Research Nerd Alert!
We are appreciate of this clinical practice guideline from the Society of Obstetricians and Gynaecologists of Canada (SOGC).
It’s all about pain. And how OBs, midwives, labour and delivery nurses, and other health professionals, should approach pain management during labour and delivery so that birth experiences are positive.
This article is:
- Based on research evidence, and
- Provides great recommendations about non-pharmacological pain management during childbirth.
- Recognizes the role of the brain and central nervous system in pain perception
You can read the entire article yourself, but for now, I’m going to post selected summary statements and recommendations that are relevant to all the things we do in pre and postnatal pelvic floor physiotherapy – especially in our pelvic floor birth prep course. Check em out:
SUMMARY STATEMENTS
- “A growing body of scientific literature supports the use of nonpharmacological approaches to pain management during childbirth due to their numerous benefits for the mother and child, including a reduction in the need for obstetrical interventions, labour augmentation, or Caesarean section (l).”
- “The Gate Control Theory mechanism, which consists of creating pleasant stimulations in the painful area between or during contractions is best achieved through ambulation, gentle massage, stroking, water, or vibrations (I).”
- “The Central Nervous System Control mechanism, which consists of deviating or focussing the woman’s attention is best activated through labour support and the practice of yoga, relaxation, visualization, breathing, auto-hypnosis and cognitive restructuring (I).”
- “Natural oxytocin is not only important for uterine contractions; it enhances a sense of calmness and reduces pain. Because synthetic oxytocin does not cross the blood-brain barrier in a significant manner, the analgesic and psychological effects on the mother of calmness and well-being are lost (II).”
- “Health care providers and the birthing environment can have a major impact on labour progress and experience by paying attention to and reducing a woman’s stress level (I).
- “Neurophysiologic and hormonal mechanisms contribute to help women cope with the intensity of labour (l).”
RECOMMENDATIONS:
- “To help women cope with normal labour, nonpharmacological approaches are recommended as a safe first-line method for pain relief and should be continued throughout labour whether or not pharmacologic methods are used (I-A).”
- “To prevent suffering, health professionals should address the emotional component of pain (pain unpleasantness). This is most effectively achieved through support and nonpharmacological approaches to pain management.”
- “To further reduce the need for obstetric interventions and avoid associated risks and side-effects, health professionals should provide continuous labour support with the addition of at least one other nonpharmacological pain modulating mechanism (I-A).”
- “Health professionals should, where possible, promote and support the physiological progress of labour, delivery, and the postpartum period trusting the woman’s ability to work with her pain and encouraging her to rely on her ability to give birth (III-A).”
- “Health professionals should encourage parents and the people assisting them to prepare for the birth by learning about birth physiology and gaining skills in working with pain (III-A).”
Source:
