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Post-partum massage: an underrated, yet very good idea

Submitted by RST on Sun, 10/16/2011 - 11:08
Posted in

Over at his joint, Dale Favier does an awesome job of combining the physiological facts of pregnancy and the post-partum period with his capacity for empathy with the new mother's experience.

He synthesizes those universal and unique aspects into a persuasive argument in favor of post-partum massage.

Check it out over at Portland Home Massage: Postpartum Massage.

Fetal activity following stimulation of the mother's abdomen, feet, and hands (Diego 2002)

Submitted by RST on Wed, 08/10/2011 - 15:20
Posted in

Diego MA, Dieter JN, Field T, Lecanuet JP, Hernandez-Reif M, Beutler J, Largie S, Redzepi M, Salman FA. Fetal activity following stimulation of the mother's abdomen, feet, and hands. Developmental Psychobiology. 2002 Dec;41(4):396-406.

 

Abstract: Fetal activity during midgestation (M fetal age=19.8 weeks) was studied in response to vibratory stimulation of the mother's abdomen (at the height of the fetal head), foot massage, hand massage, or control condition (no stimulation). Consistent with previous research conducted during midgestation, the fetuses of mothers who received two trials of 3-sec, 60-Hz vibratory stimulation did not show changes in movement. In contrast, the fetuses of mothers who received a 3-min foot massage showed greater movement than the control fetuses. However, stimulating the mother's hand (another highly innervated area) did not increase fetal activity. By late gestation (M fetal age=35.4 weeks), vibratory stimulation resulted in increased fetal activity. These findings replicate previous research indicating that vibratory stimulation to the mother's abdomen does not elicit fetal activity until later in gestation. Furthermore, our findings indicate that stimulating the mothers' feet, but not the hands, can evoke fetal activity in midgestation.

 

 

Why is fetal movement in response to vibration a good thing?

Vibratory stimulation has been shown to affect fetal activity, breathing, heart rate (Devoe, 1999; Gagnon, Hunse, Carmichael, Fellows, & Patrick, 1986; Kisilevsky, Muir, & Low, 1990; Smith, 1995), and behavioral state (Gagnon, Hunse, & Foreman, 1989; Kasahara, 1991). The ability of vibratory stimulation to elicit fetal activity has prompted its use in the antepartum assessment of fetal well-being (Devoe, 1999; Smith, 1995). Fetuses who respond to vibratory stimulation have better biophysical profiles (Inglis, Druzin, Wagner, & Kogut, 1993; Sarinoglu, Dell, Mercer, & Sibai, 1996), and fetal movement has been correlated with fetal well-being, (Sadovsky, 1981). Furthermore, vibratory stimulation has been used to test fetal hearing (Ke, Gu, & Wu, 1995), and procedures measuring habituation to vibratory stimulation have been suggested as a means to test fetal central nervous system function in utero (Devoe, 1999; Kuhlman, Burns, Depp, & Sabbagha, 1988).

 

Type of article

Controlled trial; apparently not randomized

 

PMID

12430163

Patient/client

  • 160 women (n=160)
    • Study 1: Mid-gestation vibratory stimulation
      • n=40
      • second trimester of pregnancy
    • Study 2: Late-gestation vibratory stimulation
      • n=40
      • third trimester of pregnancy
    • Study 3: Foot massage
      • n=40
      • second trimester of pregnancy
    • Study 4: Hand massage
      • n=40
      • second trimester of pregnancy

 

Condition

pregnancy

 

Inclusion criteria

  • attending prenatal clinic at university hospital
  • pregnancy
    • average gestation 19.8 weeks
    • fetus was normal on ultrasound evaluation

 

Exclusion criteria

  • nonsmoking
  • not drinking alcohol
  • not taking medications other than vitamins
  • no multiple pregnancies
  • no pregnancy complications

 

Control

  • Vibration: baseline readings from mothers during rest served as control
  • Massages:
    • mothers lie in the left lateral recumbent position
    • rest quietly for 3 min

 

Sign(s)/symptom(s)

N/A

 

Anatomy

...of the condition

  • Uterus

...of the sign(s)/symptom(s)

  • N/A

...of the treatment 

  • Abdomen or hand or foot

 

What was measured

  • Fetal movement in response to massage

 

Treatment location

  • Outpatient prenatal clinic at university hospital

Treatment routine: Study 1

The vibratory stimulation procedure consisted of placing a hand-held, commercially available vibrator (Conair HM11BT) on the mother’s abdomen via a bulb-shaped rubber probe with a 12.5 cm2 contact surface area. The vibrator produced a 60-Hz vibration and a 40-dB airborne sound level 1 m from the source. When the fetus showed no movement, the vibrator was placed at the height of the fetal head and activated for 3 sec. Two stimulation trials were conducted for all fetuses in Study 1 midgestation vibratory stimulation and Study 2 late-gestation vibratory stimulation.

Treatment routine: Study 2

same as Study 1 for 3rd trimester

 

Treatment routine: Study 3

Routine based on

not specified

Frequency

N/A: 2 successive trials

Position

  • therapist at the foot of the table
  • mother in a left recumbent position

Pressure

not specified

Sequence/Duration

  1. Stretching the feet by holding the ankle with one hand and pulling the top of the foot toward the therapist with the other hand (5 sec)
  2. Intermittently squeezing the feet starting at the heel and moving toward the toes by holding both feet with the thumb on the top and the other fingers on the soles of the feet (20 sec)
  3. Using both hands on one foot at a time, applying pressure to the arch with the thumbs and then using the thumbs to rub between each toe using an up (toward the web of the toe) and down (toward the end of the toe) motion (30 sec, two times)
  4. Kneading the bottom of each foot (20 sec, two times) and then the top of the foot, one foot at a time (20 sec, two times)
  5. Flexing and extending each foot and then flexing and extending all toes on one foot at a time (3 sec)
  6. Squeezing foot, moving from the heel to toes one foot at a time (5 sec)
  7. Finger stroking the entire top and bottom of foot with all five fingers one foot at a time (7 sec).

Support

not specified

 

Treatment routine: Study 4

Routine based on

not specified

 

Frequency

N/A: 2 successive trials

 

Position

  • therapist at the side of the table
  • mother in a left recumbent position

 

Pressure

not specified

 

Sequence/Duration

  1. Holding the wrist with one hand and with the hand pushing against the fingers and palm of the participant’s hand (5 sec)
  2. With both hands briskly stroking the top of the mother’s hand (10 sec)
  3. With the thumb on top of the hand and the other fingers on the palm intermittently compressing both hands at the same time starting at the pinky and moving toward the thumb (10 sec)
  4. Finger stroking the entire back of the hand from the fingers to the wrist (10 sec)
  5. Using the thumb and the forefinger to squeeze each finger (20 sec)
  6. Stretching each finger by completely encircling each finger with the therapists’ fingers and gently pulling fingers away from the hand (20 sec)
  7. Intermittently applying pressure to one hand at a time from the center to the edge of the hand (10 sec)
  8. Holding the wrist with the left hand and with the right hand, gently pulling the hand away from the wrist (5 sec).
 

Support

not specified

 

Therapist training

not specified

 

Therapist experience

not specified

 

Other therapist factors

not specified

 

Other factors

not specified

 

Research question/hypothesis

  • Vibratory abdominal stimulation, hand massage, and foot massage will cause fetal movement in normal pregnancy.

 

Findings/results

  • All the mothers showed decreased anxiety, which the authors state is probably due to reassurance about the pregnancy gained from the ultrasound evaluation.
  • Vibratory stimulation to the abdomen caused movement in fetuses in later pregnancy, but not in early pregnancy.
  • Foot massage caused increased fetal movement, but hand massage did not.

 

Specialty

  • Obstetrics
  • Neonatology

 

Affiliation

  • Touch Research Institute, University of Miami School of Medicine, Miami, Florida, USA

 

Funding

  • NIMH Senior Research Scientist Award (MH 00331);
  • NIMH merit award (MH 46586) to Tiffany Field;
  • funding from Johnson & Johnson
 

MeSH terms

Abdomen/physiology*

Adult

Analysis of Variance

Anxiety/psychology

Female

Fetal Movement/physiology*

Foot/physiology*

Hand/physiology*

Humans

Male

Massage*

Physical Stimulation

Pregnancy

Relaxation/psychology

Vibration*

 

Background

Understanding the response of a fetus to stimulation before birth is important for two reasons—for one, the fetus may be affected by the stimulation, and for that reason, knowing what effect (positive or negative) the stimulus has on the fetus can be useful in determining whether a particular intervention on the mother is helpful or harmful to the fetus.

For another, even if it is not in direct response to a stimulus, fetal activity can be another indicator of the well‐being and development of the fetus—since we cannot measure those factors directly before birth, we measure them indirectly through the movement and activity of the fetus, which we observe through the mother’s perceptions, and through imaging and other technologies.

As the fetus grows and develops, activity should continue to increase; nurse-midwives, obstetricians, and other birth professionals look at that activity as an indirect indicator of how the fetus is progressing.

Summary

In order to better understand fetal response to stimulation, the authors designed a study that looked at the effects of four kinds of maternal stimulation on the fetus:

  1. vibration with a mechanical hand‐held vibrator held at the level of the fetus’ head in early pregnancy,
  2. the same vibration treatment in later pregnancy,
  3. massage to the mother’s feet, and
  4. massage to the mother’s hands.

They found that vibration in early pregnancy did not stimulate fetal movement, while in later pregnancy it did.

The hand and foot massage produced surprising results. The foot massage stimulated fetal activity, while hand massage did not stimulate fetal activity.

Discussion

An interesting aspect of this study is that, unlike in most of the studies we review, there are actually 2 different client/patients here—the massage is performed on the mother, yet the effect of the massage is demonstrated by the fetus. For this reason, while most of the studies we classify will be clearly under “pregnancy massage” or under “infant massage”, because of who the patient is, we classify this one under both categories for both client/patients.

This study is intriguing because, in massage school, we are often taught that certain strokes or areas of the body are to be avoided, because of the possibility of inducing premature contractions. This study relates to that topic by demonstrating that certain massage stimulation to the mother can indeed directly cause response by the fetus. It does not fully connect the dots on what we are taught, but it indicates that the question is possible to study.

The authors review possible mechanisms involving neurohormones and neurotransmitters in studies on fetal response to maternal stimulation, including acupuncture and exercise, as well as anecdotal/empirical observations by midwives. They state "Massage therapy has been shown to affect maternal cortisol and cathecholamine [sic] levels (see Field, 1998, for review) and may have similar physiological effects to certain forms of exercise.".

In light of the new evidence by Moyer 2011 (click here to see it reviewed in Journal Club), however, the claim about cortisol has been shown to have been the result of a non-standard analysis. When the data is analyzed in the standard way, the effect that massage is supposed to have on cortisol disappears. Although the effect of massage on catecholamines has not be analyzed in the same way, it is safe to assume that the evidence for this outcome is a result of the same type of non-standard analysis, and remains to be demonstrated with standard methodology.

They admit that they find their results “perplexing”, as a 3‐minute foot massage to the mother caused significant fetal movement, while the mother’s hands, although containing a similar number and density of nerves as the feet, did not show a significant effect, contrary to their expectation that the result would be similar. The difference in results is not due to a difference in position of the mother during the massage, as they specified that the women lay on their left side for both the hand and foot massages.

In order to explain these results, they discuss their power analysis, which they used to determine how many mother‐fetus pairs to study, and conclude that a larger sample, or a longer massage, with a different type of study design, may have been more accurate at determining

Similarly, they differentiate the effects of vibratory stimulation in younger and older fetuses, and point out that this may have a confounding effect on the study design. They propose future studies directly observing the effects of hand and foot massage on the mothers’ physiology, to determine whether there are direct biochemical changes in the mothers which would account for the observed effects, as well as to determine whether, in a larger study sample, the hand massage would indeed show a similar effect as the foot massage did--whether there really was no effect from the hand massage, or whether there was one, which was missed.

 

 

Pregnancy

Submitted by RST on Sat, 02/26/2011 - 04:10
Posted in

 


 

 

 

Foundational information

 

Visualization

 

Discussion

 

References

 

 

Pregnancy

 

patient is being treated for symptom by modality in anatomic location in condition by specialist in institution

 

 

 

 

Study

Population

Outcomes

Page

Mynaugh 1991

 

 

 

Vago ????

 

 

 

Elliott ????

 

 

 

Labrecque 1994

 

 

 

Belluomini 1994

 

 

 

Storr 1988

 

 

 

Simkin 1995

 

 

 

Stiles 1980

 

 

 

Field 1999a

 

 

 

Field 1997a

 

 

 

Renfrew 1998

 

 

 

 

Clinical scenario

 

Mynaugh 1991

 

Mynaugh PA. 1991. A randomized study of two methods of teaching perineal massage: effects on practice rates, episiotomy rates, and lacerations. Birth 18(3):153-9.

 

Patient

83 healthy primiparas, + 25-36 weeks gestation, + uncomplicated vaginal delivery

Symptom

episotomy or laceration risk

Anatomy

perineum

Condition

pregnancy

Specialty

obstetrics, midwifery, childbirth education

Institution

childbirth education class

IV

video demonstration of perineal massage

DV

rate of perineal massage practice, rate of episiotomy, severity of lacerations

Control

printed and verbal instructions on perineal massage

Hypothesis

Delivering instruction on perineal massage via video in addition to printed and verbal instructions will have an effect on practice rates, episiotomy rates, and laceration rates.

Findings

Episiotomy and laceration rate not affected by teaching method. Practice rates almost doubled in experimental group, but not statistically significant.

 

Comments: This is not a study of massage, but rather a study of massage education—it contrasted a video demonstration of perineal massage with the traditional verbal instructions and printed information packet. The experiment appears well-designed, and the thoughts behind the methodology and statistics are explained in detail. Her conclusion is that the intervention made no difference in rates of practice, episiotomy, or laceration. However, this serves to illustrate the principle that statistical significance is not always the same as practical difference: practice rates almost doubled in the experimental group (p = 0.08), 5% fewer women in the experimental group had episiotomies than in the control group, and the ratio of severe to minor lacerations in the experimental group was half as high as in the control group (although the experimental group experienced more severe lacerations. Although she is careful to explicitly repeat that none of these changes are statistically significant, as a clinician, I might consider whether they indicate a trend. Certainly they are worth following up in a study to find whether they can be made stronger or actually disproved. Remember the previous discussion about how a high p value does not necessarily disprove the hypothesis, it just means that the researcher has not succeeded in proving it.

 

Mynaugh raises some good points in her discussion about limitations of the study which could have interfered with her methods. The women’s practice of perineal massage did not affect the physicians’ decisions about whether to perform episiotomies, and so there was not a direct causal link from intervention to outcome. In fact, several women reported negative remarks about perineal massage by physicians, which affected the women’s compliance, and may possibly indicate a bias toward episiotomy on the part of the physicians. The hospital’s IRB (ethics board) limited the study, so that rather than a randomized controlled trial where the control group received no instruction, every woman in the study had to receive some kind of instruction. Therefore, there would have had to have been a much larger difference between the video and the standard instruction to register the treatment effect. Finally, Mynaugh points out that the classes the women were drawn from were what was randomized, rather than the women, which may have affected the study. All in all, an interesting study which did not succeed in proving its hypothesis, but whose results are intriguing enough to indicate that a followup study would be worthwhile.

 

 

 

 

 

 

 

Vago ???? "Breast stimulation to ripen cervix", T. Vago, MD; A. Jhirad, MD. American Journal of Obstetrics and Gynecology, Volume 149, Number 5.

 

\begin{itemize}

\item Patient:

\item Symptom:

\item Anatomic location, body part or region:

\item Disease, condition, or syndrome:

\item Medical specialty:

\item Institution, treatment location:

\item IV:

\item DV:

\item Hypothesis:

\item Population:

\item Findings:

\item Comments:

\end{itemize}

 

{Affiliation-}

{Author-Vago, T.}

{Author-Jhirad, A.}

{Journal-American Journal of Obstetrics and Gynecology }

 

 

 

 

 

 

Elliott ???? "Reply to Vago and Jhirad", John P. MD. American Journal of Obstetrics and Gynecology, Volume 149, Number 5. Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, Good Samaritan Medical Center, Phoenix, AZ.

 

\begin{itemize}

\item Patient:

\item Symptom:

\item Anatomic location, body part or region:

\item Disease, condition, or syndrome:

\item Medical specialty:

\item Institution, treatment location:

\item IV:

\item DV:

\item Hypothesis:

\item Population:

\item Findings:

\item Comments:

\end{itemize}

 

 

 

 

 

 

 

 

 

 

 

Labrecque 1994 Birth 1994 Mar;21(1):20-5 Prevention of perineal trauma by perineal massage during pregnancy: a pilot study. Labrecque M, Marcoux S, Pinault JJ, Laroche C, Martin S.

 

Although the performance of perineal massage by a woman or her partner during the last weeks of pregnancy may help to prevent perineal trauma at delivery, the technique has never been evaluated rigorously. This study examined the feasibility of a randomized, controlled trial, and more specifically assessed the participation rate, the acceptability of the intervention, and whether or not an attending physician could remain blind to participants' groups. The pilot study was a single-blinded, randomized, controlled trial. Nulliparous women, 32 to 34 weeks pregnant, were recruited from June 8 to July 31, 1992, at the offices of family physicians and obstetricians who practice at the Hopital du Saint-Sacrement in Quebec City. Women assigned to the intervention group practiced daily 10-minute perineal massage and completed a diary, and those in the control group had standard care. Women and attending physicians completed a questionnaire about the aspect of blindness. Among the 174 women who delivered during the study period, 104 (59.8%) were approached by a midwife and 46 (26.4%) were randomized. Twenty (91.0%) of the 22 women in the massage group returned their perineal massage diaries. Based on the postpartum questionnaire, 20 women practiced the technique at least four times a week for three weeks or longer. No woman in the control group practiced massage. The attending physician was aware of the woman's group in only three instances (6.7%). Based on the results of this pilot study, a randomized, controlled trial to evaluate the efficacy of perineal massage in preventing perineal trauma at birth appears feasible.

 

Pregnancy and massage Michel Labrecque, MD, MSc; Sylvie Marcoux, MD, PhD; Jean-Jacques Pinault, MD; Christine Laroche, SFD (Fr); and Sylvie Martin, BSc. "Prevention of Perineal Trauma by Perineal Massage During Pregnancy: A Pilot Study", Birth, 21:1, March 1994, pp. 20-25. Purpose: To examine the feasibility of a randomized, controlled trial, participation rate, acceptability of the intervention, and whether or not an attending physician could remain blind to participants' groups. Intended audience: Birth professionals Focus: Exclusively massage Modalities: Perineal massage Scope of practice: No Author affiliation: Department of Family Medicine, Laval University, Québec City, Québec, Canada; Department of Preventive and Social Medicine, Laval University, Québec City, Québec, Canada; Department of Gynecology and Obstetrics, Hôpital du Saint-Sacrement, Québec City Disclosures: Supported by the Fonds de la recherche en santé du Québec, and by Rougier, Inc. Type of study: Single-blinded, randomized controlled trial References: 26 references Animal study: no Language: English Location: Québec, Canada Population: 174 nulliparous women, 32 to 34 weeks pregnant Frequency/duration: 10-minute perineal massage once daily; diary Measurement, objective: Caesarean rate Measurement, subjective: questionnaire, diary Outcome: Caesarean rate in massage group was 18.2%; caesarean rate in control group was 21.7%. Discussion: Perineal massage was very acceptable to these women. Conclusion: Based on the results of this pilot study, a randomized controlled trial to evaluate the efficacy of perineal massage in preventing perineal trauma at birth appears feasible.

 

Pregnancy and massage Michel Labrecque, MD, MSc; Sylvie Marcoux, MD, PhD; Jean-Jacques Pinault, MD; Christine Laroche, SFD (Fr); and Sylvie Martin, BSc. "Prevention of Perineal Trauma by Perineal Massage During Pregnancy: A Pilot Study", Birth, 21:1, March 1994, pp. 20-25. Purpose: To examine the feasibility of a randomized, controlled trial, participation rate, acceptability of the intervention, and whether or not an attending physician could remain blind to participants' groups. Intended audience: Birth professionals Focus: Exclusively massage Modalities: Perineal massage Scope of practice: No Author affiliation: Department of Family Medicine, Laval University, Québec City, Québec, Canada; Department of Preventive and Social Medicine, Laval University, Québec City, Québec, Canada; Department of Gynecology and Obstetrics, Hôpital du Saint-Sacrement, Québec City Disclosures: Supported by the Fonds de la recherche en santé du Québec, and by Rougier, Inc. Type of study: Single-blinded, randomized controlled trial References: 26 references Animal study: no Language: English Location: Québec, Canada Population: 174 nulliparous women, 32 to 34 weeks pregnant Frequency/duration: 10-minute perineal massage once daily; diary Measurement, objective: Caesarean rate Measurement, subjective: questionnaire, diary Outcome: Caesarean rate in massage group was 18.2%; caesarean rate in control group was 21.7%. Discussion: Perineal massage was very acceptable to these women. Conclusion: Based on the results of this pilot study, a randomized controlled trial to evaluate the efficacy of perineal massage in preventing perineal trauma at birth appears feasible.

 

\begin{itemize}

\item Patient:

\item Symptom:

\item Anatomic location, body part or region:

\item Disease, condition, or syndrome:

\item Medical specialty:

\item Institution, treatment location:

\item IV:

\item DV:

\item Hypothesis:

\item Population:

\item Findings:

\item Comments:

\end{itemize}

 

 

 

Pregnancy and massage. "Prevention of Perineal Trauma by Perineal Massage During Pregnancy: A Pilot Study", , 21:1, March 1994, pp. 20-25. Purpose: To examine the feasibility of a randomized, controlled trial, participation rate, acceptability of the intervention, and whether or not an attending physician could remain blind to participants' groups. Intended audience: Birth professionals Focus: Exclusively massage Modalities: Perineal massage Scope of practice: No Author affiliation:

 

{Affiliation-Department of Family Medicine, Laval University, Québec City, Québec, Canada; Department of Preventive and Social Medicine, Laval University, Québec City, Québec, Canada; Department of Gynecology and Obstetrics, Hôpital du Saint-Sacrement, Québec City}

{Author-Labrecque, Michele}

{Author-Marcoux, Sylvie}

{Author-Pinault, Jean-Jacques}

{Author-Laroche, Christine}

{Author-Martin, Sylvie}

{Journal-Birth}

 

 

 

 

 

 

Belluomini 1994 Citation: "Acupressure for Nausea and Vomiting of PregnancyL A Randomized, Blinded Study", Obstetrics & Gynecology, Vol. 84, No. 2, August 1994, pp. 245-248. Authors: Jenny Belluomini, MSN; Robin C. Litt, MSN; Kathryn A. Lee, RN, PhD; Michael Katz, MD Affiliation: Department of Obstetrics and Gynecology, California Pacific Medical Center; School of Nursing, University of California, San Francisco, California (cross-ref with nausea & vomiting)

 

\begin{itemize}

\item Patient:

\item Symptom:

\item Anatomic location, body part or region:

\item Disease, condition, or syndrome:

\item Medical specialty:

\item Institution, treatment location:

\item IV:

\item DV:

\item Hypothesis:

\item Population:

\item Findings:

\item Comments:

\end{itemize}

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

\begin{figure}[ht]

\vspace{1in}

\epsfig{file=storr87.eps, width=\linewidth}

\end{figure}

 

Storr 1988 J Obstet Gynecol Neonatal Nurs 1988 May-Jun;17(3):203-9 Prevention of nipple tenderness and breast engorgement in the postpartal period. Storr, Gail Blair, RN, MEd. University of New Brunswick, Canada.

 

" Patient: breastfeeding women

" Medical specialty: obgyn

" Body part or region: breast

" Symptom: nipple tenderness, breast engorgement

" Disease or syndrome: none

" Treatment location: clinic

" IV: breast massage

" DV: nipple tenderness, breast engorgement

" Population: breastfeeding women

" Findings: reduced nipple tenderness, reduced breast engorgement

 

A study was conducted to identify an effective preparation method for breastfeeding and to develop measurement tools for nipple tenderness and breast engorgement for use in a clinical setting. Twenty-five subjects served as their own controls by preparing one nipple and massaging one breast, either the left or right, but not the other breast or nipple. Nipple tenderness and breast engorgement were recorded on five-point scales. Analysis of the data revealed that tenderness and engorgement were decreased in the prepared, massaged breast.

 

\begin{itemize}

\item Patient:

\item Symptom:

\item Anatomic location, body part or region:

\item Disease, condition, or syndrome:

\item Medical specialty:

\item Institution, treatment location:

\item IV:

\item DV:

\item Hypothesis:

\item Population:

\item Findings:

\item Comments:

\end{itemize}

 

 

 

 

 

 

 

 

 

 

 

Simkin 1995 Birth 1995 Sep;22(3):161-71 Reducing pain and enhancing progress in labor: a guide to nonpharmacologic methods for maternity caregivers. Simkin P.

 

" Patient:

" Medical specialty:

" Body part or region:

" Symptom:

" Disease or syndrome:

" Treatment location:

" IV:

" DV:

" Population:

" Findings:

 

: Am J Obstet Gynecol. 2002 May;186(5 Suppl Nature):S131-59. Links

 

 

Nonpharmacologic relief of pain during labor: systematic reviews of five methods.

 

Simkin PP, O'hara M.

 

Department of Family Medicine, University of Washington, Seattle 98112, USA.

 

Nonpharmacologic measures to reduce labor pain have been used throughout history. Despite reports that some of these methods reduce pain, increase maternal satisfaction, and improve other obstetric outcomes, they have received limited attention in the medical literature and are not commonly available to women in North America. The controlled studies of nonpharmacologic methods are limited in number and sometimes provide conflicting results. This systematic review was conducted to assess the safety and efficacy of the best studied techniques, as well as to highlight areas in need of further research. Five comfort measures were selected for review, based on these criteria: they have been evaluated with prospective controlled studies and they require institutional support (eg, skills, policies, equipment). These 5 methods included continuous labor support, baths, touch and massage, maternal movement and positioning, and intradermal water blocks for back pain relief. An extensive search of electronic databases and other sources identified studies for consideration. Critical evaluation of controlled studies of these 5 methods suggests that all 5 may be effective in reducing labor pain and improving other obstetric outcomes, and they are safe when used appropriately. Additional well-designed studies are warranted to further clarify their effect and to evaluate their cost effectiveness.

 

Publication Types:

Review

Review, Tutorial

 

MeSH Terms:

Analgesia, Obstetrical/methods*

Back Pain/therapy

Female

Human

Movement

Posture

Pregnancy

Randomized Controlled Trials

 

 

 

 

Birth. 1995 Sep;22(3):161-71. Links

 

 

Reducing pain and enhancing progress in labor: a guide to nonpharmacologic methods for maternity caregivers.

 

Simkin P.

 

Many simple, effective, low-cost methods to relieve labor pain can be initiated by nurses, midwives, or physicians with the potential benefits of improved labor progress, reduction in use of riskier medications, patient satisfaction, and lower costs. These nonpharmacologic methods are categorized by the mechanisms through which they reduce pain or improve labor progress: diminishing the painful stimulus at the source; providing alternate stimuli to inhibit pain awareness; and reducing the woman's negative reaction to the pain. This is a review of numerous pain relief techniques and a guide for maternity caregivers.

 

\begin{itemize}

\item Patient:

\item Symptom:

\item Anatomic location, body part or region:

\item Disease, condition, or syndrome:

\item Medical specialty:

\item Institution, treatment location:

\item IV:

\item DV:

\item Hypothesis:

\item Population:

\item Findings:

\item Comments:

\end{itemize}

 

 

 

 

 

 

 

 

 

 

 

Stiles 1980 Issues Health Care Women 1980 May-Aug;2(3-4):105-11 Techniques for reducing the need for an episiotomy. Stiles Donna, BSN, MSN, CNM.

 

\begin{itemize}

\item Patient:

\item Symptom:

\item Anatomic location, body part or region:

\item Disease, condition, or syndrome:

\item Medical specialty:

\item Institution, treatment location:

\item IV:

\item DV:

\item Hypothesis:

\item Population:

\item Findings:

\item Comments:

\end{itemize}

 

 

 

 

 

 

 

 

 

 

Field 1999a J Psychosom Obstet Gynaecol 1999 Mar;20(1):31-8 Pregnant women benefit from massage therapy. Field T, Hernandez-Reif M, Hart S, Theakston H, Schanberg S, Kuhn C. Touch Research Institute, University of Miami School of Medicine, Florida, USA.

 

\begin{itemize}

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\item Institution, treatment location:

\item IV:

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\item Population:

\item Findings:

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\end{itemize}

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Field 1997a J Psychosom Obstet Gynaecol 1997 Dec;18(4):286-91 Labor pain is reduced by massage therapy. Field T, Hernandez-Reif M, Taylor S, Quintino O, Burman I. Touch Research Institute, University of Miami School of Medicine, Florida, USA.

 

\begin{itemize}

\item Patient:

\item Symptom:

\item Anatomic location, body part or region:

\item Disease, condition, or syndrome:

\item Medical specialty:

\item Institution, treatment location:

\item IV:

\item DV:

\item Hypothesis:

\item Population:

\item Findings:

\item Comments:

\end{itemize}

 

 

Affiliation-Touch Research Institute, University of Miami School of Medicine, Florida, USA

Author-Field, T.

Author-Hernandez-Reif, M.

Author-Taylor S.

Author-Quintino, O.

Author-Burman, I.

Journal-J Psychosom Obstet Gynaecol

 

 

 

 

 

 

Renfrew 1998 Birth 25:3 September 1998 pp. 143-???. "Practices that minimize trauma to the genital tract in childbirth", Renfrew, Mary J BSc, RGN, SCM, PhD, Hannah, Walter MD, FRCSC, Albers, Leah CNM, DrPH, Floyd, Elizabeth BN, RGN, RM, MSc.

 

\begin{itemize}

\item Patient:

\item Symptom:

\item Anatomic location, body part or region:

\item Disease, condition, or syndrome:

\item Medical specialty:

\item Institution, treatment location:

\item IV:

\item DV:

\item Hypothesis:

\item Population:

\item Findings:

\item Comments:

\end{itemize}

 

 

Affiliation-

Author-Renfrew, Mary J

Author-Hannah, Walter

Author-Albers, Leah

Author-Floyd, Elizabeth

Journal-Birth

 

 

 

 

 

 

Mynaugh 1991

 

: Birth. 1991 Sep;18(3):153-9. Links

 

 

A randomized study of two methods of teaching perineal massage: effects on practice rates, episiotomy rates, and lacerations.

 

Mynaugh PA.

 

This study examined the effects of two methods of teaching perineal massage on the rates of practice of perineal massage, of episiotomy, and of lacerations in primiparas at birth. Couples in 20 randomly selected sections of four prenatal class series received routine printed and verbal instruction and a 12-minute video demonstration of perineal massage, or only the routine printed and verbal instruction. Women reported their practice rates in daily diary records, which were mailed to the researcher weekly. Hospital records provided delivery data. Of the 83 women, 23 (28%) practiced perineal massage: 16 (35.6%) in the experimental group, 7 (18.4%) controls. Even though the rate of practice almost doubled among experimental group women, the videotape instruction method was statistically nonsignificant. Episiotomy and laceration rates were not affected by teaching method. More severe lacerations occurred among the experimental group; however, the control group had almost four times as many severe (21%) as minor (5.3%) lacerations. The experimental group had twice as many severe (28.9%) as minor (13.3%) lacerations. These results were also nonsignificant.

 

\begin{itemize}

\item Patient:

\item Symptom:

\item Anatomic location, body part or region:

\item Disease, condition, or syndrome:

\item Medical specialty:

\item Institution, treatment location:

\item IV:

\item DV:

\item Hypothesis:

\item Population:

\item Findings:

\item Comments:

\end{itemize}

 

{a!a}

{Affiliation-}

{Author-}

{Journal-}

 

 

Perineal massage

Aikins 1998 Aikins Murphy P, Feinland JB. Perineal outcomes in a home birth setting. Birth. 1998 Dec; 25(4): 226-34.

 

Allaire 2000 Allaire AD, Moos MK, Wells SR. Complementary and alternative medicine in pregnancy: a survey of North Carolina certified nurse-midwives. Obstet Gynecol. 2000 Jan; 95(1): 19-23.

 

Avery 1986 Avery MD, Burket BA. Effect of perineal massage on the incidence of episiotomy and perineal laceration in a nurse-midwifery service. J Nurse Midwifery. 1986 May-Jun; 31(3): 128-34. No abstract available.

 

Avery 1987 Avery MD, Van Arsdale L. Perineal massage. Effect on the incidence of episiotomy and laceration in a nulliparous population. J Nurse Midwifery. 1987 May-Jun; 32(3): 181-4. No abstract available.

 

Bodner 2002 Bodner-Adler B, Bodner K, Mayerhofer K. Perineal massage during pregnancy in primiparous women. Int J Gynaecol Obstet. 2002 Jul; 78(1): 51-3. No abstract available.

 

Bruce 2003 Bruce E. Everything you need to know to prevent perineal tearing. Midwifery Today Int Midwife. 2003 Spring; (65): 10-3. No abstract available.

 

Davidson 2000 Davidson K, Jacoby S, Brown MS. Prenatal perineal massage: preventing lacerations during delivery. J Obstet Gynecol Neonatal Nurs. 2000 Sep-Oct; 29(5): 474-9.

 

Duhamel 1982 Duhamel J, Garrigues JM, Romand-Heuyer Y, Robert R, Longgreen C. [Primitive ano-rectal neuralgia. Atypical cases (author's transl)] Sem Hop. 1982 Feb 18; 58(7): 392-6. French.

 

Eason 2000 Eason E, Labrecque M, Wells G, Feldman P. Preventing perineal trauma during childbirth: a systematic review. Obstet Gynecol. 2000 Mar; 95(3): 464-71.

 

Eason 2002 Eason E, Labrecque M, Marcoux S, Mondor M. Anal incontinence after childbirth. CMAJ. 2002 Feb 5; 166(3): 326-30.

 

Flynn 1997 Flynn P, Franiek J, Janssen P, Hannah WJ, Klein MC. How can second-stage management prevent perineal trauma? Critical review. Can Fam Physician. 1997 Jan; 43: 73-84. Review.

 

Goodburn 1995 Goodburn EA, Gazi R, Chowdhury M. Beliefs and practices regarding delivery and postpartum maternal morbidity in rural Bangladesh. Stud Fam Plann. 1995 Jan-Feb; 26(1): 22-32.

 

Halligan 2001 Halligan S. Perineal massage in pregnancy. True incidence of third degree tears should be ascertained. BMJ. 2001 Sep 29; 323(7315): 754. No abstract available.

 

Heit 2001 Heit M, Mudd K, Culligan P. Prevention of childbirth injuries to the pelvic floor. Curr Womens Health Rep. 2001 Aug; 1(1): 72-80. Review.

 

Johanson 2000 Johanson R. Perineal massage for prevention of perineal trauma in childbirth. Lancet. 2000 Jan 22; 355(9200): 250-1. No abstract available.

 

Keenan 2000 Keenan P. Benefits of massage therapy and use of a doula during labor and childbirth. Altern Ther Health Med. 2000 Jan; 6(1): 66-74. Review.

 

Korczynski 2002 Korczynski J. [Routine episiotomy in modern obstetrics. Is it necessary?] Przegl Lek. 2002; 59(2): 95-7. Review. Polish.

 

Labrecque 1994 Labrecque M, Marcoux S, Pinault JJ, Laroche C, Martin S. Prevention of perineal trauma by perineal massage during pregnancy: a pilot study. Birth. 1994 Mar; 21(1): 20-5.

 

Labrecque 1999 Labrecque M, Eason E, Marcoux S, Lemieux F, Pinault JJ, Feldman P, Laperriere L. Randomized controlled trial of prevention of perineal trauma by perineal massage during pregnancy. Am J Obstet Gynecol. 1999 Mar; 180(3 Pt 1): 593-600.

 

Labrecque 2000 Labrecque M, Eason E, Marcoux S. Randomized trial of perineal massage during pregnancy: perineal symptoms three months after delivery. Am J Obstet Gynecol. 2000 Jan; 182(1 Pt 1): 76-80.

 

Labrecque 2001 Labrecque M, Eason E, Marcoux S. Perineal massage in pregnancy. Such massage significantly decreases perineal trauma at birth. BMJ. 2001 Sep 29; 323(7315): 753-4. No abstract available.

 

Labrecque 2001 Labrecque M, Eason E, Marcoux S. Women's views on the practice of prenatal perineal massage. BJOG. 2001 May; 108(5): 499-504.

 

McCandlish 2001 McCandlish R. Perineal trauma: prevention and treatment. J Midwifery Womens Health. 2001 Nov-Dec; 46(6): 396-401. Review.

 

Mynaugh 1991 Mynaugh PA. A randomized study of two methods of teaching perineal massage: effects on practice rates, episiotomy rates, and lacerations. Birth. 1991 Sep; 18(3): 153-9.

 

Renfrew 1998 Renfrew MJ, Hannah W, Albers L, Floyd E. Practices that minimize trauma to the genital tract in childbirth: a systematic review of the literature. Birth. 1998 Sep; 25(3): 143-60. Review.

 

Sa'adah 1999 Sa'adah S. Perineal massage to prevent perineal trauma during pregnancy. J Fam Pract. 1999 Jul; 48(7): 494-5. No abstract available.

 

Shipman 1997 Shipman MK, Boniface DR, Tefft ME, McCloghry F. Antenatal perineal massage and subsequent perineal outcomes: a randomised controlled trial. Br J Obstet Gynaecol. 1997 Jul; 104(7): 787-91.

 

Stamp 1997 Stamp GE. Care of the perineum in the second stage of labour: a study of views and practices of Australian midwives. Midwifery. 1997 Jun; 13(2): 100-4.

 

Stamp 2001 Stamp G, Kruzins G, Crowther C. Perineal massage in labour and prevention of perineal trauma: randomised controlled trial. BMJ. 2001 May 26; 322(7297): 1277-80.

 

Stamp 2001 Stamp GE, Kruzins GS. A survey of midwives who participated in a randomised trial of perineal massage in labour. Aust J Midwifery. 2001 Mar; 14(1): 15-21.

 

Swalec 1989 Swalec KM, Smeak DD. Priapism after castration in a cat. J Am Vet Med Assoc. 1989 Oct 1; 195(7): 963-4.

 

Vendittelli 2001 Vendittelli F, Tabaste JL, Janky E. [Antepartum perineal massage: review of randomized trials] J Gynecol Obstet Biol Reprod (Paris). 2001 Oct; 30(6): 565-71. Review. French.

 

Labor

Achanna 1996 Achanna S, Monga D, Hassan MS. Case report: torsion of a gravid horn of a didelphic uterus. J Obstet Gynaecol Res. 1996 Apr; 22(2): 107-9.

 

Aikins 1998 Aikins Murphy P, Feinland JB. Perineal outcomes in a home birth setting. Birth. 1998 Dec; 25(4): 226-34.

 

Allaire 2000 Allaire AD, Moos MK, Wells SR. Complementary and alternative medicine in pregnancy: a survey of North Carolina certified nurse-midwives. Obstet Gynecol. 2000 Jan; 95(1): 19-23.

 

Allaire 2001 Allaire AD. Complementary and alternative medicine in the labor and delivery suite. Clin Obstet Gynecol. 2001 Dec; 44(4): 681-91. Review. No abstract available.

 

Atkinson 1996 Atkinson MW, Owen J, Wren A, Hauth JC. The effect of manual removal of the placenta on post-cesarean endometritis. Obstet Gynecol. 1996 Jan; 87(1): 99-102.

 

Becroft 1989 Becroft DM, Gunn TR. Prenatal cranial haemorrhages in 47 Pacific Islander infants: is traditional massage the cause? N Z Med J. 1989 May 10; 102(867): 207-10.

 

Behrman 1969 Behrman RE, James LS, Klaus M, Nelson N, Oliver T. Treatment of the asphyxiated newborn infant. Current opinions and practices as expressed by a panel. J Pediatr. 1969 Jun; 74(6): 981-8. No abstract available.

 

Bonard 1999 Bonard L, Pellet B. [A case of uterine inversion] Rev Med Suisse Romande. 1999 Aug; 119(8): 661-4. French. No abstract available.

 

Brailey 2003 Brailey S. Making room for babies. Midwifery Today Int Midwife. 2003 Spring; (65): 14-5. Review. No abstract available.

 

Breborowicz 1986 Breborowicz G, Malewski Z, Budner M, Slomko Z, Zaremba Z. [Test of uterine contraction induced by stimulation of the nipples] Ginekol Pol. 1986 Jun; 57(6): 414-9. Polish. No abstract available.

 

Bruce 2003 Bruce E. Everything you need to know to prevent perineal tearing. Midwifery Today Int Midwife. 2003 Spring; (65): 10-3. No abstract available.

 

Cassar 2001 Cassar MP. Massage in pregnancy. Pract Midwife. 2001 May; 4(5): 10-3. No abstract available.

 

Castaneda 1996 Castaneda Camey X, Garcia Barrios C, Romero Guerrero X, Nunez-Urquiza RM, Gonzalez Hernandez D, Langer Glass A. Traditional birth attendants in Mexico: advantages and inadequacies of care for normal deliveries. Soc Sci Med. 1996 Jul; 43(2): 199-207.

 

Chang 2002 Chang MY, Wang SY, Chen CH. Effects of massage on pain and anxiety during labour: a randomized controlled trial in Taiwan. J Adv Nurs. 2002 Apr; 38(1): 68-73.

 

Chen 1973 Chen PC. An analysis of customs related to childbirth in rural Malay culture. Trop Geogr Med. 1973 Jun; 25(2): 197-204. No abstract available.

 

Christiansen 1976 Christiansen A. [Letter: Milk production without preceding labor] Ugeskr Laeger. 1976 Mar 22; 138(13): 800-1. Danish.

 

Cook 1997 Cook A, Wilcox G. Pressuring pain. Alternative therapies for labor pain management. AWHONN Lifelines. 1997 Apr; 1(2): 36-41. No abstract available.

 

Cooper 1986 Cooper MD, Foote RH. Effect of oxytocin, prostaglandin F2 alpha and reproductive tract manipulations on uterine contractility in Holstein cows on days 0 and 7 of the estrous cycle. J Anim Sci. 1986 Jul; 63(1): 151-61.

 

Cooper 1985 Cooper MD, Newman SK, Schermerhorn EC, Foote RH. Uterine contractions and fertility following clitoral massage of dairy cattle in estrus. J Dairy Sci. 1985 Mar; 68(3): 703-8.

 

Curtis 1989 Curtis P, Evens S, Resnick J, Thompson CJ, Rimer R, Hisley J. Patterns of uterine contractions and prolonged uterine activity using three methods of breast stimulation for contraction stress tests. Obstet Gynecol. 1989 Apr; 73(4): 631-8.

 

Davidson 2000 Davidson K, Jacoby S, Brown MS. Prenatal perineal massage: preventing lacerations during delivery. J Obstet Gynecol Neonatal Nurs. 2000 Sep-Oct; 29(5): 474-9.

 

Eason 2000 Eason E, Labrecque M, Wells G, Feldman P. Preventing perineal trauma during childbirth: a systematic review. Obstet Gynecol. 2000 Mar; 95(3): 464-71.

 

Eason 2002 Eason E, Labrecque M, Marcoux S, Mondor M. Anal incontinence after childbirth. CMAJ. 2002 Feb 5; 166(3): 326-30.

 

Elliott 1984 Elliott JP, Flaherty JF. The use of breast stimulation to prevent postdate pregnancy. Am J Obstet Gynecol. 1984 Jul 15; 149(6): 628-32.

 

Ellis 1979 Ellis MI, Hey EN, Walker W. Neonatal death in babies with rhesus isoimmunization. Q J Med. 1979 Apr; 48(190): 211-25.

 

Feder 1994 Feder E, Liisberg GB, Lenstrup C, Roseno H, Taxbol D. [Zonal therapy in relation to women in childbirth] Jordemodern. 1994 May; 107(5): 168-70. Swedish. No abstract available.

 

Field 1997 Field T, Hernandez-Reif M, Taylor S, Quintino O, Burman I. Labor pain is reduced by massage therapy. J Psychosom Obstet Gynaecol. 1997 Dec; 18(4): 286-91.

 

Field 1999 Field T, Hernandez-Reif M, Hart S, Theakston H, Schanberg S, Kuhn C. Pregnant women benefit from massage therapy. J Psychosom Obstet Gynaecol. 1999 Mar; 20(1): 31-8.

 

Findley 1999 Findley I, Chamberlain G. ABC of labour care. Relief of pain. BMJ. 1999 Apr 3; 318(7188): 927-30. Review. No abstract available.

 

Flynn 1997 Flynn P, Franiek J, Janssen P, Hannah WJ, Klein MC. How can second-stage management prevent perineal trauma? Critical review. Can Fam Physician. 1997 Jan; 43: 73-84. Review.

 

Galant 2003 Galant S, Sterrenberg M, Kay P, Farris-Folkerts D, Sollman R, Lennox S. What new or old techniques have proven useful to you in preventing tears during childbirth? Midwifery Today Int Midwife. 2003 Spring; (65): 8. No abstract available.

 

Gantes 1985 Gantes M, Kirchhoff KT, Work BA Jr. Breast massage to obtain contraction stress test. Nurs Res. 1985 Nov-Dec; 34(6): 338-41.

 

Geisler 1966 Geisler E, Zopff G. [Peripheral facial nerve paralysis in children] Munch Med Wochenschr. 1966 Feb 4; 108(5): 237-46. German. No abstract available.

 

Gentz 2001 Gentz BA. Alternative therapies for the management of pain in labor and delivery. Clin Obstet Gynecol. 2001 Dec; 44(4): 704-32. Review. No abstract available.

 

Goldstein 1999 Goldstein L. What is "morning sickness" and what can I do to feel better? What massage techniques are helpful during labor? Birth Gaz. 1999 Fall; 15(4): 22-5. No abstract available.

 

Goodburn 1995 Goodburn EA, Gazi R, Chowdhury M. Beliefs and practices regarding delivery and postpartum maternal morbidity in rural Bangladesh. Stud Fam Plann. 1995 Jan-Feb; 26(1): 22-32.

 

Gubarevich 1969 Gubarevich IaG, Voskoboinikov VM, Spiridonov VS. [Treatment of sows with weak labor] Veterinariia. 1969 Jun; 46(6): 84-5. Russian. No abstract available.

 

Hagen 1966 Hagen H, Plass R, Bothig S. [Adams-Stokes syndrome in intermittent total a.v. block in pregnancy and during delivery] Zentralbl Gynakol. 1966 Jul 2; 88(27): 890-7. German. No abstract available.

 

Halligan 2001 Halligan S. Perineal massage in pregnancy. True incidence of third degree tears should be ascertained. BMJ. 2001 Sep 29; 323(7315): 754. No abstract available.

 

Harmon 2003 Harmon P, Marks V, Enning C. Tips on tear prevention. Midwifery Today Int Midwife. 2003 Spring; (65): 20. No abstract available.

 

Hedstrom 1986 Hedstrom LW, Newton N. Touch in labor: a comparison of cultures and eras. Birth. 1986 Sep; 13(3): 181-6. No abstract available.

 

Heit 2001 Heit M, Mudd K, Culligan P. Prevention of childbirth injuries to the pelvic floor. Curr Womens Health Rep. 2001 Aug; 1(1): 72-80. Review.

 

Hunter 1999 Hunter C. Shiatsu therapy in labour. Aust Nurs J. 1999 Mar; 6(8): 36. No abstract available.

 

Jackson 2001 Jackson KW Jr, Allbert JR, Schemmer GK, Elliot M, Humphrey A, Taylor J. A randomized controlled trial comparing oxytocin administration before and after placental delivery in the prevention of postpartum hemorrhage. Am J Obstet Gynecol. 2001 Oct; 185(4): 873-7.

 

Jin 1996 Jin Y, Wu L, Xia Y. [Clinical study on painless labor under drugs combined with acupuncture analgesia] Zhen Ci Yan Jiu. 1996; 21(3): 9-17. Chinese.

 

Johanson 2000 Johanson R. Perineal massage for prevention of perineal trauma in childbirth. Lancet. 2000 Jan 22; 355(9200): 250-1. No abstract available.

 

Jouppila 1995 Jouppila P. Postpartum haemorrhage. Curr Opin Obstet Gynecol. 1995 Dec; 7(6): 446-50. Review.

 

Keenan 2000 Keenan P. Benefits of massage therapy and use of a doula during labor and childbirth. Altern Ther Health Med. 2000 Jan; 6(1): 66-74. Review.

 

Kim 2001 Kim J, Jang S, Kim Y, Lee S, Song J. Developing CD-ROM based multimedia digital textbook of 'San-Yin-Jiao(SP-6) pressure for reducing the labor pain and shortening the labor time'. Medinfo. 2001; 10(Pt 2): 1038-41.

 

Kim 2003 Kim J, Chang S, Lee S, Jun E, Kim Y. An experimental study of students' self-learning of the San-Yin-Jiao pressure procedure using CD-ROM or printed materials. J Nurs Educ. 2003 Aug; 42(8): 371-6.

 

Kimber 1998 Kimber L. Effective techniques for massage in labour. Pract Midwife. 1998 Apr; 1(4): 36-9. No abstract available.

 

Kimber 1998 Kimber L. How did it feel? An informal survey of massage techniques in labour. Pract Midwife. 1998 Dec; 1(12): 38-41. No abstract available.

 

Kimber 2002 Kimber L. Massage for childbirth and pregnancy--8 years on. Pract Midwife. 2002 Mar; 5(3): 20-3. No abstract available.

 

Kitzinger 1974 Kitzinger S. Speaking the same language. Working with West Indian patients. Practitioner. 1974 Dec; 213(1278): 843-50. No abstract available.

 

Korczynski 2002 Korczynski J. [Routine episiotomy in modern obstetrics. Is it necessary?] Przegl Lek. 2002; 59(2): 95-7. Review. Polish.

 

Kornilov 1975 Kornilov NV, Gol'dblat VI, Iur'ev PV. [Treatment of injuries of the tendons of digital flexors] Vestn Khir Im I I Grek. 1975 Jan; 114(1): 91-6. Russian.

 

Krasnodebski 1988 Krasnodebski J, Orzel Z, Pietrzykowska U. [Effect of massage of the breasts in prolonged pregnancy on cervical maturation] Ginekol Pol. 1988 Sep; 59(9): 534-8. Polish. No abstract available.

 

Krasnodebski 1985 Krasnodebski J, Pietrzykowska U, Orzel Z. [Induction of labor in prolonged pregnancy by breast massage] Ginekol Pol. 1985 Dec; 56(12): 748-53. Polish. No abstract available.

 

Krasnodebski 1987 Krasnodebski J, Rokicki W, Pietrzykowska U, Orzel Z. [Clinical evaluation of newborn infants after labor induced by breast massage] Ginekol Pol. 1987 Jan; 58(1): 31-4. Polish. No abstract available.

 

Labrecque 1994 Labrecque M, Marcoux S, Pinault JJ, Laroche C, Martin S. Prevention of perineal trauma by perineal massage during pregnancy: a pilot study. Birth. 1994 Mar; 21(1): 20-5.

 

Labrecque 1999 Labrecque M, Eason E, Marcoux S, Lemieux F, Pinault JJ, Feldman P, Laperriere L. Randomized controlled trial of prevention of perineal trauma by perineal massage during pregnancy. Am J Obstet Gynecol. 1999 Mar; 180(3 Pt 1): 593-600.

 

Labrecque 1999 Labrecque M, Nouwen A, Bergeron M, Rancourt JF. A randomized controlled trial of nonpharmacologic approaches for relief of low back pain during labor. J Fam Pract. 1999 Apr; 48(4): 259-63.

 

Labrecque 2001 Labrecque M, Eason E, Marcoux S. Perineal massage in pregnancy. Such massage significantly decreases perineal trauma at birth. BMJ. 2001 Sep 29; 323(7315): 753-4. No abstract available.

 

Labrecque 2001 Labrecque M, Eason E, Marcoux S. Women's views on the practice of prenatal perineal massage. BJOG. 2001 May; 108(5): 499-504.

 

Lai 1991 Lai CW, Lai YH. History of epilepsy in Chinese traditional medicine. Epilepsia. 1991 May-Jun; 32(3): 299-302.

 

Lang 1997 Lang JB, Elkin ED. A study of the beliefs and birthing practices of traditional midwives in rural Guatemala. J Nurse Midwifery. 1997 Jan-Feb; 42(1): 25-31.

 

Leeman 2003 Leeman L, Fontaine P, King V, Klein MC, Ratcliffe S. The nature and management of labor pain: part I. Nonpharmacologic pain relief. Am Fam Physician. 2003 Sep 15; 68(6): 1109-12.

 

Lehrer 2003 Lehrer L. Easing the baby out. Midwifery Today Int Midwife. 2003 Spring; (65): 18. No abstract available.

 

Lewis 1995 Lewis L. Caring for the carers. Mod Midwife. 1995 Feb; 5(2): 7-10.

 

McCandlish 2001 McCandlish R. Perineal trauma: prevention and treatment. J Midwifery Womens Health. 2001 Nov-Dec; 46(6): 396-401. Review.

 

Morini 1994 Morini A, Angelini R, Giardini G. [Acute puerperal uterine inversion: a report of 3 cases and an analysis of 358 cases in the literature] Minerva Ginecol. 1994 Mar; 46(3): 115-27. Review. Italian.

 

Oppitz 1993 Oppitz M. [Who heals the healer? Shaman practice in the Himalayas] Psychother Psychosom Med Psychol. 1993 Nov; 43(11): 387-95. German.

 

Parke 1996 Parke TJ, Kinsella SM. The effect of abdominal massage on the onset of epidural blockade in laboring women. Anesth Analg. 1996 Apr; 82(4): 887. No abstract available.

 

Radionchenko 1984 Radionchenko AA, Novopashina GN. [Vibration massage as a means of accelerating uterine involution following labor] Akush Ginekol (Mosk). 1984 Feb; (2): 55-7. Russian. No abstract available.

 

Radionchenko 1984 Radionchenko AA, Zal'mezh LV, Konishcheva OE, Volkova LA. [Prevention of post-abortion complications] Sov Med. 1984; (11): 108-10. Russian.

 

Redding 1999 Redding K. Touching lives. Massage in pregnancy and labor. Midwifery Today Int Midwife. 1999 Winter; (52): 13. No abstract available.

 

Reid 2001 Reid J. Getting the massage across. Nurs Times. 2001 Apr 12-18; 97(15): 26. No abstract available.

 

Reissland 1987 Reissland N, Burghart R. The role of massage in south Asia: child health and development. Soc Sci Med. 1987; 25(3): 231-9.

 

Renfrew 1998 Renfrew MJ, Hannah W, Albers L, Floyd E. Practices that minimize trauma to the genital tract in childbirth: a systematic review of the literature. Birth. 1998 Sep; 25(3): 143-60. Review.

 

Rotkina 1979 Rotkina IE, Chechenina AA. [Breast stimulation test for determination of body's readiness for labor] Vopr Okhr Materin Det. 1979 Oct; 24(10): 64-6. Russian. No abstract available.

 

Schneegans 1968 Schneegans E, Amar G, Isch C, Schneegans D. [Sciatic paralysis of newborn and premature infants] Ann Pediatr (Paris). 1968 Oct 2; 15(10): 657-63. French. No abstract available.

 

Schrag 1979 Schrag K. Maintenance of pelvic floor integrity during childbirth.J Nurse Midwifery. 1979 Nov-Dec; 24(6): 26-31. No abstract available.

 

SCHULTZE 1956 SCHULTZE KW. [Connective tissue massage and commencement of labor pains] Zentralbl Gynakol. 1956 Sep 22; 78(38): 1495-8. German. No abstract available.

 

SCHULTZE 1957 SCHULTZE KW. [Massage of connective tissue for labor induction] Hippokrates. 1957 Mar 31; 28(6): 164-6. German. No abstract available.

 

Schuppe 2003 Schuppe M. The perineum and the birth environment. Midwifery Today Int Midwife. 2003 Spring; (65): 22-3. Review. No abstract available.

 

Shettles 1975 Shettles LB. Letter: Third stage labor. Obstet Gynecol. 1975 Sep; 46(3): 371-2. No abstract available.

 

Shipman 1997 Shipman MK, Boniface DR, Tefft ME, McCloghry F. Antenatal perineal massage and subsequent perineal outcomes: a randomised controlled trial. Br J Obstet Gynaecol. 1997 Jul; 104(7): 787-91.

 

Simkin 2002 Simkin PP, O'hara M. Nonpharmacologic relief of pain during labor: systematic reviews of five methods. Am J Obstet Gynecol. 2002 May; 186(5 Suppl Nature): S131-59. Review.

 

Stamp 1997 Stamp GE. Care of the perineum in the second stage of labour: a study of views and practices of Australian midwives. Midwifery. 1997 Jun; 13(2): 100-4.

 

Stamp 2001 Stamp G, Kruzins G, Crowther C. Perineal massage in labour and prevention of perineal trauma: randomised controlled trial. BMJ. 2001 May 26; 322(7297): 1277-80.

 

Stamp 2001 Stamp GE, Kruzins GS. A survey of midwives who participated in a randomised trial of perineal massage in labour. Aust J Midwifery. 2001 Mar; 14(1): 15-21.

 

Stiles 1980 Stiles D. Techniques for reducing the need for an episiotomy. Issues Health Care Women. 1980 May-Aug; 2(3-4): 105-11. No abstract available.

 

Susloparov 1973 Susloparov LA. [Effect of oxytocin on the coagulating properties of the blood and on the thrombocyte formation activation processes by placental tissue activators during labor] Vopr Okhr Materin Det. 1973; 18(4): 72-7. Russian. No abstract available.

 

Thambu 1971 Thambu JA. Rupture of the uterus: treatment by suturing the tear. Med J Malaya. 1971 Jun; 25(4): 293-4. No abstract available.

 

Vago 1984 Vago T, Jhirad A. Breast stimulation to ripen cervix. Am J Obstet Gynecol. 1984 Jul 1; 149(5): 583. No abstract available.

 

Van Patten 1932 Van Patten N. Obstetrics in Mexico prior to 1600. Ann Med Hist. 1932 Mar; 4(2): 203-12.

 

Voorhoeve 1982 Voorhoeve AM, Kars C, van Ginneken JK. Machakos project studies. Agents affecting health of mother and child in a rural area of Kenya. XXI. Antenatal and delivery care. Trop Geogr Med. 1982 Mar; 34(1): 91-101.

 

Waters 2003 Waters BL, Raisler J. Ice massage for the reduction of labor pain. J Midwifery Womens Health. 2003 Sep-Oct; 48(5): 317-21.

 

Weerasekera 1993 Weerasekera DS. Sweeping of the membranes is an effective method of induction of labour in prolonged pregnancy: a report of a randomised trial. Br J Obstet Gynaecol. 1993 Feb; 100(2): 193-4. No abstract available.

 

Wendel 1995 Wendel PJ, Cox SM. Emergent obstetric management of uterine inversion. Obstet Gynecol Clin North Am. 1995 Jun; 22(2): 261-74. Review.

 

Whelton 1990 Whelton J. Pain control in labour. Nursing (Lond). 1990 Jan 11-24; 4(2): 14-8. No abstract available.

 

Wilkowski 2001 Wilkowski R. Chinese medicine for pregnancy and childbirth. Midwifery Today Int Midwife. 2001 Summer; (58): 39-41. Review. No abstract available.

 

Worthington 1980 Worthington EL Jr, Martin GA. A laboratory analysis of response to pain after training three Lamaze techniques. J Psychosom Res. 1980; 24(2): 109-16. No abstract available.

 

Yates 1999 Yates S. Optimal fetal positioning. The experience of a shiatsu practitioner. Pract Midwife. 1999 Dec; 2(11): 20-2. No abstract available.

 

 

Obstetrics

(obstetrics OR pregnancy OR birth) AND massage: 365

 

 

Pregnancy

325

 

 

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