Potential benefits of mind-body interventions in labor pain relief

Mind-body interventions may reduce labor pain intensity, c-section rates, labor duration, and fear of childbirth.

Labor pain affects both mother and baby, and while mind-body interventions show promise, their effectiveness for pain management in labor is debated. This systematic review and meta-analysis was carried out to determine the impact of mind-body interventions on labor pain, including pain intensity, use of pharmacological pain relief agents, and outcomes like cesarean section rates, childbirth fear, and labor duration.

A systematic search across ten databases identified randomized controlled trials on mind-body interventions for labor pain relief. Two investigators independently assessed methodological quality, extracted data, and graded evidence. Meta-analyses were performed for studies having comparable outcomes, calculating risk ratios (RR) for dichotomous variables and standardized mean differences (SMD) for continuous variables. Analyses were conducted via RevMan version 5.3.

Overall, 25 studies from 24 trials were included, examining six mind-body intervention categories: (1) hypnosis, (2) mindfulness, (3) breathing skills, (4) muscle relaxation, (5) guided imagery, and (6) therapeutic touch. Hypnosis and mindfulness were particularly useful in alleviating labor pain intensity, with large effect sizes (SMD: -1.45 and -1.22, respectively), but did not reduce epidural analgesia use. Also, mindfulness significantly reduced the rate of c-sections (RR: 0.46) and fear of childbirth (SMD: -0.63). All mind-body interventions were linked with a shorter labor duration in comparison with control conditions.

Mind-body interventions show potential in lowering labor pain intensity, c-section rates, labor duration, and childbirth fear, with varying effect sizes. Hypnosis and mindfulness, in particular, depicted pivotal relief of labor discomfort with large effect sizes. These interventions could be valuable complementary or alternative methods for birth pain management. However, additional rigorous trials are needed to substantiate these findings.