Acupuncture as Pain Relief During Delivery: A Randomized Controlled Trial

Abstract

The effect of acupuncture on labor pain has been poorly documented. The few randomized controlled trials published after 2002 that evaluated the effectiveness of acupuncture for pain relief during labor, varied in size and quality. This randomized unblinded study compared the effect of acupuncture on pain relief and relaxation during delivery with the pain relief provided by transcutaneous electric nerve stimulation (TENS) or traditional analgesics. A total of 607 healthy laboring women with normal singleton pregnancies at term (37-42 weeks) were randomized to receive either acupuncture (n = 314), TENS (n = 144) or traditional analgesics (n = 149). The primary outcomes were a need for pharmacological and invasive treatment for pain relief and a subjective assessment of birth experience and satisfaction with delivery at 2 months postpartum. The level of pain was determined by a visual analogue scale. Of the 517 women who completed the treatment, 490 responded to a questionnaire 2 months after delivery, assessing their experience and satisfaction with the 3 methods. Significantly fewer women in the acupuncture group received pharmacological or invasive methods for pain relief, or both, compared with the traditional group (P < 0.001) or the TENS group (P < 0.031). No significant difference between the 3 treatment groups was found in pain scores or in secondary outcomes, including the need for oxytocin, mode of delivery, duration of labor, mean Apgar score at 5 minutes, or cord pH blood value. When asked if they would want to use acupuncture again for a future delivery, 53% of the women in the acupuncture group answered positively and 18% negatively. In contrast, when asked this same question, 18% of the women in the TENS group answered positively and 66% negatively. The degree of relaxation and control of the situation reported by women in the acupuncture group tended to be higher compared to the other 2 groups, but no differences were reported for other birth experience variables. These findings suggest that the need for pharmacological and invasive methods to achieve pain relief may be significantly lower during labor with acupuncture compared to use of TENS or traditional analgesics. The investigators suggest that acupuncture may be a useful supplement to other types of pain relief for women in labor.