Evidence map›Paper›PMID 27406639›Full record

Trial reportBMJ open2016

Complementary therapies for labour and birth study: a randomised controlled trial of antenatal integrative medicine for pain management in labour.

Kate M Levett, C A Smith, A Bensoussan, H G Dahlen

Erratum issuedOpen access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 33 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 8 pooled it
10.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 8 syntheses or guidelines pooled it, 139 citations in OpenAlex.

  1. Pooled it
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  5. Acupuncture or acupressure for pain management during labour.The Cochrane database of systematic reviews · 2020
    Pooled it
  6. Relaxation techniques for pain management in labour.The Cochrane database of systematic reviews · 2018
    Pooled it
  7. Massage, reflexology and other manual methods for pain management in labour.The Cochrane database of systematic reviews · 2018
    Pooled it
  8. Acupuncture or acupressure for induction of labour.The Cochrane database of systematic reviews · 2017
    Pooled it
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

4 authors at 1 institution in 1 country.

Kate M LevettNational Institute for Complementary Medicines (NICM), Western Sydney University, Sydney, Australia.
C A SmithNational Institute for Complementary Medicines (NICM), Western Sydney University, Sydney, Australia.
A BensoussanNational Institute for Complementary Medicines (NICM), Western Sydney University, Sydney, Australia.
H G DahlenSchool of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
Western Sydney University · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate the effect of an antenatal integrative medicine education programme in addition to usual care for nulliparous women on intrapartum epidural use.

designOpen-label, assessor blind, randomised controlled trial.

setting2 public hospitals in Sydney, Australia. POPULATION: 176 nulliparous women with low-risk pregnancies, attending hospital-based antenatal clinics. METHODS AND

interventionThe Complementary Therapies for Labour and Birth protocol, based on the She Births and acupressure for labour and birth courses, incorporated 6 evidence-based complementary medicine techniques: acupressure, visualisation and relaxation, breathing, massage, yoga techniques, and facilitated partner support. Randomisation occurred at 24-36 weeks' gestation, and participants attended a 2-day antenatal education programme plus standard care, or standard care alone.

main outcome measuresRate of analgesic epidural use. Secondary: onset of labour, augmentation, mode of birth, newborn outcomes.

resultsThere was a significant difference in epidural use between the 2 groups: study group (23.9%) standard care (68.7%; risk ratio (RR) 0.37 (95% CI 0.25 to 0.55), p≤0.001). The study group participants reported a reduced rate of augmentation (RR=0.54 (95% CI 0.38 to 0.77), p<0.0001); caesarean section (RR=0.52 (95% CI 0.31 to 0.87), p=0.017); length of second stage (mean difference=-0.32 (95% CI -0.64 to 0.002), p=0.05); any perineal trauma (0.88 (95% CI 0.78 to 0.98), p=0.02) and resuscitation of the newborn (RR=0.47 (95% CI 0.25 to 0.87), p≤0.015). There were no statistically significant differences found in spontaneous onset of labour, pethidine use, rate of postpartum haemorrhage, major perineal trauma (third and fourth degree tears/episiotomy), or admission to special care nursery/neonatal intensive care unit (p=0.25).

conclusionsThe Complementary Therapies for Labour and Birth study protocol significantly reduced epidural use and caesarean section. This study provides evidence for integrative medicine as an effective adjunct to antenatal education, and contributes to the body of best practice evidence. TRIAL REGISTRATION NUMBER: ACTRN12611001126909.

Indexed as

Complementary TherapiesIntegrative MedicineLabor, ObstetricLabor PainPain ManagementAdultAnalgesia, EpiduralAustraliaCesarean SectionFemaleHumansPatient Education as TopicPregnancyPrenatal Careantenatal educationCaesarean sectionCOMPLEMENTARY MEDICINEEpiduralnormal birthrandomised controlled trial

Identifiers

PMID27406639
PMCPMC4947718
OpenAlexW2474121075

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.