The effect of intermittent local heat and cold on labor pain and child birth outcome

Zhila Ganji, Marjan A Shirvani, Farideh Rezaei-Abhari, Mahmonir Danesh, Zhila Ganji, Marjan A Shirvani, Farideh Rezaei-Abhari, Mahmonir Danesh

Abstract

Background: Labor pain is one of the severest pains that cause many women request cesarean section for fear of pain. Thus, controlling labor pain is a major concern of maternity care. Nowadays, interest in non-pharmacological pain relief methods has been increased because of their lower side effects. The effects of discrete heat and cold on decreasing labor pain have been reported but there was no evaluation of the effects of simultaneous heat and cold. The aim of this study was to investigate the effect of intermittent heat and cold on pain severity and childbirth outcomes.

Materials and methods: This study was a randomized controlled trial. Sixty-four nulliparous women with term, One fetus, and low-risk pregnancy were divided into the intervention (32 participants) and the control group (32 participants) by random allocation. Excluding criteria were: administration of pain relief drugs, skin disease in the field of intervention, fetal distress, bleeding, fever, and disagreement with participation in the study. Warm and cold packs were used intermittently on low back and lower abdomen during the first phase and on perineum during the second phase of labor. Pain intensity was assessed with Visual Analogue Scale. Descriptive statistic, chi square, and t-test were used for data analysis.

Results: There were no significant differences in demographic and midwifery characteristics and the baseline pain between two groups. The pain was significantly lower in intervention group during the first and second phases of labor. Duration of the first and third phases of labor was shorter in the case group. There were no significant differences in type of delivery, perineal laceration, oxytocin uptake, fetal heart rate, and APGAR between two groups.

Discussion: Local warming with intermittent cold pack can reduce labor pain without adverse effects on maternal and fetal outcomes. It is an inexpensive and simple method.

Conclusion: Intermittent local heat and cold therapy is a no pharmalogical, safe and effective method to relief labor pain.

Keywords: Child birth; cold temperature; hot temperature; labor pain.

Conflict of interest statement

Conflict of Interest: None.

Figures

Figure 1
Figure 1
The comparison of pain severity between groups during labor

References

    1. Waters L, Raisler J. Ice massage for reduction of labor pain. J Midwifery Womens Health. 2003;48:317–21.
    1. Sercekus P, Okumus H. Fears associated with child birthing among nulliparous women in Turkey. Midwifery. 2007;25:155–62.
    1. Dahlen HG, Homer CS, Cooke M, Upton AM, Nunn RA, Brodrick BS. Soothing the ring of fire: Australian women's and midwives experiences of using perineal warm packs in the second stage of labor. Midwifery. 2009;25:39–48.
    1. Nerum H, Halvorsen L, Sorlie T, Oian P. Maternal request for caesarean section due to fear of birth: Can it be changed through crisis-oriented counseling? Birth. 2006;33:221–8.
    1. Kolas T, Hofoss D, Daltveirt AK, Nilsen ST, Henriksen T, Häger R, et al. Indications for caesarean deliveries in Norway. Am J Obstet Gynecol. 2003;188:864–70.
    1. Ahmad-Nia S, Delavar B, Eini-Zinab H, Kazemipour S, Mehryar AH, Naghavi M. Caesarean section in the Islamic Republic of Iran: Prevalence and some socio-demographic correlates. East Mediterr Health J. 2009;15:1389–98.
    1. Hodnett ED. Pain and women's satisfaction with the experience of childbirth: A systematic review. Am J Obstet Gynecol. 2002;186:160–72.
    1. Lowe NK. The nature of labor pain. Am J Obstet Gynecol. 2002;186:16–24.
    1. Cunningham G, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. chapter 19. NewYork: Mc Grow Hill Medical; 2010. Williams obstetrics.
    1. Simkin P, Bolding A. Update on non-pharmacologic approaches to relieve labor pain and prevent suffering. J Midwifery womens Health. 2004;49:489–504.
    1. Ernst E, Fialka V. Ice freezes pain? A review of the clinical effectiveness of analgesic cold therapy. J Pain Symptom Manage. 1994;9:56–9.
    1. Tootoonchi M, Aein F, Hasanpour M, Yadegarfar GH. The effect of local therapy and destruction on children's pain intensity of intramuscular injection. J Res Med Sci. 1999;4:73–7.
    1. Melzack R, Wall P. Pain mechanisms: A new theory. Science. 1965;150:971–9.
    1. Allaire AD. Complementary and alternative medicine in the labor and delivery suite. Clin Obstet Gynecol. 2007;44:681–91.
    1. Lieberman AB. Revised ed. Boston: Harvard Common Press; 1992. Easing labor pain: The complete guide to a more comfortable and rewarding birth; pp. 114–5.
    1. Curkovic B, Vitulic V, Babić-Naglić D, Dürrigl T. The influence of heat and cold on the pain threshold in rheumatoid arthritis. Z Rheumatol. 1993;52:289–91.
    1. Habananda T. Non-pharmacological pain relief in labor. J Med Assoc Thai. 2004;87:194–202.
    1. Taavoni S, Abdolahian S, Haghani H. Sacrum-Perinea heat therapy for physiologic labor pain management: A Randomized control trial study. Eur J Pin Suppl. 2011;5:15–295.
    1. Geissbuhler V, Stein S, Eberhard J. Water births compared with land births: An observational study of nine years. J Perinat Med. 2004;32:306–7.
    1. Grodzka M, Makowsha P, Wielgos M, Przyboś A, Chrostowska J, Marianowski L. Water birth in parturient's estimation? Ginekol Pol. 2001;72:1025–30.
    1. McCaffery M. Using superficial cooling for pain relief. Am J Nurs. 1999;99:24.
    1. Moneta J, Okninska A, Wielgos M, Przyboś A, Chrostowska J, Marianowski L. The influence of warm water immersion on the course of labor? Gynekol Pol. 2001;72:1031–6.
    1. Sanders J, Peters T, Campbell R. Techniques to reduce perineal pain during spontaneous vaginal delivery and perineal suturing: A UK survey of midwifery practice. Midwifery. 2005;21:154–60.
    1. c0 luett ER, Nikodem VC, Mcand RE, Burns EE. Immersion in water in pregnancy, labor and birth. Cochrane Database syst Rev. 2004:CD000111.
    1. Behmanesh F, Fahami F, Zeinalzadeh M. Effect of heat therapy on pain severity and duration of labor in primigravida women. Babol J Med Sci. 2008;10:48–54.
    1. Hobbs L. Oxford: Books for Midwives Press; 2001. The best labor possible.
    1. Eckert K, Turnbull D, Maclennan A. Immersion in water in the first stage of labor: A randomized controlled trial. Birth. 2001;28:84–92.
    1. ohlsson G, Buchlave P, Leanderssion u, Nordström L, Rydhström H, Sjölin I. Warm tube bathing during labor: Maternal and neonatal effects. Acta Obstet Gynecol scand. 2001;80:311–4.
    1. Malarewice A, Wydrzynski G, Szymkiewicz J, Adamczyk Gruszka O. The influence of water immersion on the course of first stage of parturition in primiparous women. Med wieku Rozwoj. 2005;9:773–80.
    1. Lowe NK, Robers J. The convergence between in labor report and postpartum recall of parturition pain. Res Nurs Health. 1998;11:11–21.
    1. Khamis Y, Shaala S, Dammarawy H, Romia A, Toppozada M. Effect of heat on uterine contractions during normal labor. Int J Gynecol Obstet. 1983;21:491–3.
    1. Vähä-Eskeli K, Erkkola R. The effect of short term heat stress on uterine contractility, Fetal heart rate and fetal movements at late pregnancy. Eur J obstet Gynecol Reprod Biol. 1991;38:9–14.
    1. Leah L. Midwifery care measures in the second stage of labor and reduction of genital tract trauma at birth: A randomized trial. J Midwifery womens health. 2005;50:365–72.
    1. Brown ST, Douglas C, Flood LP. Women's evaluation of intrapartum non-pharmacological pain relief methods used during labor. J Perinat Educ. 2001;10:1–8.

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