way of curing an ailment or pain quickly, it can start from the later months of pregnancy, with the aim of reducing the eventual labour pain. These drugs only be taken by recognized homeopathy practitioner and obstetrician. Homeopathy is a safe, natural alternative alter native to pitocin/oxytocin. If the baby is overdue,induce labour naturally by alternating the remedies caulophyllum 12C and cimicifuga 12C, given once every hour. For example, hour 1: caulophyllum, hour 2: cimicifuga, hour 3: caulophyllum, etc.

9. Therapeutic touch: 



The purpose of therapeutic touch in labor is to communicate caring and reassurance. Painful contractions of the uterus can be treated by the application of pressure with the hands to the woman's back, abdomen, hips, thighs, sacrum or perineum. Whether touch is perceived as positive or not is dependent on who is touching the patient: in one study, touching was perceived positively by 94% of patients when they were touched by a relative or friend, 86% by their husbands, 73% by a nurse and 21% by a physician (32). Anxiety is reported to be reduced in patients who receive reassuring touch. In a retrospective study of 30 patients, 77% experienced ‘less pain’ when they were touched during labor, and 40% reported less need for pain medication.

10. Massage therapy: 





Touch and manipulation with the hands has been used in the practice of medicine since its inception. The value of touch and massage and its positive effect is well documented. Massage therapy can incorporate in nursing practice throughout labour to promote relaxation and stress reduction. Massage is thought to have a physiological basis, blocking pain impulses by increasing A-fiber transmission or by stimulating the local releases of endorphins,







11. Transcutaneous Transcutaneous Electrical Nerve Stimulation(TENS):

This is a method of pain management in which electrodes fitted at the back, to pass electric current into the body. This stimulates the natural secretion of endorphins, the body’s painkillers. This usually used in the early stages and has no known known side effect.







13. Hydro therapy: 







The use of hydrotherapy during labour, whether in a shower or a tub, is a proven means of relaxation and pain relief. The warm water stimulates the release of endorphins, relaxes muscles to decrease tension, stimulates large diameters nerve fibers to close gate on pain, and promotes better circulation and oxygenation. Hydrotherapy can promote increased diueresis, decreased edema, decreased blood pressure, enhanced fetal rotation due to increased buoyancy faster labour, less use of intramuscular and intravenous medications, less use of epidural, episiotomies and increased satisfaction with birth experience. Prior to implementing hydrotherapy, procedures and protocols should be developed. developed. A common question asked by providers is whether hydrotherapy can or should be used when membranes are ruptured. Several studies have looked at the risks of using hydrotherapy after rupture of membranes. Finding gave shown no increase in choriomnionitis, postpartum endometritis, neonatal infections etc., however







14. Birth ball:  



The Swiss Ball has been used in physical therapy and exercise programs for decades. Birth balls were originally developed by physiotherapists and used for treating orthoneural disorders, but using them has been found equally beneficial for a pregnant woman. Research on the use of ball demonstrates a significant improvement in core muscle stability, including the muscles of the chest, abdomen and pelvis These muscles are instrumental in the labour process for deep breathing, pushing and general movement Rocking and movement can be accomplished on a birthing ball during labour not only does the ball facilitate the physiologic benefits of movements to help the fetus find its best fit through the pelvis but also promotes comfort and can decrease pain by stimulating mechanoreceptors (sense organ or cell that responds to mechanical stimuli such as touch or sound) and joint receptors.

The ball should be used with the following precautions:  



The woman should never use the balls unless her support person is with her The woman should always have a firm support in front of her to hold on to for security A policy should be written outlining their use, cleaning and storage.

15. Aromatherapy: 



Aromatherapy is the therapeutic use of plant derived essential oils to promote physical and psychological wellbeing. Essential oils are lipid soluble and are rapidly absorbed when applied externally or are







16. Breathing therapy: 

Controlled, rhythmic breathing has been found to be relaxing by women dealing with labour pain.



If women takes deep breathing it can help to calm and distract from the pain.



It can also help to diminish the natural instinct to hold the contractions.

17. Position: 

Different positions during labour have different ways of helping to relax and be more









18. Heat therapy: 







Sometimes a simple heating pad may work wonders to relieve the pain felt while giving birth. Pads are available in different size and shapes suitable for almost all women and are easy to use. If not available heat therapy can be done by using warm water bag or even a warm pack or soak. Heat caused a small increase in uterine contraction and no any effect on fetal heart







the pituitary glands to release pain killing hormones. Reflexology should only be performed by an experienced practitioner. 20. Distraction: 



In this a woman in pain can take her mind off of the contractions and labour by reading a book, listening to music, walking, talking to a friend or watching TV. These activities are simple to do and provide distraction from pain.

21. Nipple stimulation: 

Rubbing or rolling your nipples helps the body release oxytocin.

Oxytocin plays a role in arousal, initiating labor, and bonding between mother and child. 

This hormone also makes the uterus contract after labor, helping it return to its pre pregnancy size. Stimulating the breasts may also help bring on full labor by making contractions stronger and longer. 

If you want to try it, gently rub or roll your nipples. Massage the darker area around your nipple (areola), not just the tip of your nipple. You can do this by placing your palm over the areola and moving it in a circular motion, firmly and gently. Stimulate your breasts for an hour, three times a day. 

In a study published in Worldviews on Evidence-Based Nursing, Nursing, a group of 390 Turkish pregnant women were randomly assigned to one of three groups during their labors: nipple stimulation, uterine stimulation, and control. The results were compelling. The women in the nipple stimulation group had the shortest durations of each phase of labor and delivery. According to the study, the average duration was 3.8 hours for the first phase (dilation), 16 minutes for the second phase (pushing and







physical examination. 7. Know that herbals, in particular, can have significant effect on prescription drugs and body function. 

Summary:

Today we have discussed about alternative & complementary therapies used in labour to reduce the labour pain & to help the mother. There are various therapies which we have discussed like- hypnosis, Sophrology, Acupuncture, Acupressure, Hydrotherapy, Breathing therapy, Music therapy, Bio feedback, Yoga, Massage therapy, sterile water injection, Therapeutic touch, Transcutaneous electrical nerve stimulation, Homeopathy, Birth ball, Aroma therapy, Heat therapy, reflexology, different positions & distraction therapy.



Conclusion:

Alternative & complementary therapies are the special treatment modalities which can be used along with conventional therapies or mainstream therapies. It helps the mother in reducing pain of labour, reducing the duration of labour & increasing the progress of labour. It also helps in making the mother relaxed & reducing her anxiety or psychological affects & making her string enough to cope with labour pain. Midwife should be enough knowledgeable & skillful to apply all these therapies in her practice life as she is the important person to help the mother to go through the labour pain. 

Books:

Bibliography:

Alternative & Complementary Therapy in Labour

Recommend Documents