Aromatherapy for pain management in labour

Aromatherapy draws on the healing power of plants with the use of essential oils to enhance physical and mental wellbeing. The oils may be massaged into the skin, in a bath or inhaled using a steam infusion or burner. The pain of labour can be intense, with tension, fear and anxiety making it worse. Many women would like to labour without using drugs, or invasive methods such as an epidural, and turn to complementary therapies to help reduce their pain perception Many complementary therapies are tried and include acupuncture, mind-body techniques, massage, reflexology, herbal medicines or homoeopathy, hypnosis, music and aromatherapy. The review identified two randomised controlled trials of aromatherapy. One trial involving 513 women compared one of Roman chamomile, clary sage, frankincense, lavender or mandarin essentials oils with standard care. The aromatherapy was applied using acupressure points, taper, compress, footbath, massage or a birthing pool. The second trial involved 22 women randomised to bathe for at least an hour in water with either essential oil of ginger or lemongrass added. All women received routine care and had access to pain relief. The trials found no difference between groups for pain intensity, assisted vaginal birth, caesarean section or the use of pharmacological pain relief (epidural). Overall, there is insufficient evidence from randomised controlled trials about the benefits of aromatherapy on pain management in labour. More research is needed.

Authors' conclusions: 

There is a lack of studies evaluating the role of aromatherapy for pain management in labour. Further research is needed before recommendations can be made for clinical practice.

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Background: 

Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of aromatherapy for pain management in labour.

Objectives: 

To examine the effects of aromatherapy for pain management in labour on maternal and perinatal morbidity.

Search strategy: 

We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (31 October 2010), The Cochrane Complementary Medicine Field's Trials Register (October 2010), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2010, Issue 4), MEDLINE (1966 to 31 October 2010), CINAHL (1980 to 31 October 2010), the Australian and New Zealand Trials Registry (31 October 2010), Chinese Clinical Trial Register (31 October 2010), Current Controlled Trials (31 October 2010), ClinicalTrials.gov (31 October 2010), ISRCTN Register (31 October 2010), National Center for Complementary and Alternative Medicine (NCCAM) (31 October 2010) and the WHO International Clinical Trials Registry Platform (31 October 2010).

Selection criteria: 

Randomised controlled trials comparing aromatherapy with placebo, no treatment or other non-pharmacological forms of pain management in labour.

Data collection and analysis: 

Two authors independently assessed trial quality and extracted data. We contacted study authors for additional information.

Main results: 

We included two trials (535 women) in the review. The trials found no difference between groups for the primary outcomes of pain intensity, assisted vaginal birth (risk ratio (RR) 1.04, 95% confidence interval (CI) 0.48 to 2.28, one trial, 513 women; RR 0.83, 95% CI 0.06 to 11.70, one trial, 22 women), and caesarean section (RR 0.98, 95% CI 0.49 to 1.94, one trial, 513 women; RR 2.54, 95% CI 0.11 to 56.25, one trial, 22 women); there were more babies admitted to neonatal intensive care in the control group of one trial (RR 0.08, 95% CI 0.00 to 1.42, one trial, 513 women) but this difference did not reach statistical significance. The trials found no differences between groups for the secondary outcomes of use of pharmacological pain relief (RR 0.35, 95% CI 0.04 to 3.32, one trial, 513 women; RR 2.50, 95% CI 0.31 to 20.45, one trial, 22 women), spontaneous vaginal delivery (RR 1.00, 95% CI 0.94 to 1.06, one trial, 513 women; RR 0.93, 95% CI 0.67 to 1.28, one trial, 22 women) or length of labour and augmentation (RR 1.14, 95% CI 0.90 to 1.45, one trial, 513 women). The risk of bias was low in the trials.

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