Dear all,
We are conducting a randomised controlled trial of the use of acupuncture
compared to sham acupuncture to induce post dates labor. Caroline Smith, an
acupuncturist and researcher is conducting the RCT and I am doing a
qualitative component of women's and health professional's views.
kind regards
Carmel Collins
Women's & Children's Hospital, Adelaide, Australia
-----Original Message-----
From: Jane Sandall [mailto:[log in to unmask]]
Sent: Thursday, 8 November 2001 04:18
To: [log in to unmask]
Subject: Summary of natural methods of induction query and another
question
Dear all,
Here is a summary of my query sent to the list below, a couple of
weeks ago.
>Is anyone using natural methods of induction? If so what are you using?
This was sent because we don't have good research evidence in this
area, and I wanted to find out what midwives and women were doing
in practice. I have summarised the replies below, but I would like to
know how many midwives are using castor oil or acupuncture as an
induction method and what is your experience of it?
many thanks in advance
SUMMARY
There are 2 Cochrane reviews that both conclude further research is
needed.
1) Smith CA, Crowther CA. Acupuncture for induction of labour
(Cochrane Review). In: The Cochrane Library, Issue 4, 2001. Oxford:
Update Software concludes There is a need for a well designed
randomised controlled trial to evaluate the role of
acupuncture to induce labour.
2) Kelly AJ, Kavanagh J, Thomas J. Castor oil, bath and/or enema for
cervical priming and induction of labour (Cochrane Review). In: The
Cochrane Library, Issue 4, 2001. Oxford: Update Software that
concluded Further research is needed to attempt to quantify the
efficacy of castor oil as an induction agent.
There are lots of suggestions on the ARM archive
pages - www.radmid.demon.co.uk/alternative.htm and also see Archives of
US midwives http://www.gentlebirth.org/archives/natinduc.html
Here is a summary of responses to what people were doing in practice.
1) Homeopathy, polarity therapy, Zero balance... and to have the
woman see another experienced midwife (usually a traditional
midwife) who will tell her (if she believes so) that everything is
alright and that her baby will be born soon and without
difficulties.... it works! (from Mexico).
3) Sex.
4) Castor Oil with orange juice,
5) Reflexology or acupuncture.
Point in the roof of the mouth that stimulates the uterus. The
technique seems to work best if the client has at least reached 3cm.
Carol recommended using "dum dum" (brand name, spherical) lollipops.
They fit perfectly into that spot in the roof of the mouth! One
other bit of information- this should speed up contractions within
30 minutes... if it doesn't the body is probably not ready.
6) Thigh massage, Proceedure: Warm some lotion or oil in the palms,
begin massage of the inner thighs working in an oval motion coving
the area from the knees to the
groin. The laboring woman must tell the midwife when the
contractions starts so message can be stopped. This will prevent
overstimulation and contractions that are too strong.
___________________________________________________________________
7) Membrane sweeping safe but of limited use.
A review of all the literature on sweeping of the membranes
at the end of pregnancy was published in May's British Journal of
Obstetrics & Gynaecology. The review found that overall the
intervention is associated with a 24% increase in chance of
delivering within 48 hours, a 46% increase in chance of delivering
within a week and a 74% reduction in likelihood of going 2 weeks
over dates.It is not associated with any increased risk of infection
of the mother or baby, premature membrane rupture, forceps or
caesarean section. It does make the vaginal examination more painful
is associated with light vaginal bleeding and brings on irregular
contractions not necessarily leading to the onset of labour.
In summary, as a method of induction of labour, it is poor,
but at the end of pregnancy, sweeping the membranes is a safe way of
doubling chances of spontaneous labour over the next week.
Many thanks
----------------------
Dr Jane Sandall
Professor of Midwifery and Women's Health
King's College
57 Waterloo Road
London
SE1 8WA
Tel: 020 7848 3605
Fax: 020 7848 3506
email: [log in to unmask]
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