ALTERNATIVE

AND
COMPLEMENTARY
THERAPIES
IN LABOR
INTRODUCTION
 ALTERNATIVE THERAPIES
Alternative therapies are used instead of
conventional or mainstream therapies for examples,
the use of acupuncture/acupressure rather than
analgesics to relieve pain.
 COMPLEMENTARY THERAPIES

Complementary therapies are those used in conjunction

with conventional therapies for example meditation used as
an adjunct to analgesics drugs.
 PURPOSES:
Reduce labour pain

Reduce fear & anxiety

Decrease the duration of labour

Increase progress of labour

 ALTERNATIVE &
COMPLEMENTARY
APPROACHES
1.HYPNOSIS:
The word hypnosis originates from the Greek Hypnos
which means sleep. Hypnosis is not sleep but a state of
attentive and focused concentration in which the patient
can be relatively unaware, yet not completely blind to their
surroundings.
Hypnotic focus on diminishing the awareness of pain as
well as fear and anxiety.
Hypnosis advocates give several explanations of how the
process works.
One theory holds that when a woman feels fear during
childbirth, her body releases stress hormones that trigger the
body's "fight or flight" response. This causes muscles to tighten
and interferes with the birthing process.
By training the subconscious mind to expect a safe, gentle
birth, they say, women can avoid going into the fight-or-flight
state, allowing for a smoother birth.
Self hypnosis can be taught at various hypnosis
training centers on special childbirth classes
that teach the technique of positive statements
and concentrating on beautiful images of child.
2.BIOFEEDBACK:

Biofeedback is a treatment that uses

monitoring instruments to provide visual or
acoustic feedback to patients physiological
information of which they are normally
unaware.
It is a therapeutic technique that teaches you how
to control physical responses such as breathing,
muscle tension, hand temperature, heart
rate,blood pressure and brain activity that are not
normally controlled voluntarily.
3.YOGA:

Yoga, a method of Indian origin, proposes control of mind

and body.
Between the different types of yoga, energy yoga can be
applied to pregnancy and delivery.
It achieves changes in levels of consciousness, relaxation,
receptivity to the world and inner peace.
According to professionals who
use this technique for delivery,
yoga shortens the duration of
labor, decreases pain and reduces
the need for analgesic medication.
 DIFFERENT YOGA POSITIONS:

Cat pose Dog tail wagging

Child pose Squat
4.SOPHROLOGY:

The word Sophrology derives from two Greek words, sos

harmony or serenity and phren conscience or spirit. This
technique derived from Indian yoga was introduced in
Europe during the 1960s.
Its purpose is to improve the control of body and spirit
through three degrees of dynamic relaxation:
concentration, contemplation and meditation.
Applied to obstetrics,
better control of the
delivery process is
expected by means of
relaxation, reducing
anxiety & fear.
5.MUSIC THERAPY:

The use of music to relieve pain and decrease anxiety has

been known to be helpful for the relief of postoperative pain
for same time.
Research regarding the use of music to reduce labour pain
has also demonstrated that music may be used to promote
relaxation during the early stages of labour and as a
stimulant to promote movement during later stages, when
physical exertion is required for bearing down process.
6.ACUPUNCTURE:

Acupuncture is well known Chinese practice. In this

one uses needles inserted at specific points to relieve
pain.
During labor, acupuncture can be used for pain relief,
as a calming technique (which again will lessen pain)
and to keep labor contractions going.
The placement of the needle will depend on
which stage of labor patient is and kind of pain.
Advisable to take this treatment with
experienced certificate practitioners.
The basic theory include altering the bodys
levels of chemical neurotransmitters and
influencing the natural electrical currents or
electromagnetic fields
7.ACUPRESSURE SYSTEMS:

Acupressure is a descendant of Chinese

manipulative therapy in which points are
stimulated by pressure, using hands, fingers
and thumbs .
Acupressure might increase blood flow to
the uterus, influence hormonal responses,
and stimulate uterine contractions.
8. HOMEOPATHY:
There are homeopathic drugs that may help to lessen the
pain of natural child birth. These are pills with no side effects
to be said that have to be taken at regular intervals through
out the labour.

These drugs only be taken by recognized homeopathy

practitioner and obstetrician.
Homeopathy is a safe, natural alternative to pitocin/oxytocin.
If the baby is overdue, induce labour naturally by alternating
the remedies caulophyllum 12C and cimicifuga 12C, given
once every hour. For example, hour 1: caulophyllum, hour 2:
cimicifuga, hour 3: caulophyllum, etc.
9.THERAPEUTIC TOUCH:

The purpose of therapeutic touch in labor is to

communicate caring and reassurance. Painful contractions
of the uterus can be treated by the application of pressure
with the hands to the woman's back, abdomen, hips, thighs,
sacrum or perineum.
Whether touch is perceived as positive or not is dependent on
who is touching the patient: in one study, touching was
perceived positively by 94% of patients when they were touched
by a relative or friend, 86% by their husbands, 73% by a nurse
and 21% by a physician .
Anxiety is reported to be reduced in patients who receive
reassuring touch. In a retrospective study of 30 patients, 77%
experienced less pain when they were touched during labor,
and 40% reported less need for pain medication.
10.MASSAGE THERAPY:

Touch and manipulation with the hands has been used in

the practice of medicine since its inception. The value of
touch and massage and its positive effect is well
documented.
Massage therapy can incorporate in nursing practice
throughout labour to promote relaxation and stress
reduction.
Massage is thought to have a physiological basis,
blocking pain impulses by increasing A-fiber transmission or
by stimulating the local releases of endorphins,
stimulating large-diameter nerve fibers to close a gate of pain,
stimulating mechanoreceptors,
stimulating circulation with resultant increased oxygenation to
tissues.

Massage has been shown to be factors in promoting labour

progress, decreasing pain perception and increasing the
womans ability to cope with labour.
11.TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION (TENS):

This is a method of pain management in which

electrodes fitted at the back, to pass electric
current into the body.
This stimulates the natural secretion of endorphins,
the bodys painkillers.
This usually used in the early stages and has no
known side effect.
12.STERILE WATER INJECTION:
This is relatively new technique for curbing back pain
during labour. Using this technique allows the mother to
remain fully conscious during labour.
She can move and may not need an epidural in the later
stage. Counter-irritation is the process by which localized
pain felt in one part of the body may be relieved by
irritating the skin in same dermatomal distribution with either
a hot, cold scratchy or electrical Stimulus.
A small amount of sterile water(0.1-0.2 ml) is injected in
four places just under the skin that covers the sacrum, the
lower part of the back.

Its thought that the sterile water injections stimulate the

nerves which quickly send messages to the brain and
interrupt the slower messages from inside the body this
has been called the gate control theory of pain
management.

Relief lasts for an hour, are more and procedure can be

repeated any number of times.
13.HYDROTHERAPY:
The use of hydrotherapy during labour, whether in a
shower or a tub, is a proven means of relaxation and
pain relief.
The warm water stimulates the release of endorphins,
relaxes muscles to decrease tension, stimulates large
diameters nerve fibers to close gate on pain, and
promotes better circulation and oxygenation.
Hydrotherapy can promote increased diueresis,
decreased edema, decreased blood pressure,
enhanced fetal rotation due to increased
buoyancy faster labour, less use of intramuscular
and intravenous medications, less use of
epidural, episiotomies and increased satisfaction
with birth experience. Prior to implementing
hydrotherapy, procedures and protocols should
be developed.
A common question asked by providers is whether
hydrotherapy can or should be used when
membranes are ruptured. Several studies have
looked at the risks of using hydrotherapy after
rupture of membranes. Finding gave shown no
increase in choriomnionitis, postpartum
endometritis, neonatal infections etc., however
precautions needed to reduce infection
14.BIRTH BALL:
The Swiss Ball has been used in physical therapy and
exercise programs for decades.
Birth balls were originally developed by physiotherapists
and used for treating ortho-neural disorders, but using them
has been found equally beneficial for a pregnant woman.
Research on the use of ball demonstrates a significant
improvement in core muscle stability, including the muscles
of the chest, abdomen and pelvis
These muscles are instrumental in the labour process
for deep breathing, pushing and general movement
Rocking and movement can be accomplished on a
birthing ball during labour not only does the ball
facilitate the physiologic benefits of movements to help
the fetus find its best fit through the pelvis but also
promotes comfort and can decrease pain by
stimulating mechanoreceptors( sense organ or cell that
responds to mechanical stimuli such as touch or
sound) and joint receptors.
The ball should be used with the following
precautions:
The woman should never use the balls
unless her support person is with her
The woman should always have a firm
support in front of her to hold on to for security
A policy should be written outlining their
use, cleaning and storage.
15.AROMATHERAPY

Aromatherapy is the therapeutic use of plant

derived essential oils to promote physical and
psychological wellbeing.
Essential oils are lipid soluble and are rapidly
absorbed when applied externally or are inhaled.
They are excreted through kidneys or expired
through the lungs.
 For labor therapeutic grade oils in low doses for
massage or as an environmental fragrance is
increasing in health care settings.
For labour , therapeutic grade oils such as lavender
or jasmine can promote relaxation and perception
of pain.
peppermint oil may be effective in decreasing
nausea and vomiting.
To use aromatherapy effectively , nurses should
have basic understanding of the chemical.
16.BREATHING:

Controlled, rhythmic breathing has been found to be

relaxing by women dealing with labour pain.
If women takes deep breathing it can help to calm and
distract from the pain.
It can also help to diminish the natural instinct to hold the
contractions.
17.POSITION:
Different positions during labour have different ways of
helping to relax and be more comfortable.
To avoid pain many nurses and doctors suggest mothers
adopt semi-reclining position or lie on their side.
A walk, squatting position or fetal position can help case
pain. What ever position in which woman find
comfortable can be good for her.
 18. HEAT THEORY
Sometimes a simple heating pad may work
wonders to relieve the pain felt while giving birth.

Pads are available in different size and shapes

suitable for almost all women and are easy to use.

If not available heat therapy can be done by

using warm water bag or even a warm pack or
soak
 Heat caused a small increase in uterine
contraction and no any effect on fetal heart rate.
It seems that the heat stimulates heat receptors of
skin and deeper tissues, and it may reduce the
pain as per the gate control theory.
 19.REFLEXOLOGY:
Another ancient practice is in which pressure is
applied to specific body parts, specifically the
soles of body.
During labour, a reflexologist can help woman
cope with pain and speed the process of
childbirth by pressure and stoking specific ankle
points, which are said to stimulate the pituitary
glands to release pain killing hormones.
Reflexology should only be performed by an
experienced practitioner.
 20.DISTRACTION:

In this a woman in pain can take her mind

off of the contractions and labour by reading a
book, walking, talking to a friend or watching
TV.

These activities are simple to do and provide

distraction from pain.
 21.NIPPLE STIMULATION:
Rubbing or rolling nipples helps the body release
oxytocin.
Oxytocin plays a role in arousal, initiating labor, and
bonding between mother and child.
This hormone also makes the uterus contract after
labor, helping it return to its prepregnancy size.
Stimulating the breasts may also help bring on full
labor by making contractions stronger and longer.
Explain mother to gently rub or roll nipples.
Massage the darker area around
nipple (areola), not just the tip of nipple. She
can do this by placing palm over the areola and
moving it in a circular motion, firmly and gently.

Stimulate breasts for an hour, three times a day.

Research findings support the nipple stimulation

helps in progress of labour.
 ROLE OF MIDWIFE

1.Be non-judgmental despite personal opinions.

2. Build rapport by showing client respect.

3. Understand that it can be beneficial, when used

correctly.

4. Be aware that it can be dangerous if it interacts or

interferes with conventional treatment
5. Be willing to teach the public about the positive and
negative information regarding that.

6. Be aware that use of it is popular and increasing and must

be included in the history & physical examination.

7. Know that herbals, in particular, can have significant

effect on prescription drugs and body function.
THANK
YOU