# Effect of Heat Therapy on Pain During the First Stage of Labor Among Primigravid Women: A Pilot Study

## TL;DR

This pilot study found that applying heat to the lower back during labor significantly reduced pain levels in first-time pregnant women compared to standard care.

## Contribution

The study introduces lumbosacral heat therapy as a novel non-pharmacological intervention for managing labor pain in primigravid women.

## Key findings

- Heat therapy significantly reduced labor pain scores in primigravid women during the first stage of labor.
- The repeated measures ANOVA showed a large effect size and significant mean differences in pain scores after heat application.
- The intervention group had a progressive decrease in pain scores compared to baseline and the control group.

## Abstract

Background

Labor pain is often one of the most severe pains a woman may feel in her lifetime, and childbirth is usually considered one of the most physically demanding experiences a woman may have. An effective and safe midwifery intervention for reducing labor pain in pregnant women is the administration of heat.

Aim

The objective of the article is to compare the effectiveness of lumbosacral heat application on pain throughout the active first stage of labor between the interventional and control groups.

Method

A randomized controlled trial among 10 low-risk primigravid women admitted to Bharatpur Hospital in Chitwan, Nepal, was carried out to evaluate the intensity of pain and duration of the active first phase of labor by allocating them randomly into intervention (5) and control groups (5); one group received heat therapy on the lumbosacral region, while the other received standard care. The Visual Analog Scale (VAS) was applied as an instrument to assess pain four times: before heat therapy at 4-5 cm of cervix dilation and three times after heat application at 4-5, 7-8, and 9-10 cm. The data were analyzed descriptively and inferentially using a repeated measures ANOVA test.

Results

The mean age of the mothers was 21.80±3.327, most of them belonged to the low socioeconomic class, all of them were living in joint families, 80% of participants had less than 18.5 body mass index, all participants had visited an antenatal clinic for check-ups, and 60% had spontaneous labor started. The findings show a higher labor pain score before intervention (mean=6.80) which progressively decreased after an intervention: post-test 2 (M=6.20; SD=0.83), post-test 3 (M=5.60; SD=0.89), and post-test 4 (M=5.00; SD=0.70). The mean, standard deviation, and F-value of labor pain before and after the application of heat therapy among primigravid women indicated a significant mean difference in labor pain (F (3,12)=4.500; MES=0.66; p=0.025; η2=0.53) with a large effect size in contrast to the control group. The p-value for post-test 4 was 0.025, representing that the null hypothesis was rejected. This acclaims that heat therapy has an effect on labor pain.

Conclusion

It is concluded that the application of heat on the lower back during labor lowered the pain level experienced by primigravid women in the interventional group compared to those in the control group. Thus, heat therapy can be considered a viable method for managing labor pain.