An examination into reviews on use of no pharmacologic approaches in management of labor pain and child birth has cast aspiration on the safety and efficiency of these methods. It is hard to ascertain how safe and adequate these approaches are. The examination goes ahead to categorize these approaches into three based on efficiency.
In the category of those that have been found to work are the use of epidural injections, combined spinal epidurals and inhaled analgesic (Gail, 2012). Even with evidence from the reviews that these approaches adequately manage pain during labor and child birth, they’ve been found to have adverse effects. Use of inhaled analgesic has been established to cause drowsiness, dizziness and vomiting to the patient. Administering epidurals on the other hand increases the risk for instrument-assisted virginal birth and cesarean section.
The second category consists of methods that may work. These include massage, acupuncture, and immersion in water, relaxation, local anesthetic nerve block and use of nonopioid drugs. In these cases, evidence of managing of pain in labor and childbirth was limited mainly to individual trials (Gain, 2012). However, even with few cases reporting success, it was noted that these methods had relatively few adverse effects on the patient and child birth.
The third category of methods consists of methods that yielded insufficient evidence to determine their effectiveness. Interventions in this category are largely noninvasive and appear to be safe for both mother and child. They include sterile water injection, biofeedback, aromatherapy, transcutaneous electrical nerve simulation and hypnosis. Reviews for these methods provided little high quality evidence on their adequacy.
The nursing fraternity however, finds the use of nonpharmacologic methods in pain management in labour and childbirth practically effective. Eileen Ehudin Beard, a senior adviser for the American College of Nurse-Midwives, attributes a host of advantages to these methods in their day to day application as opposed to use of pharmacological methods. She however points out the need for further research to enable women make better-informed decisions on which approach to use. Authors of the Cochrane reviews (15 of which were examined) are also of the idea for further research into this methods. Of specific interest is the transcutaneous electrical nerve simulation method which, even lacking definitive trials, continues to be popular with nurses and midwives.
References
Gail M. Pfeifer. (2012). Effectiveness of Nondrug Pain Relief during Labor. Print.
