The Effect of Localized Heat and Cold Therapy on Pain Intensity, Duration of Phases of Labor, and Birth Outcomes Among Primiparous Females: A Randomized, Controlled Trial

Abstract

Background: Pain is a common and unavoidable phenomenon in childbirth, and in terms of severity, childbirth pain is among the most severe pains in human. Objectives: The current study aimed at investigating the effect of localized heat and cold therapy on pain intensity, duration of phases of labor, and birth outcomes among primiparous females. Satisfaction was also compared in the two intervention groups. Methods: The current randomized, controlled trial was conducted on 120 primiparous females in three groups (heat/ cold therapy, and control) from September 2015 to January 2016. Intensity of pain, duration of phases of labor, and birth outcomes were measured before and after intervention in the three groups. Satisfaction with localized heat and cold therapy was compared in the two intervention groups. No intervention was conducted in the control group. Data were analyzed using the Fisher exact, Chi-square, the Kruskal-Wallis, and ANOVA tests with SPSS version 19. Results: After intervention, statistically significant difference was found in the average pain severity respectively among the heat therapy, cold therapy, and control groups in dilations of 5-6 cm (3.25 ± 0.91, 3.57 ± 1.14, 4.00 ± 1.37) 7-8 cm (4.08 ± 0.91, 4.88 ± 1.05, 4.97 ± 1.17), and 9-10 cm (6.00 ± 1.35, 6.40 ± 1.09, 7.80 ± 1.18) in the first and second phase of the labor (6.22 ± 1.13, 7.37 ± 1.08, 7.94 ± 1.08). There was a statistically significant differences in the average duration of first phase of labor, respectively among heat therapy, cold therapy, and control groups (293.70 ± 68.97, 368.57 ± 79.82, 400.86 ± 77.43) and second phases of labor respectively among heat therapy, cold therapy, and control groups (42.85 ± 13.60, 51.71 ± 12.24, 46.85 ± 13.67), but there was no statistically significant difference among the three groups in terms of the average duration of labor in the third phase. No significant difference was observed between heat and cold therapy groups in terms of satisfaction. No significant difference was observed among the three groups in birth outcomes, including the mean first and fifth Apgar scores, time of cuddling newborn, and the first breastfeeding of newborn. Conclusions: Localized heat and cold therapy are non-pharmacological, non-invasive, satisfactory for the primiparous females, and effective methods to control and relieve pain during labor without adverse effects on maternal and fetal outcomes. © 2018, Author(s).