What is the issue?

This Cochrane Review looked at whether mind-body techniques for relaxation such as breathing techniques, visualisation, yoga or music would help with reducing pain, and improve women’s experiences of labour. We collected and analysed all relevant studies to answer this question (date of search: May 2017).

Why is this important?

The pain of labour can be intense, with body tension, anxiety and fear making it worse. Many women would like to go through labour without using drugs, or invasive methods such as an epidural. These women often turn to complementary therapies to help to reduce the intensity of pain in labour and improve their experiences of labour.

Many complementary therapies are used by women in labour, including acupuncture, mind-body techniques, massage, reflexology, herbal medicines or homoeopathy, hypnosis, music and aromatherapy. Mind-body techniques for relaxation can be widely accessible to women through the teaching of these techniques during antenatal classes. The relaxation techniques include guided imagery, progressive relaxation and breathing techniques. We also include yoga and music in this review. Other Cochrane Reviews cover hypnosis in labour, manual methods (like massage and reflexology), aromatherapy and acupuncture/acupressure. Many of these relaxation techniques are coping strategies used to reduce the experience of pain. These techniques utilise practices that aim to reduce stress and reduce the perception of pain. It is important to examine if these therapies work and are safe, to enable women to make informed decisions about their care.

What evidence did we find?

We found 15 studies involving 1731 women that contributed data to the analyses. Studies were undertaken across the world, including countries in Europe and Scandinavia, and Iran, Taiwan, Thailand, Turkey and USA.

We found that relaxation techniques, yoga and music may help women manage labour pain, although the quality of the evidence varied between low and very low, and more data are needed. Also, in these trials there were variations in how these techniques were used. There was no clear evidence that these therapies had an impact on assisted vaginal or caesarean birth. There were insufficient data to say if these techniques influenced the baby’s condition at birth.

What does this mean?

The use of some relaxation therapies, yoga, or music may possibly be helpful with reducing the intensity of pain, and in helping women feel more in control and satisfied with their labours. However, the wide variations in types of techniques used in these studies make it difficult to say specifically what might help women. Therefore further research studies are needed.