USE OF NON-PHARMACOLOGICAL PAIN RELIEF METHODS IN LABOR

Klein, Bruna Euzebio; Gouveia, Helga Geremias

doi:10.5380/ce.v27i0.87101

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ORIGINAL ARTICLE • Cogitare Enferm. 27 • 2022 • https://doi.org/10.5380/ce.v27i0.87101 copy

USE OF NON-PHARMACOLOGICAL PAIN RELIEF METHODS IN LABOR

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

to analyze the practice of using non-pharmacological pain relief methods during labor.

Method:

a quantitative and descriptive cross-sectional study developed from December 2019 to September 2020 in a Maternal and Child Nursing Service from southern Brazil. A total of 560 medical charts were analyzed and data collection took place in the institutional database. The Kolmogorov-Smirnov test was used for normality of the variables and, for associations, the t test for independent samples, chi-square or Fischer’s exact test.

Results:

It was found that 164 (29.3%) of the parturients resorted to at least one type of method, the most used being hydrotherapy with 137 (24.5%), change of position with 124 (22.1%) and breathing exercises with 121 (21.6%). There was a significant association (p<0.05) between methods, type of delivery, pregnancy and parity.

Conclusion:

This study highlights the profile of parturients who benefit from these practices and exposes the low frequency of their use, showing a promising area for studies and continuing education activities.

DESCRIPTORS:
Obstetrics; Humanized Delivery; Labor Pain; Nursing; Women’s Health

Variables	n (%)
Age group
15 years old	1 (0.6)
15-35 years old	148 (90.2)
Over 35 years old	15 (9.2)
Schooling
No Schooling	1 (0.6)
Incomplete Elementary School	8 (4.8)
Complete Elementary School	9 (5.5)
Incomplete High School	57 (34.9)
Complete High School	62 (37.8)
Incomplete Higher Education	15 (9.1)
Complete Higher Education	12 (7.3)
Marital status
Single	140 (85.4)
Married	19 (11.6)
Other	5 (3)
Type of delivery
Vaginal	144 (87.8)
Caesarean section	20 (12.2)
Number of pregnancies
1	73 (44.5)
2 or more	91 (55.5)
Parity (admission)
0 (no previous deliveries)	84 (51.2)
>1 previous deliveries	80 (48.8)

Non-pharmacological methods^ More than one answer option	n (%)
Hydrotherapy	137 (24.5)
Changed position	124 (22.1)
Breathing exercise	121 (21.6)
Walked	106 (18.9)
Massage	42 (7.5)
Ball	33 (5.9)
Stool	5 (0.9)
Labor chair	3 (0.5)
Aromatherapy	3 (0.5)
Foot bath	1 (0.2)

Use of non-pharmacological methods
Variables	No n (%) 396	Yes n (%) 164	p-value
Age group (a)			0.26
15 years old	2 (0.5)	1 (0.6)
15-35 years old	338 (85.4)	148 (90.2)
Over 35 years old	56 (14.1)	15 (9.2)
Age	27.46 ± 6.56	25.86 ± 6.20	0.01^* * Significant at the 0.05 level - (a) Chi-Square Test (b) Fisher’s Exact Test Source: The authors (2020).
Schooling (a)			0.55
No Schooling	1 (0.3)	1 (0.6)
Incomplete Elementary School	19 (4.8)	8 (4.8)
Complete Elementary School	37 (9.3)	9 (5.5)
Incomplete High School	141 (35.6)	57 (34.9)
Complete High School	153 (38.6)	62 (37.8)
Incomplete Higher Education	25 (6.3)	15 (9.1)
Complete Higher Education	20 (5.1)	12 (7.3)
Marital status (a)			0.43
Single	320 (80.7)	140 (85.4)
Married	53 (13.4)	19 (11.6)
Other	23 (5.9)	5 (3)
Type of the current delivery: (b)			0.02^* * Significant at the 0.05 level - (a) Chi-Square Test (b) Fisher’s Exact Test Source: The authors (2020).
Vaginal	263 (66.4)	144 (87.8)
Caesarean section	133 (33.6)	20 (12.2)
Number of pregnancies: (b)			0.02^* * Significant at the 0.05 level - (a) Chi-Square Test (b) Fisher’s Exact Test Source: The authors (2020).
Primigravida	126 (31.8)	73 (44.5)
Not primigravida	270 (68.2)	91 (55.5)
Parity: (b)			0.03
Nulliparous	150 (37.9)	84 (51.2)
Primiparous	246 (62.1)	80 (48.8)

Methods	n (%) = 147
Hydrotherapy, Walking, Change of position, Breathing exercises	47 (32)
Hydrotherapy, Walking, Massage, Change of position, Breathing exercises	10 (6.8)
Hydrotherapy, Ball, Change of position, Breathing exercises	7 (4.8)
Hydrotherapy, Walking	6 (4.1)
Hydrotherapy, Breathing exercises	5 (3.4)
Hydrotherapy, Massage, Change of position, Breathing exercises	5 (3.4)
Hydrotherapy, Ball, Walking, Change of position, Breathing exercises	5 (3.4)
Hydrotherapy, Ball, Massage, Change of position, Breathing exercises	5 (3.4)
Walking, Change of position, Breathing exercises	4 (2.7)
Hydrotherapy, Walking, Breathing exercises	4 (2.7)
Hydrotherapy, Change of position, Breathing exercises	4 (2.7)
Walking, Massage, Change of position, Breathing exercises	4 (2.7)
Hydrotherapy, Ball, Walking, Massage, Change of position, Breathing exercises	4 (2.7)
Stool	2 (1.4)
Massage	2 (1.4)
Change of position, Breathing exercises	2 (1.4)
Massage, Change of position, Breathing exercises	2 (1.4)
Walking, Change of position, Breathing exercises	2 (1.4)
Walking, Change of position, Breathing exercises	2 (1.4)
Hydrotherapy, Labor chair, Walking, Change of position, Breathing exercises	2 (1.4)
^* * Combinations appearing only once Other combinations	23 (15.6)

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[1] Role of Authors:

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work - Klein BE, Gouveia HG; Drafting the work or revising it critically for important intellectual content - Klein BE, Gouveia HG; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved - Klein BE, Gouveia HG. All authors approved the final version of the text.