Ice Massage for the Reduction of Labor Pain

Bette L. Waters, CNM, RN, Jeanne Raisler, CNM, DrPH, FACNM

Disclosures

J Midwifery Womens Health. 2003;48(5) 

In This Article

Discussion

The study intervention ended on the completion of posttest 1. No attempt was made to monitor the participants' continued use of the ice massage or to change their minds about using medication. None of the participants viewed the technique as a tool to replace the use of narcotic or epidural pain relief. Three of the participants had cesarean birth, and several had labor augmentation with intravenous (IV) oxytocin following the ice massage. One participant had IV analgesia and continued to use ice massage administered by family members for 12 more hours until she was completely dilated. All of the study participants had good outcomes with normal Apgar scores.

Whatever intervention one uses, labor pains grow closer together and more intense. It should be noted that the ice massage was performed in the early hours of labor, and the effects may not be generalized to pain control later in labor. The convenience sample also restricts the study's generalizability. Other limitations are that the study was not randomized and the protocol precluded interobserver comparisons. Finally, interventions from another healing tradition (e.g., Shiatsu-based ice massage) can seem culturally foreign to Americans who may be uncomfortable using them. In this study, the application of ice massage to the Shiatsu energy meridian point, LI4, was a noninvasive, effective tool to help reduce the intensity and unpleasantness of pain from early labor contractions. It was more effective on the left hand for most of the women.

Over the years, the search for answers to controlling labor pain has focused on drugs that alter mental and sensory awareness of pain with noxious side effects of the partial paralysis of epidurals, the confusion of opiates, and the total absence of memory in the use of scopolamine. Midwife deliveries take place in homes, birthing centers, and in hospital settings where women may choose from multiple pain control methods. Dr. Reynolds[30] most astutely notes that most women in the world in remote and rural areas and Third World countries do not have access to medical procedures and drugs. Therefore, any technique that provides safe, effective pain reduction without serious side effects and that can be given by any health care professional is a definite advance. The results of this preliminary study suggest that ice massage of the LI4 may be in this category and can safely be added to the many other tools used by midwives, nurses, and physicians. Further research about this technique is warranted.

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