Abstract
ObjectivesThis preliminary study aimed to 1) determine changes in the salivary oxytocin (OT) level during breast stimulation for promoting the spontaneous onset of labor in low-risk term pregnancies, and 2) clarify the feasibility of the breast stimulation intervention protocol in terms of practicality and acceptability.MethodsWe used a single arm trial design. Sixteen low-risk pregnant women between 38 and 40 weeks of gestation with cephalic presentation participated. They performed breast stimulation for 3 days with an attendant midwife in a single maternity hospital. Each breast was stimulated for 15 minutes for a total of 1 hour per day. Saliva was collected 10 minutes before the intervention and 15, 30, 60, 75, and 90 minutes after the intervention, yielding 18 samples per woman.ResultsAmong a total of 282 saliva samples from the 16 participants, OT level was measured in 142 samples (missing rate: 49.6%). The median OT level showed the highest values on day 3 of the breast stimulation, with a marked increase 30 min after the intervention. In the mixed models after multiple imputation for missing data, the OT level on the first day of intervention was significantly lower than that on the third day of intervention. Fatigue from breast stimulation decreased on subsequent days, and most of the women (75%) felt no discomfort with the protocol. Uterine hyperstimulation was not observed.ConclusionFollowing a 3-day breast stimulation protocol for spontaneous onset of labor, the mean OT level showed the highest values on day 3. The breast stimulation intervention protocol showed good feasibility in terms of practicality and acceptability among the pregnant women. Additional large-scale studies are warranted to confirm the protocol’s effectiveness.
Highlights
Oxytocin (OT) infusion is one of the most commonly used techniques for labor induction to avoid increased maternal and fetal risks beyond term [1]
Among a total of 282 saliva samples from the 16 participants, OT level was measured in 142 samples
The median OT level showed the highest values on day 3 of the breast stimulation, with a marked increase 30 min after the intervention
Summary
Oxytocin (OT) infusion is one of the most commonly used techniques for labor induction to avoid increased maternal and fetal risks beyond term [1]. Labor induction is a relevant negative birth experience for women [2,3]. In Japan, about 50% of pregnant women perform exercise or breast stimulation to help induce spontaneous labor [6]. The effects of complementary and alternative medicine on labor induction are expected during membrane sweeping and breast stimulation [7,8]. Breast stimulation has historically been used to induce and augment labor [9]. Breast stimulation for inducing labor has been studied by many researchers to date [10,11,12,13,14,15,16]
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