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U of M researcher: More women use alternative methods to induce labor

image courtesy Frank de Kleine via flickr

Women across America are frequently turning to nonmedical and alternative methods to induce labor and manage pain during the childbirth process according to new research from the University of Minnesota School of Public Health.

The latest analysis is the first such study to review the use of both medical and nonmedical care during labor among women giving birth across the United States. Previously, clinicians and public health officials had little insight into the scope of use of alternative methods of labor induction and pain management; nor was the extent to which nonmedical methods are used in conjunction with medical means previously documented.

The study, conducted by University of Minnesota researchers Katy Kozhimannil, Ph.D., M.P.A., Pamela Johnson, Ph.D., M.P.H., Laura Attanasio, B.A., Dwenda Gjerdingen, M.D., M.S., and Patricia McGovern, Ph.D., M.P.H., appears today in the journal Birth.

“Our study showed that it’s very common for women to try to start their labor and manage pain during labor using nonmedical methods. In fact, these “alternative” methods are used nearly as frequently as medical methods in the United States,” said Kozhimannil. “However, there is not a lot of information on whether women and their clinicians are discussing the effectiveness, risks, and benefits of both medical and nonmedical methods.”

Kozhimannil recommends more research should be conducted to measure the use and effectiveness of alternative health strategies and their relationship with the use of medical services during pregnancy and birth.

“We need to better understand the scope and effectiveness of using nonmedical means to induce labor or manage pain,” said Kozhimannil. “A lot of women are using alternative strategies, and it is important to find out whether and how they work, and to ensure that the use of both medical and nonmedical methods is effective and appropriate, given women’s preferences.”

After looking at responses from 1,382 women who gave birth in hospitals across the U.S., the researchers found:

  • 30 percent used nonmedical methods to attempt to induce their labor, and over half experienced some medical method of labor induction (such as being given medicine to start labor)
  • 70 percent used nonmedical techniques to manage labor pain
  • 85 percent used medical pain management during labor (most commonly an epidural)
  • Women who used nonmedical means of pain management were 35% less likely to have pain medicine (such as an epidural) during birth.
  • Having care from a doula (a trained professional who provides support to a mother during pregnancy, labor and delivery) was the strongest predictor of using nonmedical methods.

Among the nonmedical means used to induce labor, women reported exercise or movement, sexual intercourse, nipple stimulation, castor oil, or herbal treatments.

Some of the nonmedical methods women reported for managing their pain during labor included position change, hands-on techniques (massage, pressure), breathing techniques, mental strategies and using a shower or tub.

The researchers believe women should talk with those who can help provide both medical and nonmedical support (doctors, nurses, midwives, doulas, husband, mothers, sisters) about their plans and preferences for starting labor and managing pain, and clinicians should also be more aware of alternative options and discuss these methods with their patients to ensure their safety and comfort as they give birth.

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