Psychophysical Approaches to Analgesia During Labor and Delivery
What is non medical method to address labor pain ?
@laia Patient education, a supportive environment, and training with nonpharmacologic analgesic techniques all appear to positively affect labor pain, particularly during the latent (early first stage) phase.
Three distinct psychophysical techniques have been developed as a means of facilitating the birth process and making it a positive emotional experience: "natural childbirth," psychoprophylaxis, and hypnosis.
Hypnosis for pain relief depends on the power of suggestion and has achieved periodic spurts of popularity since the early 1800s but has never gained wide appeal. Dick-Read developed the so-called natural childbirth method in the early 1930s and popularized in his book, Childbirth Without Fear. Dick-Read's approach emphasized the reduction of tension to induce relaxation. The psychoprophylactic technique was developed by Velvovski, who published the results of his work from Russia in 1950. Velvovski showed that obstetric psychoprophylaxis was a useful substitute for poorly administered labor anesthesia of the era. This concept of focused relaxation was later introduced in France by Lamaze and popularized in the United States by Bing and is now one of various relaxation techniques taught in childbirth classes
These techniques can significantly reduce anxiety, tension, and fear. They provide the parturient with a valuable understanding of the physiologic changes that occur during labor and delivery. In addition, they provide an opportunity for closer understanding and communication between the patient and her partner, who may be an important source of comfort.
Studies undertaken to assess the effectiveness of psychophysical techniques have reported widely divergent results. There have been no randomized controlled trials, but uncontrolled reports have suggested these methods may be helpful for nulliparous patients, with effectiveness ranging from as low as 10%-20% to as high as 70%-80%. These studies have not shown benefit for multiparous patients. Childbirth relaxation techniques have not been shown to reduce the incidence of epidural use during labor. The overall benefit is best judged by the parturient herself.
None of these psychophysical techniques should be forced on a patient, even by a skillful practitioner. The patient must not be made to feel that she has failed if she does not choose to complete her labor and delivery without analgesic medication. It must be made clear to the patient from the outset that she may ask for help if she feels she wants or needs it.