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Evidence

 

With a thorough search through several library databases, I discovered a few articles of mention in substantiating the use of focal points during labor. The article by Jones et al. (2012) has a philosophical view similar to my own-in that “The needs in labor should be tailored to each woman’s wishes and circumstances, such as anticipated duration of labor, the baby’s condition, and whether the woman chooses natural birth, augmentation or induction of labor, etc.”

Jones et al. continue their research comments with “Most methods of non-pharmacologic pain management in labor are non-invasive and appear to be safe for the mother and baby, however their efficacy is unclear due to limited high quality evidence” (Jones et al. 2012).

The Listening to Mothers III Pregnancy and Birth (Report of the Third National U.S. Survey of Women’s Childbearing Experiences) performed a study of 2,048 women giving birth in U.S. hospitals, polling a sample of women who had given birth from mid-2011 through mid-2012 that closely resembles the survey’s target population – mothers ages 18 to 45 who gave birth to a single baby in U.S. hospitals. 

In examining the use of drug-free methods for labor pain relief. The findings were as follows: 73% used at least one non-pharmacologic method of pain relief.  Almost half (48%) used breathing techniques, and 40% used position changes and/or movement to relieve discomfort.  One out of five used hands-on techniques such as massage, stroking, or acupressure (22%) or, mental strategies such as relaxation, visualization, or hypnosis, (21%).  “Using mental strategies would include the use of focal points.” 

Less frequently used methods included, application of hot or cold objects (12%), and the use of large inflatable “birth balls” (10%), showering (10%), or immersion in a tub or pool (8%). In every case except the use of position change, mothers who had taken a childbirth education class in this pregnancy were more likely to use the drug-free techniques specified (Declercq, Sakala, Corry, Applebaum and Herlich, 2013).  This study is available for reading or download at www.childbirthconnection.org, Search-Listening to Mothers III Survey.

In researching other life circumstances in which visual distraction may be helpful, I came across the following information-“Psychological interventions such as distraction, hypnosis and coping skills training have been used and studied in adults undergoing colonoscopy” (Xiaolian, Xiaolin and Lan, 2015), and adolescents and children when undergoing medical procedures, i.e. needle-related procedures (Uman et al. 2013).

Focal points have been used for a long time-as an alternative, non-pharmacologic method in helping women to navigate their way through labor. The focal point tools discussed provide laboring women with the option of using pre-chosen, re-positional focal point stickers, and pins, clips or pendants, to assist in coping with their labor and childbirth.

The premise of The Gate Control Theory is-that nerve cell groupings within the spinal cord, brain stem and cerebral cortex have the ability to modulate the pain impulses through a blocking mechanism. The theory further implies that pain sensations travel along sensory nerve pathways to the brain but only a limited number of sensations or messages can travel through these nerve pathways at a time.

For instance, if we overload our sensory nerve pain receptors by using distraction techniques, such as; stroking, massage, music, focal points or imagery-this can reduce or block the capability of nerve pathways to transmit pain-such as the pain coming from having labor contractions (Perry, Hockenberry, Lowdermilk and Wilson, 2014).

In closing; there are limited quality (i.e. randomization of quantitative, or qualitative research) studies in using alternative medicine to support the use of focal points in labor, although; according to the chosen articles, there exists some evidence to support using focal points or visual distraction, in coping with labor pain, or during various other medical procedures, more research is still needed.

 

References

 

Declercq, E.R., Sakala, C., Corry, M.P., Applebaum, S. & Herlich, A. (May 2013).  Listening to Mothers III Pregnancy and Birth (Report of the Third National U.S. Survey of Women's Childbearing Experiences).

Jones, L., Othman M., Dowswell, T., Alfirevic, z., Gates, S., Newburn, M. Jordan, S., Lavender, T. & Neilson, J.P. (2012). Pain management for women in labour: An overview of systemic reviews (Review). The Cochrane Library 2012, Issue 3.

Lothian, J. (2000). Why natural childbirth?Journal of Perinatal Education, Fall; 9(4): 44-46.
doi: 10.1624/105812400X87905

MyLanguage language translator application used for instrucciones in Español (2015). Dialect (Mexico). Version 3.0.1

Perry, S.E., Hockenberry, M.J., Lowdermilk, D.L., & Wilson, D. (2014). Maternal Child Nursing Care, 5th ed. Cashion, K., Chapter 14, Pain Management, p 358. St. Louis Missouri: Mosby.

Uman, L.S., Birnie, K.A., Noel, M., Parker, J.A., Chambers, C.T., McGrath, P.J., & Kisely, S.R. (2013). Psychological interventions for needle-related procedural pain and distress in children and adolescents (Review). The Cochrane Library 2013, Issue 10.

Xiaolian, J., Xiaolin, L. & Lan, Z.H. (2015). Effects of visual and audiovisual distraction on pain and anxiety among patients undergoing colonoscopy. Society of Gastroenterology Nurses and Associates, 38(1), Jan/Feb. doi: 10.1097/SGA.0000000000000089.

 
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