Title

Nonpharmacological approaches to improve women’s childbirth experiences: a systematic review and meta-analysis

Publication Name

Journal of Maternal-Fetal and Neonatal Medicine

Abstract

Background: Childbirth is considered a significant experience in women’s life. Different models of care and interventions without pharmacological approaches have been used to enhance women’s positive childbirth experiences, but the most effective interventions have not been clearly identified. Objective: To assess the effectiveness of nonpharmacological approaches in improving women’s childbirth experiences. Methods: We searched Cochrane Library, Medline, Web of Science, Embase, Scopus, ProQuest, Google Scholar, and Persian databases (Magiran, Scientific Information Database, and Barakat) from inception until December 2017. Randomized controlled trials and quasi-randomized controlled trials comparing interventions designed to improve women’s childbirth experiences with standard cares were included in this review. Pharmacological interventions were excluded from the study. The outcome measure was women’s childbirth experience. Heterogeneity was determined using the Cochrane’s test and I index. The standardized mean differences were pooled based on random effect models. Results: We included 19 studies (10,141 women) in the review. Results of the meta-analysis of 18 studies (8487 women) demonstrated that all the interventions with nonpharmacological approaches improved childbirth experiences (standardized mean difference: 0.49; 95% confidence interval: 0.33–0.66). But, subgroup meta-analysis showed that different models of midwifery care, support during labor and natural therapies were the most effective interventions in improving women’s childbirth experience. Conclusions: Nonpharmacological interventions that enable women to feel supported, safe and respected can lead to improved childbirth experiences. However, there is a need for further studies with larger sample sizes and standardized tool to better assess the effectiveness of specific interventions on women’s childbirth experiences. 2

Open Access Status

This publication is not available as open access

Volume

34

Issue

3

First Page

479

Last Page

491

Funding Number

IR.TBZMED.REC.1396.786

Funding Sponsor

Tabriz University of Medical Sciences

Share

COinS
 

Link to publisher version (DOI)

http://dx.doi.org/10.1080/14767058.2019.1608434