Update on Nonpharmacologic Approaches to Relieve Labor Pain and Prevent Suffering

Penny Simkin, PT; April Bolding, PT


J Midwifery Womens Health. 2004;49(6) 

In This Article

Relaxation and Breathing

Most childbirth education classes and most books on childbirth present relaxation techniques, along with a variety of rhythmic breathing patterns intended to complement and promote relaxation or to provide distraction from labor pain. They are also used to enhance a woman's sense of control.[72,73] As stated above, the thoroughness of the teaching along with the amount of time devoted to rehearsing these techniques vary widely, from a quick mention or demonstration to repeated practice and adaptation to the individuals' preferences, with goals of mastery and confidence.

Effectiveness of Relaxation in Reducing Pain and Suffering During Labor

A recent survey of American women who gave birth between 2000 and 2002[38] found that 61% of the respondents used breathing techniques, and of those, 69% rated them as "very" or "somewhat" helpful, while 30% rated them as "not very helpful" or "not helpful at all." This finding may be a reflection of the quality of the teaching received by the women, or the fact that breathing techniques are not helpful for everyone. An older survey of British women found that 88% of women who reported using relaxation found it to be "good" or "very good."[74] Relaxation and breathing techniques have not been studied as independent variables in RCTs. It is not surprising that a recent report on women's use of these techniques found that women begin to use them more during early labor, but discontinue if or when they receive pain medications.[75]

There are no known drawbacks to the use of relaxation and breathing techniques, except that women sometimes expect more pain relief than they actually get from them during labor, and they express disappointment.

Relaxation and breathing may contribute more to a woman's ability to cope with labor pain than to actually reduce that pain. The high satisfaction expressed by large majorities of surveyed women justifies their continued inclusion in childbirth classes and encouragement of their use by maternity staff.


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