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INTRODUCTION: The aim of this study was to evaluate a short educational intervention that focused on labor pain (through visual analogue scale, VAS), postpartum anxiety, and birthing experience before and during the SARS-CoV-2 (COVID-19) pandemic. METHODS: This was a quasi-experimental study conducted between November 2019 and May 2021 in Brazil in 100 women with a high-risk pregnancy in the third trimester of pregnancy with an intervention group with in-person or virtual sessions (during the COVID-19 pandemic) and a non-intervention group. The antenatal intervention included breathing and relaxation techniques, upright positions, and information about labor. For evaluation, an antenatal questionnaire, State-Trait Anxiety Inventory (STAI) and a postpartum questionnaire were used. For data analysis, Student's t-test, chi-squared and Fisher's exact tests, ANOVA, bivariate, and multivariate regression analysis, were used. RESULTS: When comparing the women in the intervention group to the non-intervention group, it was observed that the latter group reported higher fear of pain at labor during antenatal consultations (p<0.013); more women needed analgesia at 0-4 cm dilation (17/40) (p<0.018); the duration of labor was ≥12 hours (37/50) (p<0.037); while the intervention reported having a regular, good or excellent labor period (36/50) (p=0.014). The multiple regression analysis for labor pain showed a significant relationship between mode of delivery (cesarean delivery: RR; SE -21.43; 5.32, p<0.001) and labor pain, and good satisfaction with labor (RR; SE -13.86; 6.40, p=0.033). CONCLUSIONS: Women from the intervention group had more satisfaction and less pain during labor than women from the non-intervention group.

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Objetivo: Evaluar la usabilidad de un dispositivo para medir el dolor durante el trabajo de parto a través de siete ítems: tamaño, textura, facilidad de uso, peso, resistencia, comodidad y seguridad. Método: Estudio descriptivo. Se solicitó a 60 pacientes usar el sensor manual durante el transcurso de seis contracciones uterinas (aproximadamente 10-20 minutos) y al día siguiente se aplicó una encuesta en la que las pacientes evaluaron la usabilidad del dispositivo en cuanto a textura, peso, resistencia, comodidad, facilidad de uso, tamaño del sensor, seguridad de uso, peso del sensor, resistencia y comodidad, mediante una escala de Likert de 1 a 7. La seguridad fue evaluada con una escala de 1 a 5. Resultados: Se realizaron gráficos de caja. Con respecto a la seguridad, un 86% de las usuarias marcaron 5 puntos en la escala, percibiendo el dispositivo como seguro. Conclusiones: El dispositivo fue percibido como seguro, liviano, fácil de usar y cómodo.

Objective: To evaluate the usability of a device to measure pain during labor through seven items: size, texture, ease of use, weight, resistance, comfort, and safety. Method: Longitudinal observational study. 60 patients were asked to use the manual sensor during the course of six uterine contractions (approximately 10-20 minutes) and the following day a survey was applied where the patients evaluated the usability of the device in terms of texture, weight, resistance, comfort, easiness of use, sensor size, safety of use, sensor weight, resistance and comfort through a Likert scale from 1 to 7. Safety was evaluated with a scale from 1 to 5. Results: They were schematized with a box plot. Regarding safety, 86% of the users scored 5 points on the scale, perceiving the device as safe. Conclusions: It can be seen that the device was perceived as safe, light, easy to use and comfortable.

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ABSTRACT BACKGROUND AND OBJECTIVES: Aromatherapy with lavender essential oil has been used to reduce pain, anxiety, nausea and vomiting, among others. As the painful experience is unique, responses to therapeutic approaches may vary among individuals and there are specific conditions related to women's health that deserve to be examined. The objective of this study was to analyze the uses of aromatherapy with essential oil of lavender (Lavandula angustifolia), by nurses, for pain control in women. CONTENTS: This is a scoping literature review. The search was carried out in the following portals and/or databases: BVS, Pubmed, Cochrane, on June 3, 2022, and was updated on June 9, 2023. The sample consisted of four controlled clinical trials addressing aromatherapy with lavender essential oil in the "inhalation" and "massage" modalities, to treat acute labor pain and dysmenorrhea. In all studies, the intervention provided a reduction in pain without unwanted effects (p<0.05) and the nurse participated as a member of the multidisciplinary team. CONCLUSION: Aromatherapy with lavender essential oil during labor and dysmenorrhea proved to be effective in reducing pain in the analyzed sample.

RESUMO JUSTIFICATIVA E OBJETIVOS: A aromaterapia com óleo essencial de lavanda tem sido utilizada para redução de dor, ansiedade, náuseas e vômitos, dentre outros. Assim como a experiência dolorosa é única, as respostas às abordagens terapêuticas podem variar entre os indivíduos e há condições específicas relacionadas à saúde da mulher que merecem ser examinadas. O objetivo deste estudo foi analisar os usos da aromaterapia com óleo essencial de lavanda (Lavandula angustifolia), por enfermeiros, no controle da dor em mulheres. CONTEÚDO: Esta é uma revisão de escopo da literatura. A busca foi realizada nos seguintes portais e/ou bases de dados: BVS, Pubmed, Cochrane, em 03 junho de 2022, sendo atualizada em 09 de junho de 2023. A amostra foi composta de quatro ensaios clínicos controlados abordando aromaterapia com óleo essencial de lavanda nas modalidades "inalação" e "massagem", para tratar dor aguda do parto e da dismenorreia. Em todos os estudos a intervenção proporcionou redução na dor sem efeitos adversos (p<0,05) e o enfermeiro participou como integrante da equipe multidisciplinar. CONCLUSÃO: A aromaterapia com óleo essencial de lavanda no trabalho de parto e dismenorreia mostrou-se eficaz para a redução da dor na amostra analisada.

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Resumo Objetivo Descrever os processos de construção e validação de cartilha educativa sobre métodos não farmacológicos para alívio da dor no trabalho de parto e parto. Métodos Estudo metodológico, realizado em três etapas. Na primeira, foi realizado levantamento bibliográfico para seleção dos conteúdos referentes à temática. Na segunda etapa, realizou-se validação com 24 juízes de conteúdo e três juízes técnicos. Na terceira etapa, ocorreu validação pelo público-alvo, com 30 gestantes. O período do estudo foi de setembro a novembro de 2018. Foi utilizado o editor de planilhas do Office para análise dos dados. Resultados O nível de concordância atribuído pelos juízes de conteúdo e técnicos esteve entre 97,2% e 98,9% e entre 83,3% e 100%, respectivamente; o Índice de Validade de Conteúdo global foi de 0,92 e 0,97, respectivamente. Na avaliação realizada com o Suitability Assesment of Materials, os juízes de conteúdo classificaram a cartilha como "superior", com média de 85,2% e os técnicos com média de 77,5%. O público-alvo validou a cartilha com Índice de Validade de Conteúdo global de 0,98 e nível de concordância de 99,7%. Conclusão A cartilha educativa mostrou-se válida para ser utilizada junto às gestantes, sendo considerada tecnologia educativa inovadora e relevante na utilização em consulta pré-natal.

Resumen Objetivo Describir el proceso de elaboración y validación de cartilla educativa sobre métodos no farmacológicos para aliviar el dolor en el trabajo de parto y en el parto. Métodos Estudio metodológico, realizado en tres etapas. En la primera, se realizó el análisis bibliográfico para seleccionar contenidos relacionados con la temática. En la segunda etapa, se realizó la validación con 24 jueces de contenido y tres jueces técnicos. En la tercera etapa, se llevó a cabo la validación por parte del público destinatario, con 30 mujeres embarazadas. El período de estudio fue de septiembre a noviembre de 2018. Se utilizó el editor de planillas de Office para el análisis de datos. Resultados El nivel de concordancia atribuido por los jueces de contenido fue entre 97,2 % y 98,9 % y de los técnicos entre 83,3 % y 100 %. El Índice de Validez de Contenido global fue de 0,92 y 0,97, respectivamente. En la evaluación realizada con Suitability Assesment of Materials, los jueces de contenido clasificaron la cartilla como "superior", con promedio de 85,2 % y los técnicos con promedio de 77,5 %. El público destinatario validó la cartilla con Índice de Validez de Contenido global de 0,98 y nivel de concordancia de 99,7 %. Conclusión La cartilla educativa demostró ser válida para ser utilizada con mujeres embarazadas y fue considerada una tecnología educativa innovadora y relevante para utilizar en consultas de control prenatal.

Abstract Objective To describe the construction and validity of an educational booklet on non-pharmacological methods for labor and birth pain relief. Methods This is a methodological study, carried out in three stages. In the first, a bibliographic survey was carried out to select the contents related to the theme. In the second stage, validity was carried out with 24 content judges and three technical judges. In the third stage, there was validity by the target audience, with 30 pregnant women. The study took place from September to November 2018. The Office spreadsheet editor was used for data analysis. Results The level of agreement attributed by the content and technical judges was between 97.2% and 98.9% and between 83.3% and 100%, respectively. The overall Content Validity Index was 0.92 and 0.97, respectively. In the assessment carried out with the Suitability Assessment of Materials, the content judges classified the booklet as "superior", with an average of 85.2%, and the technicians, with an average of 77.5%. The target audience validated the booklet with an overall Content Validity Index of 0.98 and an agreement level of 99.7%. Conclusion The educational booklet proved to be valid for use with pregnant women, being considered innovative and relevant educational technology for use in prenatal consultation.

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Abstract Objectives: to evaluate the effectiveness of non-pharmacological measures used by obstetric nurses to relieve pain during labor. Methods: this is a systematic review of the databases carried out in the United States National Library of Medicine, Cumulative Index to Nursing and Allied Heal Literature, Scopus, Web of Science and Latin American and Caribbean Literature in Health Sciences, the descriptors were: labor pain, labor, obstetric and obstetric nursing. The search and selection followed the PRISMA recommendations, were carried out from August to September 2020, and randomized clinical trials were eligible and analyzed using descriptive statistics. Results: 17 clinical trials made up the final sample, which highlight the use of non-pharmacological measures with diversified benefits for labor, namely: thermal therapy (20%); massage/sacral massage (15%); Swiss ball exercises (15%); acupressure (15%); auriculotherapy (10%); music therapy (10%); aromatherapy (5%); acupuncture (5%); and dance (5%). Conclusion: the non-pharmacological measures found in this review are efficient to promote pain reduction during labor, associated with a decrease in the use of drug interventions.

Resumo Objetivos: avaliar a efetividade das medidas não farmacológicas utilizadas por enfermeiros obstetras para o alívio da dor durante o trabalho de parto. Métodos: trata-se de uma revisão sistemática realizada nas bases de dados United States National Library of Medicine, Cumulative Index to Nursingand Allied Heal Literature, Scopus, Web of Science e Literatura Latino-americana e do Caribe em Ciências da Saúde, os descritores foram: labor pain, labor, obstetric e obstetric nursing. A busca e seleção seguiu as recomendações do PRISMA, aconteceu de agosto a setembro de 2020, foram elegíveis ensaios clínicos randomizados e foram analisados por meio de estatística descritiva. Resultados: 17 ensaios clínicos compuseram a amostra final, os quais destacam a utilização de medidas não farmacológicas com benefícios diversificados para o trabalho de parto, a saber: terapia térmica (20%); massagem/massagem sacral (15%); exercícios em bola suíça (15%); acupressão (15%); auriculoterapia (10%); musicoterapia (10%); aromaterapia (5%); acupuntura (5%); e dança (5%). Conclusão: as medidas não farmacológicas encontradas nesta revisão são eficientes para promover a redução da dor durante o trabalho de parto, associando-se com a diminuição do uso de intervenções medicamentosas.

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This article analyzes the physiological role of pain during parturition in domestic animals, discusses the controversies surrounding the use of opioids, non-steroidal anti-inflammatory drugs (NSAIDs), and local analgesics as treatments during labor, and presents the advantages and disadvantages for mother and offspring. Labor is a potentially stressful and painful event, due to the contractions that promote expulsion of the fetus. During labor, neurotransmitters such as the prostaglandins contribute to the sensitization of oxytocin receptors in the myometrium and the activation of nociceptive fibers, thus supporting the physiological role of pain. Endogenously, the body secretes opioid peptides that modulate harmful stimuli and, at the same time, can inhibit oxytocin's action in the myometrium. Treating pain during the different stages of parturition is an option that can help prevent such consequences as tachycardia, changes in breathing patterns, and respiratory acidosis, all of which can harm the wellbeing of offspring. However, studies have found that some analgesics can promote myometrial contractility, increase expulsion time, affect fetal circulation, and alter mother-offspring recognition due to hypnotic effects. Other data, however, indicate that reducing the number of uterine contractions with analgesics increases their potency, thus improving maternal performance. Managing pain during labor requires understanding the tocolytic properties of analgesics and their advantages in preventing the consequences of pain.

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BACKGROUND: Nonpharmacological labor pain management methods (NPLPMM) are noninvasive, low-cost practices that may play a role in reducing the rates of unnecessary cesarean birth. We aimed to evaluate whether the NPLPMM is associated with the mode of birth. METHODS: We conducted a retrospective cohort study with clinical records of all women admitted for birth from January 2013 to December 2017. Records of women who had spontaneous labor or received induction or augmentation of labor during hospitalization were eligible for the study. We estimated the risk ratios for cesarean birth in general linear models using the Poisson regression with adjustments for the following variables: age, ethnicity, schooling, parity, gestational age, previous cesarean birth, spontaneous labor before admission, or induction/augmentation of labor. RESULTS: Within the total of 3,391 medical records, 40.1% had the use of a nonpharmacological labor pain management method registered. Cesarean rate among the study population was 44.2%. The use of NPLPMM decreased the risk of cesarean birth by 78% (OR = 0.22; 95% CI 0.19-0.26). History of a previous cesarean birth (RR = 2.63; 95% CI 2.35-2.64), the lack of use of NPLPMM (RR = 2.46; 95% CI 2.22-2.72), and primiparity (RR = 2.09; 95% CI 1.86-2.34) were the strongest risk factors for cesarean birth in the cohort. DISCUSSION: The use of NPLPMM may be an effective strategy to reduce unnecessary cesarean birth. Further studies to identify the efficacy of each method may help health professionals to offer more appropriate methods at different stages of labor.

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INTRODUCTION: The objective of this case series was to present the importance of labour analgesia and the preference for erector spinae plane (ESP) block as a new technique that can be used for labour analgesia. CASE REPORTS: The three patients were 25-year-old primipara with 5-cm cervical dilation, a 30-year-old multiparous with 5-cm cervical dilatation, and a 32-year-old primipara with 4-cm cervical dilation. CONCLUSIONS: Bilateral ESP block may be an alternative analgesic technique for the first stage of labour.

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RESUMO: Objetivo: analisar a prática de realização de métodos não farmacológicos para alívio da dor durante o trabalho de parto. Método: estudo quantitativo, descritivo de corte transversal desenvolvido de dezembro de 2019 a setembro de 2020 em um Serviço de Enfermagem Materno Infantil do sul do Brasil. Foram realizados analises de 560 prontuários e coletas em banco de dados institucional. Utilizou-se o teste de Kolmogorov-Smirnov para a normalidade das variáveis e, para associações, os testes t para amostras independentes, Qui-quadrado ou exato de Fischer. Resultados: Constatou-se que 164 (29,3%) das parturientes realizaram pelo menos um tipo de método, sendo os mais utilizados a hidroterapia 137(24,5%), mudança de posição 124(22,1%) e exercícios de respiração 121(21,6%). Houve associação significativa p(<0,05) entre métodos, tipo de parto, gestação e paridade. Conclusão: Este estudo evidencia o perfil de parturientes que se beneficiam destas práticas e expõe a baixa frequência do seu uso, demonstrando uma área promissora para estudos e atividades de educação continuada.

ABSTRACT Objective: to analyze the practice of using non-pharmacological pain relief methods during labor. Method: a quantitative and descriptive cross-sectional study developed from December 2019 to September 2020 in a Maternal and Child Nursing Service from southern Brazil. A total of 560 medical charts were analyzed and data collection took place in the institutional database. The Kolmogorov-Smirnov test was used for normality of the variables and, for associations, the t test for independent samples, chi-square or Fischer's exact test. Results: It was found that 164 (29.3%) of the parturients resorted to at least one type of method, the most used being hydrotherapy with 137 (24.5%), change of position with 124 (22.1%) and breathing exercises with 121 (21.6%). There was a significant association (p<0.05) between methods, type of delivery, pregnancy and parity. Conclusion: This study highlights the profile of parturients who benefit from these practices and exposes the low frequency of their use, showing a promising area for studies and continuing education activities.

RESUMEN Objetivo: analizar la práctica de implementar métodos no farmacológicos para aliviar el dolor durante el trabajo de parto. Método: estudio cuantitativo y descriptivo de corte transversal desarrollado entre diciembre de 2019 y septiembre de 2020 en un Servicio de Enfermería Materno Infantil del sur de Brasil. Se analizaron 560 historias clínicas y los datos se recolectaron en una base de datos institucional. Se utilizó la prueba de Kolmogorov-Smirnov para la normalidad de las variables y, para las asociaciones, la prueba t para muestras independientes, la de chi-cuadrado o la prueba exacta de Fisher. Resultados: Se descubrió que 164 (29,3%) de las parturientas realizaron al menos un tipo de método, siendo los más utilizados hidroterapia con 137 (24,5%), cambio de posición con 124 (22,1%) y ejercicios respiratorios con 121 (21,6%). Se registró una asociación significativa (p<0,05) entre métodos, tipo de parto, embarazo actual y paridad. Conclusión: Este estudio pone en evidencia el perfil de las parturientas que se benefician de estas prácticas y expone la baja frecuencia de su uso, demostrando así un área promisoria para estudios y actividades de formación continua.

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Resumo Objetivo Avaliar a efetividade da terapia floral associados aos fatores que potencializam a dor e o estresse no processo de parturição por meio de parâmetros obstétricos e neuroendócrinos. Métodos Ensaio clínico randomizado, triplo cego, placebo controlado, realizado com 164 parturientes de risco obstétrico habitual, subdivididas entre dois grupos para as quais foram ministradas essência floral Five Flower e placebo, respectivamente. Avaliou-se aspectos obstétricos e neuroendócrinos por meio da análise bioquímica dos hormônios Beta-endorfina e Cortisol salivar antes e ao término da intervenção. Resultados A essência floral modulou os fatores que potencializam a dor no trabalho de parto, isto é, rotura das membranas amnióticas, fase ativa e indução do parto. Houve aumento dos níveis de Beta-endorfina juntamente com a diminuição de uma contração em mulheres com rotura das membranas ovulares e com indução. Em relação ao estresse, houve constância dos valores do Cortisol para o Grupo Experimental, não alterando seu valor na fase ativa, rotura das membranas ovulares ou indução. A Essência Five Flower mostrou-se eficaz na redução de uma hora e vinte e cinco minutos do tempo do trabalho de parto no Grupo Experimental. Conclusão A terapia floral realizada, mostrou-se eficaz no controle da dor e estresse durante o trabalho de parto, refletindo positivamente na sua brevidade e qualificando seu desfecho.

Resumen Objetivo Evaluar la efectividad de la terapia floral asociada a los factores que potencializan el dolor y el estrés en el proceso de parto por medio de parámetros obstétricos y neuroendócrinos. Métodos Ensayo clínico aleatorizado, triple ciego, placebo controlado, realizado con 164 parturientas de riesgo obstétrico normal, subdivididas en dos grupos en que se les administró esencia floral Five Flower y placebo. Se evaluaron aspectos obstétricos y neuroendócrinos por medio del análisis bioquímico de las hormonas betaendorfina y cortisol salival antes y al final de la intervención. Resultados La esencia floral reguló los factores que potencializan el dolor en el trabajo de parto, es decir, ruptura de las membranas amnióticas, fase activa e inducción del parto. Hubo aumento de los niveles de betaendorfina junto con la reducción de una contracción en mujeres con ruptura de las membranas ovulares y con inducción. Con relación al estrés, hubo constancia de los valores de cortisol en el grupo experimental, sin aumento de su valor en la fase activa, ruptura de las membranas ovulares o inducción. La esencia Five Flower demostró ser eficaz para la reducción de una hora y veinticinco minutos de tiempo de trabajo de parto en el grupo experimental. Conclusión La terapia floral realizada demostró ser eficaz en el control del dolor y del estrés durante el trabajo de parto, con un impacto positivo en su brevedad y en la cualificación de su desenlace.

Abstract Objective To evaluate the effectiveness of floral therapy associated with factors that strengthen pain and stress in the labor process through obstetric and neuroendocrine parameters. Methods Randomized, triple-blind, placebo-controlled clinical trial performed with 164 parturients at usual obstetric risk subdivided into two groups to which Five Flower floral essence and placebo were administered. Obstetric and neuroendocrine aspects were evaluated through biochemical analysis of the beta-endorphin and cortisol hormones through salivary samples before and after the intervention. Results The flower essence modulated the factors that strengthen pain in labor, that is, rupture of amniotic membranes, active phase and induction of labor. There was an increase in beta-endorphin levels along with one less contraction in women with ruptured ovular membranes and labor induction. Regarding stress, cortisol values were constant for the Experimental group, and did not change in the active phase, rupture of the ovular membranes or induction. The Five Flower essence proved to be effective in reducing labor time by 1 hour 25 minutes in the Experimental group. Conclusion The floral therapy used proved to be effective in controlling pain and stress during labor, and reflected positively on its agility and qualified its outcome.

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