ALTERNATIVE THERAPIES DURING LABOUR.pptx

LABOR IS DIFFICULT PROCESS WHICH NEED ALTERNATIES MODALITIES.

1. ALTERNATIVE AND COMPLEMENTARY THERAPIES IN LABOUR Ms. Bhagyashree Dash M.sc Nursing 1 st year Obstetrics and gynecology, KINS

2. It is the happiest moment for the mother when she conceives, but it becomes worst moment when labour pain starts & she suffers from anxiety & nervousness. There is recent development in treatment modalities which is very helpful to the mother during labour. It helps to reduce the pain, lowers her anxiety level & makes her ready for the process of labour. These treatments are other than pharmacological modalities & known as alternative &complementary therapies.

3. DEFINITION Alternative therapies: Alternative therapies are used instead of conventional or mainstream therapies for examples, the use of acupuncture/acupressure rather than analgesics to relieve pain.   Complementary therapies: Complementary therapies are those used in conjunction with conventional therapies for example meditation used as an adjunct to analgesics drugs.

4. List of complementary therapies -HANDOUT

5. HOW COMPLEMENTARY THERAPY WORKS?

6. COMMON COMPLEMENTARY THEPY PRACTICES

7. PREPARATION IN LABOUR Advice the mother to buy some natural remedies over the counter. Choose good-quality  essential oils  and homeopathic remedies from a reputable supplier. For other therapies, except massage, self-hypnosis and relaxation, need to consult a complementary therapist who is qualified to care for pregnant women.

8. Alternative therapies used during labour -CHARTS

9. Acupuncture, acupressure and shiatsu during labour

10. ACUPRESSURE & SHIASTU With acupressure and shiatsu, therapist will focus on these same points. Acupressure involves fingertip pressure on the points, and shiatsu uses the points for massage. partner can press his thumbs firmly into the dimples either side of lower spine, starting at tailbone (coccyx) and moving up to waist. This may ease the pain of contractions. A pply pressure to each pair of dimples for two seconds, then move up to the next pair. There are about five pairs of dimples in this part of back. When he reaches waist, he'll need to start again at tailbone.

11. Hegu Li-4 Location : This point lies between the first and second metacarpal bones. The highest point formed when the thumb is brought to rest against the index finger. Uses: To provide general pain relief in labour To stimulate efficient uterine contraction. To regulate uterine contraction. During 2nd stage of labour to aid body's effort to move the baby down through birth canal.

12. Jianjing GB-21: Location: when you draw an imaginary line between the bony prominence of the neck (C7) and the top of the shoulder joint (acromion process), this point lies midway along the curved line, at the highest point of the shoulder muscle.GB-21leeTechnique: pressure is applied of the beginning of each contraction. Uses: 1.To aid in the descent of the baby at the first and second stage of labour. 2.To stimulate uterine contractions.

13. Samyinjiao-SP-6 Location: 4 fingers width (woman's) above the tip of the medial mallelous of the border of the tibia. Uses: 1.Aid in the dilatation of the cervix. 2.Aid in strengthening uterine contraction Cilian BL-32 Location: Centre of second sacral foramen, of the mid point of posterior superior iliac and posterior midline. Uses: 1.Aid in the descent of the baby 2. Produce a pleasant anaesthetising effect on the uterine contractions.

14. ACUPUNCTURE Acupuncture during labour, acupuncturist inserts fine needles into specific points of body to try to reduce pain. Some midwives and physiotherapists are qualified in acupuncture, but it's more likely to have a private acupuncturist during labour.

15. AROMATHERAPY & MASSAGE

16. Aromatherapy Aromatherapists   use essential oils to stimulate and balance hormone levels, and ease stress. It may help to  relax  and increase levels of feel-good hormones, such as oxytocin. Massage with or without essential oils, can help to reduce pain, and improve emotional experience of labour. For an aromatherapy massage, use up to 2 drops of essential oils at a time, blended into about a teaspoon (5ml) of an unscented base oil, such as grape seed.

17. Try the following relaxing and uplifting oils: camomile grapefruit bergamot ylang ylang rose lavender

18. Frankincense- Recommended by aromatherapists for the end of first stage of labour. It can help to stay calm if contractions become difficult to cope with. Rub a single drop of frankincense oil on to the palm of hand, Ask attender to massage the oils into back, shoulders or feet. Essential oils in the bath to relax in  early labour and if waters have not broken. Once waters have broken, the oils could affect baby, irritating baby’s skin and upsetting immune system. Alternatively, essential oils in a foot bath Or could try wooden tapers, steam inhalation or putting one drop or two drops of oil on a tissue so that can breathe it in. If having a  home birth , can use a vaporiser or diffuser. But don't use it for more than 10 minutes to 15 minutes every hour, as it may make feel sick or give a headache. Lavender and jasmine are sometimes helpful, but use them sparingly. No need to add more than a drop or two to a teaspoon of base oil.

19. MASSAGE DURING LABOUR

20. Herbal remedies during labour Herbal medicines work in the same way as drugs, and some can interfere with pregnancy, or interact with prescribed drugs.

21. Raspberry leaf tea well-known herbal remedy for pregnancy and birth. It's thought to tone the muscles of womb (uterus) and make contractions more effective, possibly reducing the length of labour. N ot much evidence for its safety or effectiveness. T hought to help if mother has been drinking it from about  32 weeks  of pregnancy, as the effects build over time.

22. Don't use raspberry leaf tea if: you need a drip to speed up your labour you've had a  caesarean section  in the past you’re having a planned  caesarean you've had any problems with  bleeding you've had  premature labour in the past Blue cohosh should never be used. It has been linked to serious side-effects in babies, including stroke and heart problems.

23. Homeopathy during labour Homeopathy uses minute, highly diluted doses of substances. There's no evidence to show that homeopathy works, but if like to try it, consult a qualified, registered homeopath. Homeopaths recommend arnica to treat any  shock, trauma or bruising  you may experience after giving birth.

24. REFLEXOLOGY DURING LABOUR

25. Reflexology relies on the idea that feet represent a map of body. Pressure points on feet correspond to organs and tissues across body, working in a similar way to acupuncture. Reflexology has not been proven to help with labour pain, but a few NHS midwives do offer it to women in labour, often alongside massage and aromatherapy.

26. finding contractions hard to cope with - squeeze heels several times during a contraction. contractions slow down - massage the back of big toes.

27. Sterile water injections during labour

28. Sterile water injections (SWI) are four injections of sterile water made under the skin of lower back. They're not routinely offered across the NHS, as there’s conflicting evidence over whether they are effective as a form of pain relief in labour. some  birth centres  do offer SWIs to help relieve lower back pain during labour. The first few minutes after the injections may be unpleasant, but SWIs appear to work quickly. Women from a 2016 study said that their pain was significantly lower after just 10 minutes and remained lower at 45 minutes, 90 minutes and even one day after the injections.

29. Self-hypnosis and hypnobirthing during labour

30. The word hypnosis originates from the Greek “Hypnos” which means sleep. Hypnosis is not sleep but a state of attentive and focused concentration in which the patient can be relatively unaware, yet not completely blind to their surroundings. Hypnotic focus on diminishing the awareness of pain as well as fear and anxiety. B ody's "fight or flight" RESPONSE

31. Kate Middleton gave her first podcast interview on an episode of "Happy Mum, Happy Baby," where she reflected on her pregnancies.   "I didn't ask [Prince William] about it, but it was just something I wanted to do for myself," Middleton said on the podcast. "I saw the power of it really — the meditation and the deep breathing and things like that that they teach you in hypnobirthing — when I was really sick and I realized that actually this was something that I could take control of during labor."

32. RELATED RESEARCH

33. 1. Complementary medicine for laboring women: a qualitative study of the effects of reflexology  AUTHOR: Zahi Arnon ,  Asnat Dor ,  Hadar Bazak  , Samuel Attias  , Shlomi Sagi  , Shoshana Balachsan  and  Elad Schiff   FROM THE JOURNAL:  Journal of Complementary and Integrative Medicine ( Volume-16, issue1) https://doi.org/10.1515/jcim-2018-0022 METHODS: This qualitative study was conducted in an Israeli university hospital that offers integrative medicine services. Reflexology was offered to laboring women in the hospital, by the medical staff. In-depth, open interviews were conducted with 36 women, still in hospital, who consented to be interviewed, within 48   h after delivery. Questions referred to their labor experience with reflexology treatment . RESULTS: Of the 36 participants, 34 (94%) described a positive and empowering experience. They reported reduced pain and anxiety, and an increased sense of self-efficacy.  

34. 2. Intracutaneous or subcutaneous sterile water injection compared with blinded controls for pain management in labour AUTHOR : Sheena Derry   1 ,  Straube ,  R Andrew Moore ,  Heather Hancock ,  Sally L Collins AFFILIATIONS EXPAND: PMID:  22258999 DOI:  10.1002/14651858.CD009107.pub2 PUBLISHED: PUB MED 2012 Jan 18;1:CD009107 . Objectives:  To determine the efficacy of sterile water injections for relief of pain (both typical contraction pain and intractable back pain) during labour compared to placebo or non-pharmacological interventions, and to identify any relevant effects on mode and timing of delivery, or safety of both mother and baby. Search methods:  searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 May 2011), MEDLINE, and EMBASE (January 2010 to 30 May 2011), together with reference lists in retrieved studies and review articles. Main results: In cluded seven studies, with 766 participants: four used intracutaneous injections, two subcutaneous, and one both. All reported on low back pain in labour only. Methodological quality was good,

35. 3 . Complementary and alternative medicine for induction of labour AUTHOR: Helen G Hall   1 ,  Lisa G McKenna ,  Debra L Griffiths Affiliations expand: PMID:  21524953   DOI:  10.1016/j.wombi.2011.03.006 PUBLISHED: 2012 Sep;25(3):142-8. Epub 2011 Apr 27. Aim:  The aim of this paper is to examine the scientific evidence for the use of complementary and alternative medicine to stimulate labour. Method:  An initial search for relevant literature published from 2000 was undertaken using a range of databases. Articles were also identified by examining bibliographies. Results:  Most complementary and alternative medicines used for induction of labour are recommended on the basis of traditional knowledge, rather than scientific research. Currently, the clinical evidence is sparse and it is not possible to make firm conclusions regarding the effectiveness of these therapies.

36. It is time that we reach for natural health than the pharma drugs that are killing the world. 

37. Complementary and alternative medicine is a category of medicine that includes a variety of treatment methods that fall outside the realm of conventional medicine.  Most of the Complementary and Alternative Medicine Therapies can be done along with conventional medical treatments. CAM is also mostly a cheaper in cost when compared to allopathic medicines. 

38. BIBLIOGRAPHY 1. Carter C, Barratt J. 2014.  Guidelines for midwives on the use of massage & aromatherapy . Worcestershire Acute Hospitals NHS Trust. 2. Cui JZ, Geng ZS, Zhang YH, et al. 2016. Effects of intracutaneous injections of sterile water in patients with acute low back pain: a randomized, controlled, clinical trial.  Braz J Med Biol Res  49(3): 1414-431X 3. Derry S, Straube S, Moore RA, et al. 2012. Intracutaneous or subcutaneous sterile water injection compared with blinded controls for pain management in labour.  Cochrane Database of Systematic Reviews . (1): CD009107. onlinelibrary.wiley.com [Accessed September 2016] 4. Hall HG, McKenna LG, Griffiths DL. 2011. Complementary and alternative medicine for induction of labour. Women Birth  online first: 25 Apr 5. https://www.degruyter.com/document/doi/10.1515/jcim-2018-0022/html 67. https://www.babycentre.co.uk/a1027876/complementary-therapies-for-labour-pain 8. Karpen M, Conrad L, Chitwood L. Essentials of Maternal Child Nursing, 2nd edition. 1995. pp. 25-32.

39. 9. Light HK, Fenster C. Maternal concerns during pregnancy , Am J Obstet Gynecol. 1974;118:46. 10. Parulekar SV. Textbook for Midwives, 2nd edition. Mumbai: Vora Medical Publications; 1998. pp. 134-6. 11. Helen V. Nurse-Midwifery, 2nd edition. Boston: Jones and Bartlett Publishers; 1996 12.https://www.physiopedia.com/Gate_Control_Theory_of_Pain#:~:text=One%20of%20two%20things%20can,pain%20won't%20be%20perceived. 13. https://www.avensonline.org/blog/complementary-and-alternative-therapies.html 14. https://discover.hubpages.com/education/Complementary-Alternative-Medicine-Therapies-cam-meaning-difference 15. https://www.scribd.com/document/351289059/Alternative-Complementary-Therapy-in-Labour