Hypnosis and acupuncture are promising approaches to relieve pain during labor and delivery, but more research is needed to determine whether these two strategies, as well as other complementary therapies - such as massage, relaxation, aromatherapy, acupressure, and white noise -- relieve labor pain.

A study that reviewed the most current scientific evidence of complementary and alternative therapies for pain management in labor published in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an organization that evaluates research and draws evidence-based conclusions about medical practice after considering both the content and quality of existing studies.

"The pain of labor can be intense, with tension, anxiety and fear making it worse," write Caroline Smith of the University of Adelaide, Australia and colleagues. Many women want to give birth without using drugs and often turn to complementary and alternative medicine to help them through the labor pain.

Smith and three associates pooled data from 14 studies involving 1,448 women who used different means of pain management during labor.

Data from the three acupuncture trials (496 women) showed a 30-percent decrease in need for pain-relieving drugs, as well as a reduced need for epidurals and drugs like oxytocin, which stimulates labor.

Women who were taught self-hypnosis in the five hypnosis trials (729 women) were also much less likely to require drug-induced pain relief, including epidurals, during labor and were significantly more satisfied with their pain management than were women in the control group.

Some other "promising benefits" of hypnosis include an increased rate of vaginal births and a decreased need for oxytocin, the authors state.

Hypnosis could be used alone for pain relief or as an add-on to facilitate and enhance other analgesics. Smith and colleagues call for larger, better-designed trials on hypnosis and acupuncture for pain management in labor.

At present, the authors say, there is insufficient evidence about the effectiveness of acupressure, aromatherapy, music therapy, massage, relaxation, and white noise for pain management in labor.

The reviewers conclude: "Acupuncture and hypnosis may be beneficial for the management of pain during labor; however, the number of women studies had been small. Few other complementary therapies have been subjected to proper scientific study."

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