Acupuncture with manual and electrical stimulation for labour pain: a two month follow up of recollection of pain and birth experience.

Linda Vixner,Lena B Mårtensson,Erica Schytt

doi:10.1186/s12906-015-0708-2

Abstract

BackgroundIn a previous randomised controlled trial we showed that acupuncture with a combination of manual- and electrical stimulation (EA) did not affect the level of pain, as compared with acupuncture with manual stimulation (MA) and standard care (SC), but reduced the need for other forms of pain relief, including epidural analgesia. To dismiss an under-treatment of pain in the trial, we did a long-term follow up on the recollection of labour pain and the birth experience comparing acupuncture with manual stimulation, acupuncture with combined electrical and manual stimulation with standard care. Our hypothesis was that despite the lower frequency of use of other pain relief, women who had received EA would make similar retrospective assessments of labour pain and the birth experience 2 months after birth as women who received standard care (SC) or acupuncture with manual stimulation (MA).MethodsSecondary analyses of data collected for a randomised controlled trial conducted at two delivery wards in Sweden. A total of 303 nulliparous women with normal pregnancies were randomised to: 40 min of MA or EA, or SC without acupuncture. Questionnaires were administered the day after partus and 2 months later.ResultsTwo months postpartum, the mean recalled pain on the visual analogue scale (SC: 70.1, MA: 69.3 and EA: 68.7) did not differ between the groups (SC vs MA: adjusted mean difference 0.8, 95 % confidence interval [CI] −6.3 to 7.9 and SC vs EA: mean difference 1.3 CI 95 % −5.5 to 8.1). Positive birth experience (SC: 54.3 %, MA: 64.6 % and EA: 61.0 %) did not differ between the groups (SC vs MA: adjusted Odds Ratio [OR] 1.8, CI 95 % 0.9 to 3.7 and SC vs EA: OR 1.4 CI 95 % 0.7 to 2.6).ConclusionsDespite the lower use of other pain relief, women who received acupuncture with the combination of manual and electrical stimulation during labour made the same retrospective assessments of labour pain and birth experience 2 months postpartum as those who received acupuncture with manual stimulation or standard care.Trial registrationClinicalTrials.gov: NCT01197950

Highlights

In a previous randomised controlled trial we showed that acupuncture with a combination of manual- and electrical stimulation (EA) did not affect the level of pain, as compared with acupuncture with manual stimulation (MA) and standard care (SC), but reduced the need for other forms of pain relief, including epidural analgesia
Three studies reported that acupuncture leads to a reduced use of pharmacological pain relief such as epidural analgesia and pethidin [6, 7, 10]
We have previously shown that acupuncture with manual stimulation or acupuncture with a combination of manual and electrical stimulation was not superior to standard care (SC) when pain was assessed prospectively on a Visual Analogue Scale (VAS) during labour [7]

Summary

Introduction

In a previous randomised controlled trial we showed that acupuncture with a combination of manual- and electrical stimulation (EA) did not affect the level of pain, as compared with acupuncture with manual stimulation (MA) and standard care (SC), but reduced the need for other forms of pain relief, including epidural analgesia. Three studies reported that acupuncture leads to a reduced use of pharmacological pain relief such as epidural analgesia and pethidin [6, 7, 10] This lower frequency of use of pharmacological pain relief may reflect lower pain intensity due to the effects of acupuncture but it is a possibility that it reflects insufficient treatment of pain. This uncertainty raises questions about the long-term effect of acupuncture on the birth experience in general and on labour pain in particular. A negative birth experience is an important predictor of depressive symptoms during the first year of motherhood [13]

Methods

Results

Conclusion