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J Med Assoc Thai. 2004 Oct;87 Suppl 3:S194-202.

Non-pharmacological pain relief in labour.

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Department of Obstetrics and Gynecology, Samitivej Hospital (Sukhumvit), Bangkok 10110, Thailand.


Pain in normal labour can be relieved using many non-pharmacological methods including:- Techniques that reduce painful stimuli: Assuming various upright positions to ease the pain, encourage labour progress and increase the diameter of the pelvis. Techniques that activate peripheral sensory receptors: Of the various techniques used, intradermal injection of sterile water (ISW) results in over 50% of pain relief compared to 18% in the 'dry needling' group, Dahl V., Aarmes T. One RCT concluded that ISW is more effective than TENS for relieving low back pain in labour. Two trials, Erkkola et al and Bundsen et al found that mothers using TENS received good to moderate pain relief 48%: 37% and 31%: 55%. There were no ill effects produced in the newborn infant. The use of essential oils, lavender, frankincense and rose for relief of anxiety and fear were favourably reported by E. Burn et al. Also for the effectiveness rating of pain by parity and labour onset more women recorded a positive or equivocal score than a negative one. The use of Active Birth embraces many methods of non-pharmacological pain relief including using a humane approach and providing continuous emotional support by a companion or caregiver throughout labour. Two Bangkok hospitals, using Active Birth, showed a marked reduction in the use of pharmacological pain relief.


Pharmacological methods to help alleviate the pain of labour should only be used as a last resort.

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