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ALTERNATIVE THERAPIES DURING LABOUR.pptx

ALTERNATIVE
AND
COMPLEMENTARY THERAPIES IN
LABOUR
Ms. Bhagyashree Dash
M.sc Nursing 1st year
Obstetrics and gynecology, KINS

“
 It is the happiest moment for the mother when she conceives, but
it becomes worst moment when labour pain starts & she suffers
from anxiety & nervousness.
 There is recent development in treatment modalities which is very
helpful to the mother during labour. It helps to reduce the pain,
lowers her anxiety level & makes her ready for the process of
labour. These treatments are other than pharmacological
modalities & known as alternative &complementary therapies.

DEFINITION
Alternative therapies:
Alternative therapies are used
instead of conventional or
mainstream therapies for
examples, the use of
acupuncture/acupressure
rather than analgesics to
relieve pain.
Complementary therapies:
▪ Complementary therapies are
those used in conjunction with
conventional therapies for
example meditation used as
an adjunct to analgesics
drugs.

List of complementary
therapies
-HANDOUT

COMMON COMPLEMENTARY
THEPY PRACTICES

PREPARATION IN LABOUR
▪ Advice the mother to buy some natural remedies over the
counter.
▪ Choose good-quality essential oils and homeopathic remedies
from a reputable supplier.
▪ For other therapies, except massage, self-hypnosis and relaxation,
need to consult a complementary therapist who is qualified to care
for pregnant women.

Alternative therapies
used during labour
-CHARTS

Acupuncture, acupressure and shiatsu
during labour

ACUPRESSURE & SHIASTU
 With acupressure and shiatsu, therapist will focus on these same points.
Acupressure involves fingertip pressure on the points, and shiatsu uses
the points for massage.
 partner can press his thumbs firmly into the dimples either side of lower
spine, starting at tailbone (coccyx) and moving up to waist. This may ease
the pain of contractions.
 Apply pressure to each pair of dimples for two seconds, then move up to
the next pair. There are about five pairs of dimples in this part of back.
When he reaches waist, he'll need to start again at tailbone.

Hegu Li-4 Location: This point lies
between the first and second
metacarpal bones. The highest point
formed when the thumb is brought to
rest against the index finger.
Uses:
1. To provide general pain relief in
labour
2. To stimulate efficient uterine
contraction.
3. To regulate uterine contraction.
4. During 2nd stage of labour to aid
body's effort to move the baby down
through birth canal.

Jianjing GB-21:
Location: when you draw an imaginary
line between the bony prominence of
the neck (C7) and the top of the
shoulder joint (acromion process), this
point lies midway along the curved
line, at the highest point of the
shoulder muscle.GB-21leeTechnique:
pressure is applied of the beginning of
each contraction.
Uses:
1.To aid in the descent of the baby at
the first and second stage of labour.
2.To stimulate uterine contractions.

Samyinjiao-SP-6
Location: 4 fingers width
(woman's) above the tip of the
medial mallelous of the border of
the tibia.
Uses:
1.Aid in the dilatation of the
cervix.
2.Aid in strengthening uterine
contraction
Cilian BL-32
Location: Centre of second
sacral foramen, of the mid point
of posterior superior iliac and
posterior midline.
Uses:
1.Aid in the descent of the baby
2. Produce a pleasant
anaesthetising effect on the
uterine contractions.

ACUPUNCTURE
 Acupuncture during labour, acupuncturist inserts fine needles into specific
points of body to try to reduce pain.
 Some midwives and physiotherapists are qualified in acupuncture, but it's
more likely to have a private acupuncturist during labour.

Aromatherapy
 Aromatherapists use essential oils to stimulate and balance
hormone levels, and ease stress.
 It may help to relax and increase levels of feel-good hormones,
such as oxytocin.
 Massage with or without essential oils, can help to reduce pain, and
improve emotional experience of labour.
 For an aromatherapy massage, use up to 2 drops of essential oils
at a time, blended into about a teaspoon (5ml) of an unscented
base oil, such as grape seed.

 Try the following relaxing and uplifting
oils:
 camomile
 grapefruit
 bergamot
 ylang ylang
 rose
 lavender

 Frankincense-
 Recommended by aromatherapists for the end of first stage of labour. It can help to
stay calm if contractions become difficult to cope with. Rub a single drop of
frankincense oil on to the palm of hand, Ask attender to massage the oils into back,
shoulders or feet.
 Essential oils in the bath to relax in early labour and if waters have not broken.
Once waters have broken, the oils could affect baby, irritating baby’s skin and
upsetting immune system.
 Alternatively, essential oils in a foot bath Or could try wooden tapers, steam
inhalation or putting one drop or two drops of oil on a tissue so that can breathe it
in.
 If having a home birth, can use a vaporiser or diffuser. But don't use it for more
than 10 minutes to 15 minutes every hour, as it may make feel sick or give a
headache.
 Lavender and jasmine are sometimes helpful, but use them sparingly. No need to
add more than a drop or two to a teaspoon of base oil.

Herbal remedies during labour
Herbal medicines work in the
same way as drugs, and some can
interfere with pregnancy, or
interact with prescribed drugs.

Raspberry leaf tea
 well-known herbal remedy for pregnancy and
birth.
 It's thought to tone the muscles of womb
(uterus) and make contractions more effective,
possibly reducing the length of labour.
 Not much evidence for its safety or
effectiveness.
 Thought to help if mother has been drinking it
from about 32 weeks of pregnancy, as the
effects build over time.

 Don't use raspberry leaf tea if:
 you need a drip to speed up your labour
 you've had a caesarean section in the
past
 you’re having a planned caesarean
 you've had any problems with bleeding
 you've had premature labour in the past
 Blue cohosh should never be used. It has
been linked to serious side-effects in
babies, including stroke and heart

Homeopathy during labour
 Homeopathy uses minute, highly diluted
doses of substances. There's no evidence to
show that homeopathy works, but if like to
try it, consult a qualified, registered
homeopath.
 Homeopaths recommend arnica to treat
any shock, trauma or bruising you may
experience after giving birth.

 Reflexology relies on the idea that feet represent a map
of body. Pressure points on feet correspond to organs
and tissues across body, working in a similar way to
acupuncture.
 Reflexology has not been proven to help with labour
pain, but a few NHS midwives do offer it to women in
labour, often alongside massage and aromatherapy.

 finding contractions
hard to cope with-
squeeze heels
several times during
a contraction.
 contractions slow
down-massage the
back of big toes.

Sterile water injections
during labour

 Sterile water injections (SWI) are four injections of sterile water
made under the skin of lower back.
 They're not routinely offered across the NHS, as there’s conflicting
evidence over whether they are effective as a form of pain relief in
labour.
 some birth centres do offer SWIs to help relieve lower back pain
during labour.
 The first few minutes after the injections may be unpleasant, but
SWIs appear to work quickly.
 Women from a 2016 study said that their pain was significantly
lower after just 10 minutes and remained lower at 45 minutes, 90
minutes and even one day after the injections.

Self-hypnosis
and
hypnobirthing during labour

 The word hypnosis originates from the Greek “Hypnos”
which means sleep.
 Hypnosis is not sleep but a state of attentive and
focused concentration in which the patient can be
relatively unaware, yet not completely blind to their
surroundings.
 Hypnotic focus on diminishing the awareness of pain as
well as fear and anxiety.
 Body's "fight or flight" RESPONSE

Kate Middleton gave her first
podcast interview on an
episode of "Happy Mum,
Happy Baby," where she
reflected on her pregnancies.
"I didn't ask [Prince William] about it,
but it was just something I wanted to
do for myself," Middleton said on the
podcast. "I saw the power of it really —
the meditation and the deep breathing
and things like that that they teach you
in hypnobirthing — when I was really
sick and I realized that actually this was
something that I could take control of
during labor."

1. Complementary medicine for laboring women: a qualitative study of the effects of
reflexology
AUTHOR: Zahi Arnon, Asnat Dor , Hadar Bazak , Samuel Attias , Shlomi Sagi , Shoshana
Balachsan and Elad Schiff
FROM THE JOURNAL: Journal of Complementary and Integrative Medicine ( Volume-16, issue1)
https://doi.org/10.1515/jcim-2018-0022
METHODS: This qualitative study was conducted in an Israeli university hospital that offers
integrative medicine services. Reflexology was offered to laboring women in the hospital, by the
medical staff. In-depth, open interviews were conducted with 36 women, still in hospital, who
consented to be interviewed, within 48 h after delivery. Questions referred to their labor experience
with reflexology treatment.
RESULTS: Of the 36 participants, 34 (94%) described a positive and empowering
experience. They reported reduced pain and anxiety, and an increased sense of self-
efficacy.

2. Intracutaneous or subcutaneous sterile water injection compared with blinded
controls for pain management in labour
AUTHOR: Sheena Derry 1, Straube, R Andrew Moore, Heather Hancock, Sally L Collins
AFFILIATIONS EXPAND:
 PMID: 22258999
 DOI: 10.1002/14651858.CD009107.pub2
PUBLISHED: PUB MED 2012 Jan 18;1:CD009107.
Objectives: To determine the efficacy of sterile water injections for relief of pain (both typical
contraction pain and intractable back pain) during labour compared to placebo or non-
pharmacological interventions, and to identify any relevant effects on mode and timing of delivery,
or safety of both mother and baby.
Search methods: searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30
May 2011), MEDLINE, and EMBASE (January 2010 to 30 May 2011), together with reference lists
in retrieved studies and review articles.
Main results: Included seven studies, with 766 participants: four used intracutaneous injections, two
subcutaneous, and one both. All reported on low back pain in labour only. Methodological quality was good,

3. Complementary and alternative medicine for induction of labour
AUTHOR: Helen G Hall 1, Lisa G McKenna, Debra L Griffiths
Affiliations expand:
 PMID: 21524953
 DOI: 10.1016/j.wombi.2011.03.006
PUBLISHED:2012 Sep;25(3):142-8. Epub 2011 Apr 27.
Aim: The aim of this paper is to examine the scientific evidence for the use of complementary and
alternative medicine to stimulate labour.
Method: An initial search for relevant literature published from 2000 was undertaken using a
range of databases. Articles were also identified by examining bibliographies.
Results: Most complementary and alternative medicines used for induction of labour are
recommended on the basis of traditional knowledge, rather than scientific research. Currently, the
clinical evidence is sparse and it is not possible to make firm conclusions regarding the
effectiveness of these therapies.

“
It is time that we reach for
natural health than the pharma
drugs that are killing the world.

Complementary and alternative medicine is a category of medicine
that includes a variety of treatment methods that fall outside the
realm of conventional medicine. Most of the Complementary and
Alternative Medicine Therapies can be done along with conventional
medical treatments. CAM is also mostly a cheaper in cost when
compared to allopathic medicines.

1. Carter C, Barratt J. 2014. Guidelines for midwives on the use of massage & aromatherapy.
Worcestershire Acute Hospitals NHS Trust.
2. Cui JZ, Geng ZS, Zhang YH, et al. 2016. Effects of intracutaneous injections of sterile water in
patients with acute low back pain: a randomized, controlled, clinical trial. Braz J Med Biol Res 49(3):
1414-431X
3. Derry S, Straube S, Moore RA, et al. 2012. Intracutaneous or subcutaneous sterile water injection
compared with blinded controls for pain management in labour. Cochrane Database of Systematic
Reviews. (1): CD009107. onlinelibrary.wiley.com [Accessed September 2016]
4. Hall HG, McKenna LG, Griffiths DL. 2011. Complementary and alternative medicine for induction
of labour. Women Birth online first: 25 Apr
5. https://www.degruyter.com/document/doi/10.1515/jcim-2018-0022/html
67. https://www.babycentre.co.uk/a1027876/complementary-therapies-for-labour-pain
8. Karpen M, Conrad L, Chitwood L. Essentials of Maternal Child Nursing, 2nd edition. 1995. pp.
25-32.

9. Light HK, Fenster C. Maternal concerns during pregnancy , Am J Obstet Gynecol. 1974;118:46.
10. Parulekar SV. Textbook for Midwives, 2nd edition. Mumbai: Vora Medical Publications; 1998. pp.
134-6.
11. Helen V. Nurse-Midwifery, 2nd edition. Boston: Jones and Bartlett Publishers; 1996
12.https://www.physiopedia.com/Gate_Control_Theory_of_Pain#:~:text=One%20of%20two%20t
hings%20can,pain%20won't%20be%20perceived.
13. https://www.avensonline.org/blog/complementary-and-alternative-therapies.html
14. https://discover.hubpages.com/education/Complementary-Alternative-Medicine-Therapies-cam-
meaning-difference
15. https://www.scribd.com/document/351289059/Alternative-Complementary-Therapy-in-Labour

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