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Application of a physiotherapy protocol to women during the active phase of labor is associated with improvements in obstetrical outcomes.
According to the findings of a randomized clinical trial, using a nonpharmacologic childbirth care protocol can effectively minimize labor pain, delay pharmacologic analgesia, and lower the requirements for additional doses of analgesics and dystocia rates without any kind of perinatal compromise. Researchers sought to determine the efficacy of a nonpharmacologic protocol in females in the active phase of labor to improve obstetrical and perinatal outcomes.
This concealed allocation, assessor blinding, and intention-to-treat assessment included 80 low-risk primigravida females at the end of pregnancy admitted at the beginning of the active phase of labor. Volunteers were segregated into an experimental group (n=40) and a control group (n=40). Subjects in the experimental group were given four interventions: (I) ambulation at 4 to 6 cm of cervical dilation, (2) alternation of maternal postures, (3) transcutaneous electrical nerve stimulation at 6 to 7 cm, and (4) a warm shower bath at >7 cm.
On the other hand, volunteers in the control group were given only routine obstetrical care during labor. During the study, the parturient could demand pharmacologic analgesia at any time. The primary endpoints were duration of expulsive phase of labor, duration of active phase of the first stage of labor, and prevalence of labor dystocia as assessed by the partograph. From official birth records, other maternal and neonatal data were gathered by researchers.
Parturients who were given the nonpharmacologic protocol exhibited a shorter active phase of the first stage of labor (373 minutes in the experimental group; 444 minutes in the control group), presented rupture of membranes later in labor (8 cm in the experimental group; 7 cm in the control group), demanded pharmacologic analgesia with more significant cervical dilation (8 cm in the experimental group; 5 cm in the control group), requested less additional doses of analgesics, and illustrated lower labor dystocia rates than the subjects in the control group.
Other maternal and perinatal factors did not differ between the experimental group and the control group. As evidenced by a decreased and delayed usage of pharmacologic analgesia, a shorter active phase of labor, and a lower rate of dystocia, the sequential nonpharmacologic protocol consisting of ambulation, transcutaneous electrical nerve stimulation with alteration of upright positions, and warm shower baths has the potential to lessen labor pain. This protocol ought to be made available by maternity hospitals, and women ought to be encouraged to ask for it when giving birth.
AJOG Global Reports
Applying a physiotherapy protocol to women during the active phase of labor improves obstetrical outcomes: a randomized clinical trial
Licia Santos Santana et al.
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