Update on Nonpharmacologic Approaches to Relieve Labor Pain and Prevent Suffering

Penny Simkin, PT; April Bolding, PT

Disclosures

J Midwifery Womens Health. 2004;49(6) 

In This Article

Aromatherapy

Aromatherapy is "the science of using highly concentrated essential oils or essences distilled from plants in order to utilize their therapeutic properties."[64] For the purposes of this article, we focus on the use of essential oils to reduce anxiety and pain in labor. Aromatherapy for these purposes has not been studied with properly controlled trials. This modality is included here because its use in maternity care is increasing, and experts state that "Essential oils are as potent as pharmacological drugs and are equally open to misuse or abuse, whether intentional or not," and, "… until more clinical research trials have been undertaken it would be prudent for midwives to work cautiously with essential oils, using the lowest possible dose and on the least number of occasions."[64]

Effectiveness of Aromatherapy in Reducing Pain and Suffering During Labor

One large, uncontrolled prospective study[65] reported on the use and effectiveness of aromatherapy in a large referral maternity unit in the United Kingdom over an 8-year period between 1990 and 1998. During this time, 8058 women received aromatherapy during labor under the supervision of midwives trained in aromatherapy. It was used for a variety of purposes: to reduce fear, anxiety, and pain; to reduce nausea or vomiting; to enhance women's sense of well-being; and to improve contractions.

Meticulous records were kept regarding the oils used, the mode and timing of administration, and reasons for use. Mothers and midwives reported on the effectiveness of the oils in accomplishing the purpose for which it was given.

Sixty-one percent of the women received aromatherapy (lavender, rose, or frankincense) to relieve anxiety and fear. Fifty percent of both mothers and midwives found it helpful, and 13% found it unhelpful. Rose oil was rated helpful by most (71%), followed by lavender (50%). Lavender and frankincense were used for pain by 537 women, of whom 54% found lavender helpful and 64% found frankincense helpful.

Essential oils have a range of possible adverse effects on the woman, as well as on others in the room, because they are volatile and produce vapors that are inhaled by everyone in the vicinity. One percent (n = 100) of women in the study[65] reported undesired effects associated with the use of aromatherapy; all were minor (nausea, rash, headache, or rapid labor). It is not clear whether they were caused by essential oils, other factors, or by labor itself.

In conclusion, aromatherapy is inexpensive and popular with laboring women and midwives. One large uncontrolled study reported that the majority of users found it helpful in reducing pain and anxiety. On the basis of these findings, and its increasing popularity, this modality merits further scientific study to establish its rightful place in maternity care.

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