Labor Pain Clinical Trial
Official title:
Effect of Hot Pack on Labor Pain, Duration of Labor, and Satisfaction of Primigravidae Women in Saudi Arabia
The study aimed at determining the effect of hot pack on labor pain reduction and the
duration of labor in comparison with routine care. Further, the study also aimed at
determining the women's satisfaction with the use of hot pack and with routine care
with hypotheses: H1: Primigravid women who received hot pack in the active phase of labor
will have a significantly lower mean labor pain score than those who received routine care.
H2: Primigravid women who received hot pack in the active phase of labor will have
significantly shorter mean labor duration than those who received routine care.
Childbirth pain is the severest type of pain that women experience in their life. Therefore,
effective management of labor pain is essential. There are various methods to control
childbirth pain: pharmacological and non-pharmacological such as Entonox and heat therapy
respectively. In most Saudi Arabian hospitals, Entonox is used as routine care, while non-
pharmacological agents are rarely used. Various forms of heat therapy are effective in labor
pain reduction and shortening the duration of labor. There is a dearth for studies that
compare the effectiveness of the hot pack with routine care that includes use of Entonox.
Objectives
- To determine the effect of the hot pack on labor pain reduction among primigravid women.
- To determine the effect of the hot pack on the duration of labor among primigravid
women.
- To determine the satisfaction of primigravid women regarding hot pack and routine care.
Methods The study was conducted in Armed Forces Hospital Southern Region, with randomized
sample of 91 primigravidae with normal pregnancy in active phase of first stage of labor,
with cervical dilatation of 6 - 8 cm. This randomized controlled trial consisted of two
groups: the experimental group (n = 45) who received hot pack. The control group (n = 46)
received routine care including Entonox. Labor pain was assessed by Visual Analogue Scale for
pain intensity (VAS); duration of labor was measured by the WHO modified partograph, and
women's satisfaction was assessed using a satisfaction scale. Following eligibility
assessment, participants were selected and allocated to the groups randomly. After obtaining
the written informed consent, the initial assessment was done; the experimental group
received hot pack, and the control group received routine care until delivery. The baseline
pain score was assessed before the intervention and every 30 minutes after the intervention
until delivery. The duration of labor was assessed using the WHO Partograph. The women
reported satisfaction two hours post-delivery using the satisfaction scale.
Results:
Before the intervention, the experimental and control group did not differ statistically in
terms of labor pain score (p = .820). Post-intervention, the labor pain score was
significantly lower in the experimental groups (p ≤ 0.05) compared to the control group at
30, 60, 90, 120, 150 and 210 minutes. The duration of the first, second, and third stages of
labor was not significantly different among both groups (p ≥ 0.05). The overall mean
satisfaction scores were significantly higher in the experimental group compared to the
control group (p ≤ 0.05), the mean scores of two items, one on happiness with the care
received, and the other with the delivery experience were not significantly different between
both groups (p ≥ 0.05).
Conclusion:
Heat therapy, such as the hot pack is a non-pharmacological method for labor pain management.
Heat therapy is effective in reducing labor pain. Although it has been not effective in
shortening the duration of labor, women are satisfied with the use of hot pack. This finding
could be useful in formulating policies regarding implementation of the non-pharmacological
methods for labor pain management. It is essential to educate healthcare professionals
regarding the benefits of heat therapy even before implementing a change.
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