Effectiveness of non-pharmacological procedures for pain relief in parturients: contributions to obstetric nursing

This study approached the use of non-pharmacological procedures for pain relief in parturients. The general objective was to know the effectiveness of three non-pharmacological procedures: the use of ice; the use of heated water through the bath; and the use of lumbar region massage in pregnant women, regarding its ability to produce pain relief in the active phase of labor. The specific objectives were: to measure the self-reported pain intensity by parturients before, during and after each application of non-pharmacological procedures; to analyze numerical scores related to pain relief and to describe the evaluations of parturients about the effects produced by non-pharmacological procedures. The thesis is: The use of ice, warm water through a shower bath or massage in the lower back of pregnant women, when employed as non-pharmacological procedures in the active phase of labor, are effective in producing pain relief. At the same time, it contributes to the physiological evolution of labor and delivery. It was based on the principles of de-medicalization and the use of non-pharmacological procedures recommended by the World Health Organization and ratified by the Ministry of Health in Brazil. This is a prospective, nonrandomized intervention clinical study that used a numerical scale as a tool to measure self-reported pain in parturients before, during and after each application of one of the non-pharmacological procedures. The results showed that: Most of the parturients preferred the application of lumbar massage (n=21) and spray bath (n=17). The use of ice was performed in seven parturients. It was observed that the amount of owmen who described increasing pain did not exceed those who described pain relief, mainly when the cervical dilation was at 9cm. It can be observed from the description of the behaviors of the parturients that few mentioned fear and most of them said they were confident and feeling well. Some women dozed off and the majority walked freely. Only eight parturients (17.7%) asked for interruption after the intervention was applied for the first time and the vast majority (91.1%) reported satisfaction with the procedure applied. Regarding the baby, none of them needed aspiration, oxygen resuscitation, tracheal intubation, cardiac massage or medication resuscitation. No cases of bradycardia or deceleration of the fetal heartbeat were detected. After delivery, all parturients were referred to the rooming-in with their babies with no needs for urgent care or hospitalization in risk care sectors. Confirming the proposed thesis, the study concluded that non-pharmacological procedures were effective in producing pain relief of parturients, and are instruments that facilitate the physiological and natural action of the female organism in labor.