Update on Nonpharmacologic Approaches to Relieve Labor Pain and Prevent Suffering
Penny Simkin, PT and April Bolding, PT
Journal of Midwifery Womens Health 49(6):489-504, 2004.

Abstract
The control of labor pain and prevention of suffering are major concerns of clinicians and their clients. Nonpharmacologic approaches toward these goals are consistent with midwifery management and the choices of many women. We undertook a literature search of scientific articles cataloged in CINAHL, PUBMED, the Cochrane Library, and AMED databases relating to the effectiveness of 13 non-pharmacologic methods used to relieve pain and reduce suffering in labor. Suffering, which is different from pain, is not an outcome that is usually measured after childbirth. We assumed that suffering is unlikely if indicators of satisfaction were positive after childbirth. Adequate evidence of benefit in reducing pain exists for continuous labor support, baths, intradermal water blocks, and maternal movement and positioning. Acupuncture, massage, transcutaneous electrical nerve stimulation, and hypnosis are promising, but they require further study. The effectiveness of childbirth education, relaxation and breathing, heat and cold, acupressure, hypnosis, aromatherapy, music, and audioanalgesia are either inadequately studied or findings are too variable to draw conclusions on effectiveness. All the methods studied had evidence of widespread satisfaction among a majority of users.

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Supporting the Laboring Woman without Injuring Oneself and How the Childbirth Educator can Help
April Bolding and Penny Simkin
International Journal of Childbirth Education (ICEA journal), January 2008

Abstract

The physical demands placed on labor support people, such as birth partners and birth doulas, are perhaps greater than on anyone else on the birth team, with the exception of the birthing mother. This article outlines nine guiding principles of self care and body mechanics to reduce the likelihood of injury to the labor support person. We have identified eight common labor support tasks and have photos demonstrating the improper and proper way of performing these tasks. Childbirth educators can help impart this knowledge to birth partners by weaving these guidelines throughout their childbirth preparation classes, while correctly modeling the safest way to perform these important tasks.

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Informed Choice Leaflet published by Midirs
Abstract
Pain relief and coping measures that focus on preventing suffering rather than completely eliminating pain build a woman?s self-confidence, help her to maintain a sense of control and well-being, and improve her perceptions of her birth experience.
In fact, the element that best predicts a woman's experience of labour pain is her level of self-confidence in her ability to cope with labour. Satisfaction, fulfilment, and a sense of accomplishment are often high, and disappointment is avoided when the woman copes well, even when the pain she is experiencing is great.
This leaflet is published in the UK by the Midwifes Information and Resource Service. Please download the.pdf file above to read this leaflet.

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Lose Your Mummy Tummy: A book and DVD review
April Bolding
BIRTH journal 34:1; March 2007

A review of Julie Tupler and Julie Gould's book and DVD Lose Your Mummy Tummy.

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Tera Schreiber
Parent Map; September 2009

This articles explores how birth changes women's bodies - what's normal and what's not - and how to keep a healthy outlook on these changes.
Tera includes information from an interview done with April.

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