II. Management: Beneficial Measures

  1. Any Stage of Labor
    1. Continuous Labor Support (Doula)
      1. Decreases obstetric interventions
    2. Hypnosis in Labor
      1. Decreases pharmacologic Pain Management in Labor
  2. First Stage of Labor
    1. Warm water baths
      1. Mixed results on efficacy in studies
      2. Safe option for limited period (<1-2 hours)
      3. Wait until active labor (cervical dilation >5 cm)
      4. Keep water Temperature less than Body Temperature
      5. Typically used in First Stage of Labor, but may be used in second stage
      6. Cluett (2018) Cochrane Database Syst Rev (5): CD000111 +PMID:19370552 [PubMed]
    2. Upright Positioning (head above hips)
      1. Lawrence (2013) Cochrane Database Syst Rev (10): CD003934 +PMID:24105444 [PubMed]
    3. Acupuncture
      1. Variable evidence in decreasing need for assisted Vaginal Delivery and Cesarean Section
    4. Intradermal sterile-water injections in sacral area
      1. Four 1 ml injections in various regions of Sacrum
      2. Causes local burning (counterirritation)
      3. Limited evidence from small studies
      4. Derry (2012) Cochrane Database Syst Rev (1):CD009107 +PMID:22258999 [PubMed]

III. Management: Unclear efficacy or disproven (small, inconclusive or negative studies)

  1. Lumbosacral Massage
  2. Warm showers
  3. Exercise Ball
  4. TENS Unit
  5. Aromatherapy (no proven effect)
  6. Audioanalgesia (no proven effect)

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