Non-Pharmacological

Pain Relief Measures

during Labor and
Delivery

Cheska M. Pileo
BSN II
NON PHARMACOLOGICAL APPROACH

Non-pharmacological pain therapy refers to

interventions that do not involve the use of
medications to treat pain. The goals of non-
pharmacological interventions are to decrease
fear, distress and anxiety, and to reduce pain
and provide patients with a sense of control.
DIFFERENT TYPES OF
NON-
PHARMACOLOGICAL
PAIN RELIEF
MEASURES IN LABOR
AND DELIVERY
A. Relaxation & Controlled Breathing
 Relaxation is a technique that can help to decrease anxiety and
fear, enhancing feelings of control. Controlled breathing is also
an important strategy to provide comfort and focus while
enhancing labor progress.

STEPS EXPECTED EFFECTS

- For relaxation, allow the patient to verbalize - Relaxation keeps the abdominal wall from
feelings and concerns. becoming tense, allowing the uterus to rise with
- Provide frequent updates about progress. contractions without pressing against the hard
- To practice controlled breathing, after a abdominal wall. It also serves as a distraction
cleansing breath, a woman inhales comfortably technique because, while concentrating on
but fully, and then exhales, with her exhalation relaxing, a woman cannot concentrate on pain.
a little stronger than her inhalation (to help - Controlled breathing enhances oxygen flow to
prevent hypoventilation). your baby and is also vital to the contracting
- Use of aroma and essential oils can help uterus.
enhance relaxation
B. Touch and Massage

 Touch can convey pain-reducing messages. Purposeful massage of the

hand or other parts of the body also communicates caring. Massage
takes the form of light or firm stroking, vibration, kneading, deep
circular pressure, and continual steady pressure.

STEPS EXPECTED EFFECTS

- Gently massage the neck, shoulders, abdomen, - Bare skin receives the signal best. Receptors in
back, thigh, feet, or hand. the brain receive the sensations of pleasure
- Place a hand on a painful spot and pat of from the massage blocking reception of the
reassurance. painful stimuli of labor.
- Stroking the cheek in an affectionate gesture,
or a tight embrace.
C. Focusing & Imagery
 Concentrating intently on an object is another method of
distraction, or another method of keeping sensory input from
reaching the cortex of the brain (Smith, Levett, Collins, et al.,
2011).

STEPS EXPECTED EFFECTS

- Giving the patient an attention to - Meant to help reduce fear, anxiety,
focus by using stimuli from the and pain, and can also be helpful
environment that will draw with any discomfort you may
attention away from pain. experience after the delivery.

- Do not ask questions or talk while a

woman is using focusing, imagery,
or chanting.
D. Hydrotherapy

 Hydrotherapy during labor (techniques using water) can be

emotionally soothing and can also help with pain relief. Many
women are comforted by the combination of warmth, water
pressure, and the sound of the water.

STEPS EXPECTED EFFECTS

- Standing under a warm shower or soaking in a - Can help support physiologic birth (Stark,
tub of warm water. Remynse, & Zwelling, 2016).
- The temperature of water used should be 37°C
- Provides comfort, supports relaxation.
to prevent hyperthermia of the woman and also
the newborn at birth.
- Do not leave women unsupervised in a tub as
they could slip and have difficulty getting their
head above water.
- A support person can join the woman in a tub
or shower if she wishes and can continue with back
massage or other measures she finds soothing.
E. Acupuncture
 Acupuncture is based on the concept that
illness results from an imbalance of energy.

STEPS EXPECTED EFFECTS

- Insert needles into the skin at designated - Supplies organs of the body with energy.
susceptible body points located along
meridians that course throughout the - Activation of these points (which are not
body. necessarily near the affected organ) results
in a release of endorphins, which makes
this system helpful, especially in the first
stage of labor (Ozgoli, Mobarakabadi,
Heshmat, et al., 2016).

- Acupuncture may also decrease the

duration of labor (Asadi, Maharlouei,
Khalili, et al., 2015).
F. Acupressure
 Acupressure is the application of pressure or
massage at these same points. It seems to be
most effective for low back pain.

STEPS EXPECTED EFFECTS

A support person holds and Acupressure can reduce maternal

squeezes the common point for anxiety as well as the length of labor
women in labor which is Co4 (Hoku or when specific pressure points are
Hegu point), it is located between used (Akbarzadeh, Masoudi, Zare, et
al., 2015).
the first finger and thumb on the
back of the hand.
G. Reflexology
 Is the practice of stimulating the hands, feet, and
ears as a form of therapy (Smith, Levett, Collins, et al.,
2012).

STEPS EXPECTED EFFECTS

Apply pressure to the point that Application of pressure to a

corresponds to the uterus is specific area aims to restore energy
located on the inside ankle to the body and improve the overall
condition. Massaging this area is
about halfway between the believed to begin labor or hurry labor,
ankle bone (malleolus) and the thus creating less pain.
heel.
H. Heat and Cold Application

 An effective way to help relieve the pain of labor.

STEPS EXPECTED EFFECTS

- Apply heat application (heating pad,

instant hot pack, warm moist compress) for
women who are having back pain
- Apply cold application for women who It promotes comfort and helps reduce edema
become warm from the exertion of labor to and swelling.
the forehead, chest, or back of the neck.
- Immediately following birth, an ice pack
applied to the perineum.
I. Spirituality

 Offering a prayer can help a

patient reduce their tense
and stress.

STEPS EXPECTED EFFECTS

Bring helpful worship objects It can give strength and encourage

such as a Bible or Qur’an into the feeling of the patient while in the
progress of labor.
their birthing setting to use
during prayer.
REFERENCES:
 Asadi, N., Maharlouei, N., Khalili, A., et al. (2015). Effects of LI-4 and SP-6 877 acupuncture on labor pain, cortisol level
and duration of labor. Journal of Acupuncture and Meridian Studies, 8(5), 249–254.
 Health Direct Australia (2018) Pregnancy, birth, and baby. Retrieved from. https://www.pregnancybirthbaby.org.au/
non-medical-pain-relief-during-labour
 Newton-Wellesley Hospital (2014) Nonphamacologic Labor Pain Treatment. Retrieved from. https://www.nwh.org/patient-
guides-and-forms/maternity-guide/maternity-chapter-3/comfort-measures-during-labor-and-delivery-non-pharmacological-methods
 Ozgoli, G., Mobarakabadi, S. S., Heshmat, R., et al. (2016). Effect of LI4 and BL32 acupressure on labor pain and
delivery outcome in the first stage of labor in primiparous women: A randomized controlled trial. Complementary Therapies in Medicine,
29, 175–180.
 Pilliteri, Adele. (2013). Maternal and child nursing: Care of the childbearing and childrearing family. 8th ed. New York:
Lippincott Williams and Wilkins
 Smith, C. A., Levett, K. M., Collins, C. T., et al. (2011). Relaxation techniques for pain management in labour. Cochrane
Database of Systematic Reviews, (12), CD000111.
 Stark, M. A., Remynse, M., & Zwelling, E. (2016). Importance of the birth environment to support physiologic birth. Journal
of Obstetric, Gynecologic & Neonatal Nursing, 45(2), 285–294.
 WHO (2018). Recommendation on manual techniques for pain management during labour.
Retrieved from. https://extranet.who.int/rhl/topics/preconception-pregnancy-childbirth-and-postpartum-
care/care-during-childbirth/care-during-labour-1st-stage/who-recommendation-manual-techniques-pain-management-during-labour
THAT’S ALL AND….
THA
NK
YOU
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