Abstract
BackgroundEpidural analgesia during labor can provide effective pain relief, but can also lead to adverse effects. The practice of moderate exercise during pregnancy is associated with an increased level of endorphins in the blood, and this could also provide pain relief during labor. Aerobic water exercises, rather than other forms of exercise, do not negatively impact articulations, reduce edema, blood pressure, and back pain, and increase diuresis. We propose a randomized controlled trial (RCT) to evaluate the effectiveness and safety of a moderate water exercise program during pregnancy on the need for epidural analgesia during labor.MethodsA multi-center, parallel, randomized, evaluator blinded, controlled trial in a primary care setting. We will randomised 320 pregnant women (14 to 20 weeks gestation) who have low risk of complications to a moderate water exercise program or usual care.DiscussionThe findings of this research will contribute toward understanding of the effects of a physical exercise program on pain and the need for analgesia during labor.Trial registrationISRCTN Registry identifier:14097513 register on 04 September 2017. Retrospectively registered.
Highlights
DiscussionThe findings of this research will contribute toward understanding of the effects of a physical exercise program on pain and the need for analgesia during labor
Epidural analgesia during labor can provide effective pain relief, but can lead to adverse effects
Epidural analgesia provides effective pain relief, it may lead to complications or adverse effects, with maternal and fetal morbidities
Summary
The management of labor pain is one of the main goals of maternity care, and non-pharmacologic approaches to labor pain are consistent with midwifery management and the choices of many women. Our RCT will provide important additional information on the effect of exercise during pregnancy and its impact in epidural use, as well as the rates of instrumental delivery, episiotomy, and induction. A primary strength of this study is its rigorous methodology and the large numbers of health-care professionals and patients. These will strengthen the validity of the findings. If the results of our study are conclusive, they might lead to changes in the standard care given to women during pregnancy, by providing an alternative to epidural analgesia for pain control during labor. The control of labor pain by an antenatal exercise program and without epidural analgesia could improve the experience of childbirth for the mother, and could have a long-term effect on future pregnancies of the mother.
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