Effectiveness of Hot Pack on Labor Pain, Duration of Labor, and Satisfaction of Primigravida: A Randomized Controlled Trial
Abstract Background: Labor pain is an intense pain experienced by women. One of the nonpharmacologic measures used for managing labor pain is heat therapy. However, there is a lack of evidence on the effectiveness of single-use hot packs for labor pain and duration. Objectives: To determine the effect of single-use instant hot pack applied on the lower back in the active phase of labor on pain intensity and labor duration and to determine the satisfaction of primigravid women. Design: Randomized controlled trial. Setting: A labor unit of an Armed Forces Hospital in Saudi Arabia. Participants: Primigravida in the active phase of the first stage of labor, with a normal onset of labor. Methods: This randomized controlled trial was conducted between August 2018 and July 2019. Participants were randomly selected and assigned to either the intervention group (n = 45) or the control group (n = 46). The intervention group received an application of a single-use instant hot pack (Dynarex) on the lower back for 30 min and rest for 10 min. The intervention was continued until delivery of the fetus. The control group received routine care, including intermittent Entonox inhalation. The outcome variable, labor pain intensity was assessed every 30 min using a visual analog scale, at 30, 60, 90,120,150 and 210 min, and the duration of labor was assessed using the WHO Modified partograph. The participant’s satisfaction with the labor experience was assessed 2 h after delivery using the Labor and Delivery Satisfaction Scale, which was developed by the authors. Results: The intervention and control group did not differ significantly in characteristics at baseline. In the intervention group, the use of hot packs significantly lowered the intensity of labor pain at all assessment points (30, 60, 90, 120, 150, and 210 min) as compared with the control group (p≤0.05). The duration of labor did not differ significantly between the two groups (p≥0.05). Furthermore, the intervention group expressed significantly higher satisfaction with the labor and delivery experience as compared with the control group (p≤0.05). Conclusions: The single-use instant hot pack is an effective, convenient, and easy nonpharmacologic approach to pain reduction during labor and provides women an overall satisfactory labor and delivery experience. However, it is not effective in shortening the duration of labor. It can be recommended for managing the pain of women in labor.