Term Paper on "Alternative Support Alternative Therapeutic Support to Labor"

Term Paper 6 pages (1591 words) Sources: 1+

[EXCERPT] . . . .

Alternative Support

Alternative Therapeutic Support to Labor Patients by Nurses to Increase Their Comfort Level and Provide a Positive Childbirth Outcome

More and more women are seeking out less invasive or non-pharmacological methods of pain management during labor. This has contributed significantly to the popularity of "complementary methods of pain management" (Smith, Collins, Cyna & Crowther, 2). Traditional forms of pain management include use of epidural anesthesia and other narcotic drugs to help deaden and reduce pain. Many of these methods however come with some unwelcome side effects, side effects that might be avoided if alternative therapeutic techniques were used in conjunction with or instead of traditional methods.

Nurses are at laboring women's bedsides, thus it is important that they are aware of any alternative therapeutic techniques available during labor to help lessen a woman's experience of pain during labor. In recent years a number of alternative therapeutic approaches have been introduced into the labor and delivery unit. Some of the more common techniques adopted by laboring women for pain management and stress relief include: acupuncture, meditation, hypnosis, massage and aromatherapy. The extent to which these therapies are supportive and beneficial is not yet completely understood. It is important however that laboring women have access to complementary therapies to improve their child birthing experience as much as possible so the end result is a positive outcome.

Purpose

The purpose of this research is to explore the phenomenon of alternative therapeutic intervention during labor and childbirth from the perspective of laboring mothers. The aim is to gain an understanding of the issues that influence patient's perception of pain during childbirth and likelihood for a positive outcome. In addition the researcher will attempt to identify what measures support staff including nurses can adopt to enable patients during the labor and childbirth process.

Problem Statement

Do alterative therapeutic interventions have a positive effect on patient's perceptions of pain and labor outcome during childbirth, and how can nurses adopt these measures to improve patient outcomes. The study will also attempt to uncover what alternative therapeutic interventions are most likely to result in maternal satisfaction and a positive outcome post-delivery.

Hypothesis

Members of the nursing staff involved in laboring mothers daily patient care can have a positive impact on patients comfort level and outcome when alternative therapeutic interventions are adopted during the labor process. Secondary to this, the use of acupuncture, massage and hypnosis during labor and childbirth improves the laboring experience contributing to a positive outcome.

Literature Review

There is a large body of evidence at present, which supports exploration of alternative therapeutic intervention during the childbirth process. Below is a review of some of the most recent research related to this subject.

Ramnero, Hanson & Kihlgren (2002) conducted an investigation of acupuncture treatment during labor as a method of decreasing pain intensity and increasing relaxation. Their randomized controlled trial examined 90 women in labor and assessed pain and relaxation during labor and delivery. The results showed that acupuncture is a positive alternative or complement to women in labor who would rather forgo analgesia. The study suggested that relaxation increased and experience of pain intensity decreased for patients receiving acupuncture treatment at the time of labor.

Another study conducted by Huntley, Coon & Earnst (2004) systematically reviewed randomized controlled trials that examined complementary and alternative therapies for addressing labor pain. Their study examined the following forms of therapy for managing labor pain: biofeedback, hypnosis, instracutaneous sterile water injections, massage and respiratory autogenic training. The results of their study proved inconclusive, with the exception of intracutaneous sterile water injections, which did reduce perceived pain in patients.

In a similar study conducted by Smith, Collins, Cyna & Crowther (2003) however, acupuncture and hypnosis were shown as effective alternative or complementary methods for reducing perceived pain during labor. Their study included seven trials of varying modalities of pain management including aromatherapy, massage, music, hypnosis and acupuncture.

Simkin & Bolding (2004) studies suggest that there is enough evidence to support the use of baths, intradermal water blocks and maternal movement and positioning as nonpharmacologic approaches toward controlling labor pain and preventing suffering. Their studies also suggest that acupuncture, massage, hypnosis and even transcutaneous nerve stimulation may be beneficial, however require further study before accurate conclusions can be made with regard to their efficacy. Other less scientific methods including aromatherapy and music have not been sufficiently studied according to the researchers, or the results have been too vague to draw adequate conclusions.

Kannan, Jamison & Datta (2001) suggest that factors other than pharmacological pain relief influence a woman's perceptions of labor and childbirth and thus whether they perceive a positive outcome. Their studies find evidence supporting the importance of discussing pre-labor expectations and preparing mothers for unexpected occurrences during labor as critical to a positive outcome Their studies find that women who are prepared by nurses and support staff for the good and bad things that can occur during labor were more likely to report satisfaction regardless of their outcome.

Ketterhage, VandeVusee & Berner (2002) show that nurses may benefit patients by learning self-hypnosis techniques and information pregnant women of them during delivery. Their study suggests that self-hypnosis may help manage pain by allowing women to control their anxiety and discomfort "by inducing a focused state of relaxation" (335).

Conceptual Framework

Women's experience of pain during labor and delivery vary; Lundgren & Dahlberg's (1998) model of care provide a framework for understanding women's experience and perceptions of pain management and outcome during childbirth. Their assumption suggest that four themes help identify the meanings women assign their childbirth experience. These include a woman's ability to trust in oneself and one's body, trust in the caregiver and partner, the manner in which a mother transitions into motherhood and the acceptance that pain is difficult to describe completely and often contradictory.

The essential element for defining pain management according to Lundgren & Dahlberg is establishing a non-objectifying view of the body, a "presence in the delivery process" and establishing a meaning connected to motherhood (Lundgren & Dahlberg, 106). The researcher concludes that nurses and midwives can help birthing women "find their own ability to cope, and should interfere only when asked" in order to help facilitate the natural birthing process (Lundgren & Dahlberg, 105).

Conclusions

Members of the nursing staff provide much needed support to laboring patients by meeting physical and emotional needs throughout the childbearing process. As more an more patients turn to alternative or non-pharmacological therapies for support during labor it is important that nurses educate themselves regarding these measures so they can inform patients of the effective options available to them for mitigating pain.

Nurses play a primary role in implementation of patient care strategies to improve patient's outcome and perceptions of pain during the labor and childbirth process. Thus it is vital that nursing education focus on all interventions, traditional and alternative, that might benefit patients during the birthing process.

The results of the literature review suggest that alternative therapeutic methods can be utilized successfully during the childbirth process to improve maternal satisfaction and facilitate a positive outcome. The methods most likely to result in improved perceptions of comfort and reduced pain or anxiety include acupuncture, intradermal water blocks, position changes and in some cases hypnosis. There is some evidence that other therapies including massage may be beneficial, however at present further research needs to be conducted to prove the extent to which these therapies may aid laboring mothers.

Less scientifically grounded approaches including aromatherapy are not yet supported as an adequate means of reducing anxiety and improving comfort levels among laboring patients. However, there is enough evidence suggesting that further exploration in these areas is warranted. Many patients continue to seek out these options whether there is scientific support for them or not.

This study confirms the… READ MORE

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