Effect of dance labor on the management of active phase labor pain & clients' satisfaction: a randomized controlled trial study

The Effect of Labor Dance in the First Stage of Labor on Labor Pain, Anxiety, Duration of Labor, and Maternal Satisfaction with Labor: A Randomized Controlled Study

Objective: The study aimed to examine the effects of labor dance applied in the first stage of labor on perceived labor pain, anxiety, duration of labor, and maternal satisfaction with labor. Design: This study is a randomized controlled trial. Methods: A sample size of 128 pregnant women was randomly assigned to a control (n = 64) or experimental (n = 64) group while ensuring equal numbers of primiparous and multiparous participants in each group. After admission to the hospital for parturition, and during the first stage of labor, the women in the experimental group were exposed to a 15-min labor dance every hour when the cervical dilation was between 3 and 8 cm. The labor dance included movements of the sacrum and waist massaged by a partner using a massage glove, which was accompanied by self-selected music. Outcome measures included the Visual Analogue Scale (VAS), the State Anxiety Scale (SAS), and the Scale for Measuring Maternal Satisfaction (SMMS)-normal birth and labor duration. These were administered before the labor dance and at the end of the labor dance at three points of cervical dilation: 3, 5-6, and 7-8 cm for the experimental group, and at similar points in the control group: at the start of dilation and 15 min later. The data were analyzed using the generalized linear model and Mann-Whitney U tests. Results: In comparison to the control group, for the group performing the labor dance, the mean VAS scores were lower (p < 0.05) at each evaluation period, and the mean scores of total SMMS and some of its subdivisions were significantly higher in the experimental group (p < 0.05). There was no statistically significant difference between the SAS scores at any evaluation point, including postpartum (p > 0.05). Similarly, there were no significant differences in labor time (p > 0.05) between groups. Conclusions: The practice of labor dance was found to be effective in reducing the perceived labor pain in pregnant women and increasing maternal satisfaction at birth, but not on the duration of labor, and anxiety. Trial registration: ClinicalTrials.gov (NCT04746170).

Evaluation of a short in-person and online antenatal educational intervention for high-risk pregnant women linked to antenatal consultation

INTRODUCTION

The aim of this study was to evaluate a short educational intervention that focused on labor pain (through visual analogue scale, VAS), postpartum anxiety, and birthing experience before and during the SARS-CoV-2 (COVID-19) pandemic.

METHODS

This was a quasi-experimental study conducted between November 2019 and May 2021 in Brazil in 100 women with a high-risk pregnancy in the third trimester of pregnancy with an intervention group with in-person or virtual sessions (during the COVID-19 pandemic) and a non-intervention group. The antenatal intervention included breathing and relaxation techniques, upright positions, and information about labor. For evaluation, an antenatal questionnaire, State-Trait Anxiety Inventory (STAI) and a postpartum questionnaire were used. For data analysis, Student's t-test, chi-squared and Fisher's exact tests, ANOVA, bivariate, and multivariate regression analysis, were used.

RESULTS

When comparing the women in the intervention group to the non-intervention group, it was observed that the latter group reported higher fear of pain at labor during antenatal consultations (p<0.013); more women needed analgesia at 0-4 cm dilation (17/40) (p<0.018); the duration of labor was ≥12 hours (37/50) (p<0.037); while the intervention reported having a regular, good or excellent labor period (36/50) (p=0.014). The multiple regression analysis for labor pain showed a significant relationship between mode of delivery (cesarean delivery: RR; SE -21.43; 5.32, p<0.001) and labor pain, and good satisfaction with labor (RR; SE -13.86; 6.40, p=0.033).

CONCLUSIONS

Women from the intervention group had more satisfaction and less pain during labor than women from the non-intervention group.

Non-Pharmacological Pain Management in Labor: A Systematic Review

Childbirth is a remarkable, life-changing process and is frequently regarded as an excruciating, physically and emotionally demanding experience that women endure. Labor pain management poses a significant challenge for obstetricians and expectant mothers. Although pharmacological pain management is the gold standard, it still imposes risks on the mother and baby. Recently, non-pharmacological pain management (NPPM) has emerged as a safe, effective option. Six databases were searched for articles published up to 2023 using specific related keywords and defined inclusion and exclusion criteria. The extraction and gathering of data was made so as to be categorized into physical, psychological, and complementary NPPM techniques. In light of the enormous development and diversity of NPPM techniques, the present review aims to examine contemporary NPPM knowledge and application, discussing efficacy, advantages, limitations, and potential adverse effects, with a specific focus on women's individual requirements, to strengthen obstetricians' knowledge in guiding decision-making for women in childbirth.

Delivery in a vertical birth chair supported by freedom of movement during labor: A randomized control trial

To evaluate the effect of delivery in a vertical birth chair (VBC) and traditional delivery table (DT) supported by women's movement during labor on the labor process, fetal outcome, maternal hormone levels, birth comfort, and satisfaction. This randomized controlled trial was conducted with 1:1:1 allocation. Group 1: in the VBC in upright position, Group 2: on the DT in supine position, these groups supported by freedom of movement, control group: on the DT in supine position, labor in bed. The duration of second stage of labor was not different between the groups (p = 0.246). The occurrence of instrumental birth, episiotomy, and perineal laceration was also not different among the groups (p = 0.772, p = 0.953, and p = 0.124). The use of uterotonic was observed in control group (p = 0.001). 1 and 5 APGAR scores of newborns were not different in all groups (p = 0.121, p = 0.268). The lowest pain score was observed in Group 1 (p = 0.001). Birth comfort and satisfaction were higher in Group 1 (p = 0.001 and p = 0.001). Decreased postpartum prolactin levels and increased postpartum oxytocin levels were observed in the control and Group 1 (p = 0.004, p = 0.006). Freedom of movement during labor and delivery using VBC in upright position can play birth-promoting and supporting role. There were no negative effects on the fetal outcome.

Effects of Heat and Massage Applications to the Lumbosacral Area on Duration of Delivery and Perception of Labor Pain: A Randomized Controlled Experimental Trial

Objective: This study was carried out to determine the effects of massage and hot-pack applications in the first stage of labor on perceptions of labor pain and duration of delivery. Methods: This randomized controlled experimental trial was conducted in an obstetrics and pediatrics hospital. The research sample comprised 120 pregnant women, 40 of whom were in the massage group, 40 of whom were in the hot-pack application group, and 40 of whom were in the control group. Patient identification forms, labor process monitoring forms, and a visual analogue scale (VAS) were used to collect data. Results: It was determined that the massage and hot-pack applications shortened the durations of the active and transition phases of labor. The massage and hot-pack applications also reduced perceptions of pain in the active and transition phases. Mean VAS scores of the massage and hot-pack application groups were lower than those of the control group (p

The Effect of Combination of Pelvic Rocking Exercise and Back Massage to Pain and Duration of Labor in Primigravidae

Background The combination of pelvic rocking exercise using a birth ball and back massage as non-pharmacological therapy needs to be investigated in relation to reducing pain and labor duration in primigravida mothers.   Aim This study aims to determine the effect of a combination of pelvic rocking exercise using a birth ball and back massage on pain and labor duration in primigravida mothers.    Methods The design of this study was quasy Experiment with the approach of non-equivalent control group 's. The research sample was 160 primigravida maternity mothers. The sample in the treatment group was given pelvic rocking intervention using a birth ball and back massage and the sample in the control group was given standard labor care such as touch, and taught labor positions that were in an upright position, providing encouragement and counseling. This research conducted in July–December 2020.    Results Provided evidence that pelvic rocking using a birth ball and back massage offers safe, non-invasive treatment for pain management and duration during labor.   Conclusion The results of this study provide an understanding that there is a significant effect of the combination of pelvic rocking exercise and back massage on pain and duration of labor in primigravida mothers.  

The Effect of Labor Dance on Traumatic Childbirth Perception and Comfort: A Randomized Controlled Study

This study aims to evaluate the effect of labor dance on traumatic childbirth perception and comfort. This is a randomized controlled experimental study. The study was conducted with 120 primiparous pregnant women (60 in experiment group, 60 in control group). The pregnant women in the experiment group performed labor dance with the researcher midwife during the active phase of labor. The researcher implemented the Childbirth Comfort Questionnaire (CCQ) when the cervical dilation was 8 cm. The Postpartum Comfort Scale (PCS) and Traumatic Childbirth Perception Scale (TCPS) were implemented almost 2 hours after giving birth. The scores of the women in the experiment group in TCPS were significantly lower than those in the control group while their mean scores in CCQ and PCS were significantly higher. Labor dance contributed to the women's more positive childbirth experiences, perceptions of childbirth as less traumatic, and increased their comfort levels.

Dancing During Labor: Are Women Down to Boogie?

Recent social media trends have demonstrated increased interest in dancing during the final weeks of pregnancy and labor. However, there is limited evidence about dancing during labor and its impact on labor pain and duration as well as patient satisfaction. Before conducting a prospective study, given that enrollment is often challenging, our feasibility study aimed to assess the willingness of pregnant women to participate in a future study evaluating low-impact dance during labor. We anonymously surveyed a convenience sample of English-speaking/reading pregnant women who presented for prenatal care at 1 of 3 clinics from June 2019 to July 2019. Questions related to women's interest in dancing during labor and limited demographic information were collected and analyzed. Overall, 88.6% of pregnant women who completed the survey expressed interest in participating in a future study on low-impact dance during labor, with Caucasian patients and those ≥35 years of age being less interested in future participation (P<0.05 for both). Interest in participating was not influenced by any other demographic characteristic, pregnancy history, or current activity level. Given sufficient interest among pregnant women in participating in a study aimed at evaluating the potential benefits of low-impact dance during labor, enrollment numbers may be easier to achieve than previously expected.

Effect of upright and ambulant positions versus lying down during the active first stage of labor on birth outcomes among nulliparous women: randomized controlled clinical trial

Objective

To examine the effect of upright and ambulant positions versus lying down during the active first stage of labor on birth outcomes for nulliparous women.

Methods

This is a randomized controlled clinical trial conducted at the delivery department of Damanhour Educational Institute, El Behira Governorate, Egypt. The study sample involved 150 parturient women equally divided into intervention and control groups using randomization block technique. The researchers used four tools for data collection: Demographic data interview schedule, World Health Organization Partograph, Apgar's score, to evaluate neonatal outcomes, and visual analogue pain intensity scale. For the study group, the parturient women were encouraged to assume one of the upright positions or ambulating around the bed so as to maintain the pelvis in vertical plane as far as possible for 20–25 min for every 1 h. The control group received routine hospital care, which includes lying down in bed. IBM SPSS 23.0 was used to analyze the data.

Results

Significant differences (P < 0.05) were observed between the study and control groups in relation to cervical dilation, fetal head descent, uterine contractions interval, and frequency. The duration of the first stage of labor significantly reduced (P = 0.018) in the intervention group compared with control group. No significant differences (P > 0.05) were observed between both groups in term of emergency cesarean birth rates, oxytocin use, and neonatal outcomes.

Conclusions

This study proves that upright and ambulant positions significantly enhance uterine contractility, cervical dilatation, and fetal head descent and reduce the first stage duration.

Reviewing pain management options for patients in active labor

Pain perception and preferences for pain management are unique to each woman in labor. This article provides an overview of the physiology of labor pain, discusses available nonpharmacologic and pharmacologic approaches to managing pain during active labor, and discusses potential benefits and risks for each option.

The effect of labor dance on perceived labor pain, birth satisfaction, and neonatal outcomes

OBJECTIVE

This research was conducted to determine the effects of labor dance on perceived birth pain, birth satisfaction, and neonatal outcomes.

DESIGN

This is an experimental study. Data were collected under three groups during the active phase of labor: the dance practitioner midwife group (DPMG, comprising 40 pregnant women), the dance practitioner spouse/partner group (DPSG, comprising 40 pregnant women) and the control group (CG, comprising 80 pregnant women).

SETTING

This study was conducted between 1 April 2017 and 31 October 2017 in Turkey.

PARTICIPANTS

This study was administered on pregnant women volunteers with no risk during the active phase of labor.

INTERVENTIONS

During the active phase, pregnant women in DPMG danced with the midwife; pregnant women in DPSG, on the other hand, danced with their spouses/partners throughout the active phase. When vaginal dilatation reached 4 cm and 9 cm, labor pain was measured by employing the visual analog scale (VAS). In the postpartum phase, newborn babies' first, fifth, and tenth minute Apgar scores and oxygen saturation levels were measured and registered. In the first hour after delivery, the Mackey Birth Satisfaction Scale was administered. CG, on the other hand, received only the routine procedures offered in the hospital.

FINDINGS

The mean scores of VAS 1 and VAS 2 in DPSG and DPMG were lower than in CG. The fifth and tenth minute Apgar scores and the first, fifth, and tenth minute oxygen saturation levels of the newborns in the experimental groups, as well as the level of birth satisfaction, were significantly higher than in CG.

KEY CONCLUSIONS

The study showed a positive effect of labor dancing on the labor process.

Dancing During Labor: Social Media Trend or Future Practice?

Over the past 30 years, medical interventions in pregnancy and childbirth have increased. Some pregnant women seek less invasive and nonpharmacological options to manage discomforts during labor. While exercise during pregnancy is recommended, less is known about exercise, specifically dancing, during labor. While anecdotal evidence is supportive, little is known about the implications of exercise and dance during the first stage of labor for pain reduction and labor progression. Some movements common in dance, such as expanding hip circles that loosen and relax muscles of the pelvic floor, may be beneficial to women during labor. Available evidence suggests that dancing during the first stage of labor may decrease duration and intensity of pain and increase patient satisfaction, but further study is warranted. Ultimately, before assessing the implications of dance during labor, a feasibility study should be conducted to determine pregnant women's willingness to participate in a prospective or randomized controlled trial.

Effects of Dance and Music on Pain and Fear During Childbirth

OBJECTIVE

To test the effects of dance and music and music alone on pain and fear during the active phase of labor among nulliparous women.

DESIGN

Single-blind, randomized, controlled study.

SETTING

A maternity and children's hospital in Konya Province, Turkey.

PARTICIPANTS

A total of 93 nulliparous, pregnant women who were in the active phase of labor at term gestation with single fetuses in cephalic presentation.

METHODS

We randomly assigned participants to one of three groups: dance and music, music alone, and usual care (control). We collected data four times during labor using a personal information form, labor monitoring form, visual analog scale (VAS), and Version A of the Wijma Delivery Expectancy/Experience Questionnaire (W-DEQA) to measure fear.

RESULTS

Based on multivariate analysis of variance, the effect of time and study group interaction on VAS and W-DEQA scores was statistically significant (p < .05), and the effect of study groups and time on VAS scores was statistically significant (p < .05). The effect of the study groups on W-DEQA scores was statistically significant (p < .05), but there was no statistically significant effect of time on W-DEQA scores (p > .05).

CONCLUSION

Dance and music and music alone significantly reduced pain and fear in nulliparous women during the active phase of labor. These interventions are easy for nurses and midwives to use, affordable, and effective, and they enable a woman and her partner to be actively engaged in the woman's care.

The Effect of Zumba Exercise on Reducing Menstrual Pain in Young Women with Primary Dysmenorrhea: A Randomized Controlled Trial

STUDY OBJECTIVE

To study the effectiveness of performing Zumba exercise on the severity and duration of pain in patients with primary dysmenorrhea.

DESIGN

Randomized controlled trial.

SETTING

Cairo University gynecology Hospital and Bahgat gym and fitness center.

PARTICIPANTS

Ninety-eight women diagnosed with primary dysmenorrhea.

INTERVENTIONS

Study participants were divided randomly into 2 equal groups: group I included women who engaged in Zumba exercise for 60 minutes twice weekly for 8 weeks, and group II was a control group with no intervention.

MAIN OUTCOME MEASURES

The primary outcome was the menstrual pain intensity measured using the visual analogue scale scores at 4 and 8 weeks after starting Zumba exercise. The secondary outcome was the difference in the duration of pain in both groups.

RESULTS

Both groups were homogeneous regarding the baseline demographic characteristics. The severity of primary dysmenorrhea at the beginning of the study was not significantly different between the 2 groups. Menstrual pain intensity was significantly decreased in the Zumba group after 4 and 8 weeks of Zumba compared with the control group (mean difference, -2.94 [95% confidence interval, -3.39 to -2.48] and -3.79 [95% confidence interval, -4.16 to -3.43], respectively; P = .001). Also, the duration of pain was shorter in the Zumba group compared with the control group at 8 weeks (4.92 ± 1.90 vs 9.10 ± 2.92 hours, respectively; P = .001).

CONCLUSION

The Zumba intervention can reduce the severity and duration of menstrual pain thus suggesting that regularly performing Zumba might be a possible complementary treatment for primary dysmenorrhea.

Relation between Length of Exposure to Epidural Analgesia during Labour and Birth Mode

Objective: To appraise the relationship between the length of exposure to epidural analgesia and the risk of non-spontaneous birth, and to identify additional risk factors. This study is framed within the MidconBirth project. Study design: A multicentre prospective study was conducted between July 2016 and November 2017 in three maternity hospitals in different Spanish regions. The independent variable of the study was the length of exposure to epidural analgesia, and the dependent variable was the type of birth in women with uncomplicated pregnancies. The data was analyzed separately by parity. A multivariate logistic regression was performed. The odds ratios (OR), using 95% confidence intervals (CI) were constructed. Main outcome measures: During the study period, 807 eligible women gave birth. Non-spontaneous births occurred in 29.37% of the sample, and 75.59% received oxytocin for augmentation of labour. The mean exposure length to epidural analgesia when non-spontaneous birth happened was 8.05 for primiparous and 6.32 for multiparous women (5.98 and 3.37 in spontaneous birth, respectively). A logistic regression showed the length of exposure to epidural during labour was the major predictor for non-spontaneous births in primiparous and multiparous women followed by use of oxytocin (multiparous group). Conclusions: The length of exposure to epidural analgesia during labour is associated with non-spontaneous births in our study. It highlights the need for practice change through the development of clinical guidelines, training programs for professionals and the continuity of midwifery care in order to support women to cope with labour pain using less invasive forms of analgesia. Women also need to be provided with evidence-based information.

Birth ball or heat therapy? A randomized controlled trial to compare the effectiveness of birth ball usage with sacrum-perineal heat therapy in labor pain management

OBJECTIVE

Labor pain and its management is a major concern for childbearing women, their families and health care providers. This study aimed to investigate the effects of two non-pharmacological methods such as birth ball and heat therapy on labor pain relief.

MATERIAL & METHODS

This randomized control trial was undertaken on 90 primiparous women aged 18-35 years old who were randomly assigned to two intervention (birth ball and heat) and control groups. The pain score was recorded by using Visual Analogue Scale (VAS) before the intervention and every 30 min in three groups until cervical dilatation reached 8 cm.

RESULTS

The mean pain severity score in the heat therapy group was less than that of in control group at 60 and 90 min after intervention (p < 0.05). In addition there were significantly differences between the pain scores in the birth ball group after all three investigated times in comparison to control group.

CONCLUSION

Both heat therapy and birth ball can use as inexpensive complementary and low risk treatment for labor pain.