Efeito do uso da massagem, estimulação elétrica transcutânea e placebo sobre a satisfação com o parto: ensaio clínico randomizado

Abstract

Introduction: The use of non-pharmacological therapies at the time of childbirth is part of the recommendations of the World Health Organization (WHO). Regarding studies in this area, most are focused on pain relief during labor, but little is known if its use leads to better satisfaction with childbirth. Understanding the levels of satisfaction is very important because its impacts can generate trauma in the woman and influence her next deliveries. Objective: To evaluate the effect of the use of massage, transcutaneous electrical stimulation (TENS) and placebo on satisfaction with childbirth. Materials and Methods: This is a parallel randomized clinical trial (1:1:1) controlled study with a non-probabilistic convenience sample. The parturients in labor in the active phase were divided into three groups (n=36 in each), and received usual hospital care from the institution's professionals, as an incentive to walk and adopt upright postures. In the Massage Group, 30 minutes of massage were applied in the lumbosacral region, with the women seated on the Swiss ball. In the TENS Group, with the women sitting on the Swiss ball, four electrodes were positioned at the levels of T10-L1 and S2-S4 with a frequency of 100 Hz, pulse width of 100 μs and maximum non-painful intensity (according to the threshold of parturient), for 30 minutes. In the Placebo Group, the parturients received a placebo intervention, were positioned and had the electrodes fixed in the same way as in the TENS group, but the device remained with the intensity button turned off for 30 minutes. To analyze the parturient's satisfaction with childbirth, the Questionnaire of Experience and Satisfaction with Childbirth (QESP) was used. Results: No significant differences were observed between the groups for the final score and for the QESP subscales. Only in the Support subscale did the Massage Group obtain higher values in relation to the Placebo Group (p=0.0232). Conclusion: The use of TENS and placebo during labor did not change women's satisfaction with childbirth, whereas massage increased satisfaction when related to the support received during labor.