Abstract
To identify non-pharmacological therapies applied during pregnancy and labor. Integrative review conducted in the databases: PubMed, ScieLO and PEDro, searching for articles from 2008 in English, Spanish and Portuguese. The descriptors used were: pregnancy, childbirth, physiotherapy, alternative and complementary medicine, alternative therapy, non-pharmacological therapy, biomechanical therapy. Forty-one articles were analyzed and subdivided into ten categories of nonpharmacological therapies: massage, perineal massage, hot bath, supportive care, childbirth preparation group, breathing techniques, pelvic floor exercises, transcutaneous electrostimulation, Swiss ball and spontaneous pushing. Six articles (60%) showed a positive outcome for reduction of pain in labor and all of them had a positive outcome for different variables of labor, such as reduction of time, anxiety and pelvic floor laceration rates. The use of non-pharmacological therapies was efficient to reduce the effects of labor and childbirth, such as pain, duration of labor, anxiety, laceration and episiotomy.
Highlights
The literature has different denominations for unconventional therapeutic practices in pregnancy, such as active movement, breathing exercises, use of the Swiss ball, massage, hot baths, among others, which are called: Non-Pharmacological Therapies (NPT), complementary medical therapies, alternative therapies, physiotherapeutic resources and manual therapies(1-2)
Ten NPT were identified in the studies of this review: massage, perineal massage, hot bath, supportive care, childbirth
Ten (24.39%) studies brought the application of NPT in childbirth preparation clinics with techniques that needed a longer follow-up to obtain positive outcomes, such as childbirth preparation groups, perineal massage and Pelvic Floor (PF) exercises(14,32,49)
Summary
The literature has different denominations for unconventional therapeutic practices in pregnancy, such as active movement, breathing exercises, use of the Swiss ball, massage, hot baths, among others, which are called: Non-Pharmacological Therapies (NPT), complementary medical therapies, alternative therapies, physiotherapeutic resources and manual therapies(1-2). There are two groups of NPT used in pregnancy and labor: those involving application to soft or myofascial tissues (massage, myofascial release, acupressure, reflexology, Transcutaneous Electrostimulation - TENS, acupuncture, hot baths, ice application, perineal massage, breathing exercises, muscle relaxation) and those involving joint manipulation (bone mobilization, osteopathy, active free exercises, coordinated position changes, use of the Swiss ball)(3-5). In the perspective of knowing the NPT used in pregnancy and labor for promoting comfort and independence to the parturient woman, it is necessary to identify the scientific production addressing its use in the context of care to pregnant and parturient women. The choice for an integrative review is justified by the search for studies evaluating the use of NPT in a qualitative and quantitative perspective, in order to know quantitative scientific evidence and pregnant women’s experiences with NPT. A search for NPT accessible to all health professionals, from their academic background, was performed, so that the results of this study allow any professional working in the maternal and child context to assist in the comprehensive care of pregnant women by using NPT with evidence of effective results
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