Effect of Antenatal Exercises, Including Yoga, on the Course of Labor, Delivery and Pregnancy: A Retrospective Study

The wonders of mind-body practices during pregnancy: A topical review

This topical review provides an up-to-date overview of the latest advancements in mind-body therapies in the gynaecological research field. It explores the various mind-body practices and their multifaceted benefits for expectant mothers during the transformative phase of pregnancy, including physical, emotional, and psychological aspects. The research highlights the importance of these practices in promoting maternal and fetal well-being. Prenatal yoga is found to enhance physical health, reduce discomfort, and lower stress and anxiety levels, potentially leading to shorter labour durations. Meditation is revealed to reduce stress and anxiety while nurturing emotional resilience. Prenatal Pilates improves musculoskeletal health and prepares mothers for labour, emphasising controlled movements and breathing techniques. Breathing techniques prove to be helpful for pregnant women in effectively managing pain during labour. Acupressure and reflexology offer non-pharmacological pain relief for common discomforts. Tai Chi improves physical fitness, flexibility, and mental well-being. This brief review, using evidence available from pre-clinical studies in physiological gynaecology literature, demonstrates the role of mind-body practices in enhancing the pregnancy journey, emphasising their integration into daily routines to contribute to overall well-being. By selecting the right practice or combination, expectant mothers can experience an overall better pregnancy.

The Effect of Labor Dance in the First Stage of Labor on Labor Pain, Anxiety, Duration of Labor, and Maternal Satisfaction with Labor: A Randomized Controlled Study

Objective: The study aimed to examine the effects of labor dance applied in the first stage of labor on perceived labor pain, anxiety, duration of labor, and maternal satisfaction with labor. Design: This study is a randomized controlled trial. Methods: A sample size of 128 pregnant women was randomly assigned to a control (n = 64) or experimental (n = 64) group while ensuring equal numbers of primiparous and multiparous participants in each group. After admission to the hospital for parturition, and during the first stage of labor, the women in the experimental group were exposed to a 15-min labor dance every hour when the cervical dilation was between 3 and 8 cm. The labor dance included movements of the sacrum and waist massaged by a partner using a massage glove, which was accompanied by self-selected music. Outcome measures included the Visual Analogue Scale (VAS), the State Anxiety Scale (SAS), and the Scale for Measuring Maternal Satisfaction (SMMS)-normal birth and labor duration. These were administered before the labor dance and at the end of the labor dance at three points of cervical dilation: 3, 5-6, and 7-8 cm for the experimental group, and at similar points in the control group: at the start of dilation and 15 min later. The data were analyzed using the generalized linear model and Mann-Whitney U tests. Results: In comparison to the control group, for the group performing the labor dance, the mean VAS scores were lower (p < 0.05) at each evaluation period, and the mean scores of total SMMS and some of its subdivisions were significantly higher in the experimental group (p < 0.05). There was no statistically significant difference between the SAS scores at any evaluation point, including postpartum (p > 0.05). Similarly, there were no significant differences in labor time (p > 0.05) between groups. Conclusions: The practice of labor dance was found to be effective in reducing the perceived labor pain in pregnant women and increasing maternal satisfaction at birth, but not on the duration of labor, and anxiety. Trial registration: ClinicalTrials.gov (NCT04746170).

Nonpharmacological Methods to Reduce Pain During Active Labor in A Real-life Setting

OBJECTIVE

 To evaluate the association between pain intensity in the active phase of the first stage of labor with the use or not of nonpharmacological methods for pain relief in a real-life scenario.

METHODS

 This was an observational cross-sectional study. The variables analyzed were obtained by a questionnaire with the mothers (up to 48 hours postpartum) to investigate the intensity of pain during labor using the visual analog scale (VAS). The nonpharmacological pain relief methods routinely used in obstetric practice were evaluated by consulting medical records. The patients were separated into two groups: Group I - patients who did not use nonpharmacological methods for pain relief and Group II -patients who used these methods.

RESULTS

 A total of 439 women who underwent vaginal delivery were included; 386 (87.9%) used at least 1 nonpharmacological method and 53 (12.1%) did not. The women who did not use nonpharmacological methods had significantly lower gestational age (37.2 versus 39.6 weeks, p < 0.001) and shorter duration of labor (24 versus 114 min, p < 0.001) than those who used the methods. There was no statistically significant difference in the pain scale score using the VAS between the group that used nonpharmacological methods and the group that did not (median 10 [minimum 2-maximum 10] versus 10 [minimum 6-maximum 10] p = 0.334).

CONCLUSION

 In a real-life setting, there was no difference in labor pain intensity between the patients who used nonpharmacological methods and those who did not use them during the active phase of labor.

Pregnant women’s knowledge of non-pharmacological techniques for pain relief during childbirth

INTRODUCTION

The objective of the study was to assess knowledge of pregnant women in the third trimester of pregnancy on non-pharmacological techniques for pain relief during labor and childbirth.

METHODS

A cross-sectional study was conducted at a tertiary care facility of the University of Campinas, Brazil. The participants were 171 pregnant women, aged 18–35 years with 36 or more weeks of a singleton pregnancy. Participants responded to a questionnaire with data about sociodemographic and obstetric characteristics, knowledge on non-pharmacological techniques for pain relief during childbirth, the source of the information on these techniques, practice of physical activity and occurrence of pain during pregnancy. Parous women responded on the use of non-pharmacological techniques for pain relief during childbirth in previous deliveries. Multiple regression analysis with stepwise criteria of selection of variables was used to identify variables significantly associated with knowledge of non-pharmacological techniques for pain relief during childbirth.

RESULTS

A total of 165 (96.5%) participants reported knowledge on at least one non-pharmacological technique; 87.1% on the use of a warm shower during labor for pain relief, 80.7% on the use of the birthing ball, and 74.8% on breathing techniques. There were no significant differences between nulliparous and parous women. The main source of information reported was the Internet. Multivariate analysis showed that pregnant women who had pain during pregnancy reported more knowledge on the use of warm showers during labor (OR=2.64; 95% CI: 1.03–6.73).

CONCLUSIONS

Most women had knowledge of at least one non-pharmacological technique for pain relief during childbirth.

Impact of the COVID-19 pandemic on mental health of pregnant women with diabetes mellitus and hypertension

OBJECTIVE

Psychological effects of the coronavirus disease 2019 (COVID-19) pandemic on pregnant women with diabetes and hypertension are not yet studied. Besides the pregnancy, these women have additional risk factors for severe acute respiratory syndrome due to COVID-19 and are considered a particularly vulnerable, unique population. We aimed to assess their mental health during this pandemic.

METHODS

This is a cross-sectional study carried out at a Brazilian tertiary hospital. Women with pregnancies complicated by hypertension and/or diabetes were evaluated. The primary outcome was anxiety, and depressive symptoms evaluated with the State-Trait Anxiety Inventory and Patient Health Questionnaire. Perception of changing habits during quarantine was evaluated as a secondary outcome.

RESULTS

Seventy-nine patients were included. The prevalence of State-Trait Anxiety Inventory ≥40 was 79.7% and that of Patient Health Questionnaire ≥10 was 59.2%. Lower social support was correlated with higher scores on both scales. Time spent with electronic devices was perceived as greater by 62% of the women.

CONCLUSIONS

Pregnant women with diabetes and hypertension presented high levels of anxiety and depressive symptoms during the COVID-19 pandemic. Considering that these symptoms can affect both the mother's and offspring's health, it is necessary to implement tools to improve their mental health.