Water eases pain
for first-time mothers
Dick Ahlstrom, Science Editor
First-time
mothers making slow progress with labour reported "significantly"
less pain when immersed in water, according to a new study. They
less often needed drugs to overcome pain and needed fewer medical
interventions to deliver their babies.
Dr Elizabeth Cluett of the University of Southampton and colleagues
studied women experiencing slow labour.
They compared labouring in water with standard drug-based measures
to boost the progress of labour, publishing their findings yesterday
in the British
Medical Journal.
"Slower than expected progress in the first stage of labour
(dystocia) occurs in 20 per cent of [First time\] women in labour
and accounts for 20 per cent of caesarean sections and 40 per
cent of instrumental deliveries and results in longer hospitalisation,"
the authors write.
The trial was based on two assumptions, that a lack of understanding
of labour could lead quickly to unnecessary medical intervention,
and that
anxiety and pain triggered stress, slowing the progress of labour
still further.
"Labouring in water may ameliorate this stress response by
aiding relaxation and pain relief," the authors suggested,
prompting the two-year analysis that concluded in December 2000.
The study included 99 women experiencing slow labour, defined
as cervical dilation of less than one centimetre per hour. Half
of them were immersed in a birth pool during the first stage of
labour, while the rest received
standard care including the use of oxytocin to speed up contractions.
The study showed that the 49 women in the water group were less
likely to need drugs to aid contractions and reported significantly
lower pain scores.
It also showed that only about half of these women needed complete
pain relief using an epidural, compared with the two-thirds needing
an epidural among the 50 women in the standard care group.
The average duration of labour in both groups was about the same
as was the number of caesarean sections and forceps deliveries.
Before this trial the assumption was that all women with slow
labour would require labour "augmentation" using oxytocin
or having their waters broken, and that they would have longer
labour and frequently needed obstetric
intervention, the authors report.
"However almost 30 per cent of women in the water arm did
not receive augmentation and 20 per cent received no obstetric
intervention, without evidence of longer labour, both of these
rates being significantly different
from the augmentation arm."
They retrospectively reported less pain and increased satisfaction
with greater freedom of movement, the authors add. "Also
a management approach that reduces rates of augmentation and associated
obstetric intervention may contribute positively to maternal physiological
and psychological health:
oxytocin infusion is known to increase the risk of uterine hyperstimulation
and fetal hypoxia [lack of oxygen], and obstetric interventions
are associated with lower maternal satisfaction."
|
News
|
