Batten Meghann, Stevenson Eleanor, Zimmermann Deb, Isaacs Christine
J Midwifery Womens Health. 2017 Mar;62(2):210-214. doi: 10.1111/jmwh.12580. Epub 2017 Apr 4.
A growing number of women are seeking alternatives to traditional pharmacologic pain management during birth. While there has been an extensive array of nonpharmacologic options developed for labor, there are limited offerings in the postpartum period. The purpose of this quality improvement project was to implement a hydrotherapy protocol in the early postpartum period to improve pain management for women choosing a nonmedicated birth.
The postpartum hydrotherapy protocol was initiated in a certified nurse-midwife (CNM) practice in an urban academic medical center. All women who met criteria were offered a 30-minute warm water immersion bath at one hour postpartum. Pain scores were assessed prior to the bath, at 15 minutes after onset, and again at the conclusion (30 minutes). Women who completed the bath were also asked to complete a brief survey on their experience with postpartum hydrotherapy.
In women who used the bath (N = 45), there was a significant reduction in pain scores (P < .001) between the onset of the bath and scores at both 15 minutes and 30 minutes. There was no significant difference between pain scores at 15 minutes and 30 minutes (P = .97). Of those women who completed a survey (n = 43), 97.7% reported both that the bath reduced their pain and improved their birth experience. One hundred percent reported they would use it again in another birth.
This project demonstrated successful implementation of a hydrotherapy protocol as an alternative or adjunct to medication for early postpartum pain management that significantly reduced pain and improved the birth experience for those who used it. It offers a nonpharmacologic alternative where there have traditionally been limited options.
越来越多的女性在分娩期间寻求传统药物疼痛管理的替代方法。虽然已经开发出大量用于分娩的非药物选择，但产后阶段的此类选择有限。本质量改进项目的目的是在产后早期实施水疗方案，以改善选择非药物分娩的女性的疼痛管理。
产后水疗方案在一家城市学术医疗中心的认证助产士（CNM）诊所启动。所有符合标准的女性在产后一小时可享受30分钟的温水浸泡浴。在沐浴前、开始后15分钟和结束时（30分钟）评估疼痛评分。完成沐浴的女性还被要求完成一份关于她们产后水疗体验的简短调查问卷。
在使用沐浴的女性（N = 45）中，从沐浴开始到15分钟和30分钟时的疼痛评分显著降低（P <.001）。15分钟和30分钟时的疼痛评分之间无显著差异（P =.97）。在完成调查问卷的女性（n = 43）中，97.7%报告称沐浴减轻了她们的疼痛并改善了分娩体验。100%报告称她们会在下次分娩时再次使用。
该项目证明了水疗方案作为产后早期疼痛管理的药物替代或辅助方法的成功实施，显著减轻了疼痛并改善了使用该方案的女性的分娩体验。它提供了一种传统上选择有限的非药物替代方法。
