Non-pharmacological methods for pain relief during labor: integrative review

Abstract

RESUMOA presente revisão integrativa objetivou a busca de evidências disponíveis na literatura que abordem os métodos não farmacológicos para alívio da dor durante o trabalho de parto por meio de pesquisa nas bases de dados LILACS, SCIELO, BDENF e PUBMED. Na literatura levantada incluemse 19 estudos publicados entre os anos de 2003 e 2013, que avaliaram: a eletroestimulação transcutânea, a técnica de exercício respiratório, a deambulação ou mudança de posição, a massagem, o relaxamento muscular, a hidroterapia, a crioterapia e a assistência da doula. Os resultados demonstraram que o uso da eletroestimulação transcutânea é mais recorrente no período referente ao início da primeira fase do trabalho de parto; outros métodos associados (massagem lombossacral, exercício respiratório e relaxamento), a hidroterapia e a crioterapia propiciaram, por seu turno, a redução dos escores de dor na fase ativa; enquanto que a presença da doula foi considerada importante para a transmissão de segurança e confiança às parturientes. Assim, tais métodos conduzem para a conclusão de que valorizar a liberdade da mulher, oferecendo-lhe alternativas e medidas de conforto, é uma importante via na assistência à parturiente em seu trabalho de parto.

Non-invasive care technologies: nurses' contributions to the demedicalization of health care in a high-risk maternity hospital

“…[4][5][6]23 From the perspective of safety and health quality, scientific evidence confirms that using TNICEO is associated with a positive experience of parturition and birth, and presents favorable maternal and fetal outcomes, such as: facilitating the release of endogenous oxytocin; allowing light movement and enlargement of the pelvis diameter, helping the baby to come out and fetal rotation through the birth canal; favoring dilation of the uterine cervix; minimizing pain, from the release of catecholamines and the elevation of endorphins; facilitating the progression of the active phase; improving blood flow and oxygenation of tissues; promoting relaxation; and reducing anxiety, stress and fear. 7,9,12,[34][35][36][37][38] Seen that, it was observed that obstetrics nurses in this study develop a care process with demedicalized characteristics and focus on sensitive work, from the use of TNICEO, especially those classified as soft. Thus, parturients and their subjectivities are placed in the centrality of high-risk maternity care, where, commonly, the valorization of biomedical pathology and knowledge forms a prescriptive and interventionist logic about parturition, focusing on rough work and hard technologies.…”

Obstetric Nursing in best practices of labor and delivery care

“…NPM reduce parturient stress and anxiety levels and promote greater satisfaction (29) . It is important to emphasize and value the autonomy of women in LA, since each one faces this phase differently (30) .…”

Obstetric practices performed by nurse-midwives of a hospital natural birth center

“…2,3 It is important to emphasize that one of the benefits of alternative therapies for pain management is to give women the freedom to choose a measure of comfort that best fulfills their need. 18 In addition, these practices and the freedom of position and movement during the labor, present in 83.0% of the records, are associated with relaxation, reduction in the number of interventions and reduction of the duration of the labor. [19][20][21][22] The partograph was used by 98.3% of the nurses, emphasizing its importance in the prevention of complications, interventions and surgical deliveries, as directed by the Guidelines for Natural Childbirth Care of the MH 23 , an important document that seeks to qualify childbirth care in Brazil through the use of evidencebased practices.…”