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Effect of Inhalation of Aroma of Geranium Essence on Anxiety and Physiological Parameters during First Stage of Labor in Nulliparous Women: a Randomized Clinical Trial

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Anxiety increases significantly during labor, especially among nulliparous women. Such anxiety may affect the progress of labor and physiological parameters. The use of essential oils of aromatic plants, or aromatherapy, is a non-invasive procedure that can decrease childbirth anxiety. This study examined the effect of inhalation of the aroma of geranium essential oil on the level of anxiety and physiological parameters of nulliparous women in the first stage of labor. In study, was carried out on 100 nulliparous women admitted to Bent al-Hoda Hospital in the city of Bojnord in North Khorasan province of Iran during 2012-2013. The women were randomly assigned to two groups of equal size, one experimental group (geranium essential oil) and one control (placebo) group. Anxiety levels were measured using Spielberger' questionnaire before and after intervention. Physiological parameters (systolic and diastolic blood pressure, respiratory rate, pulse rate) were also measured before and after intervention in both groups. Data analysis was conducted using the x2 test, paired t-test, Mann-Whitney U test, and Wilcox on test on SPSS 11.5. The mean anxiety score decreased significantly after inhalation of the aroma of geranium essential oil. There was also a significant decrease in diastolic blood pressure. Aroma of essential oil of geraniums can effectively reduce anxiety during labor and can be recommended as a non-invasive anti-anxiety aid during childbirth.
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Journal of Caring Sciences, 2015, 4(2), 135-141
doi:10.15171/jcs.2015.014
http:// journals.tbzmed.ac.ir/ JCS
* Corresponding Author: Mahbubeh Tabatabaeichehr (MSc), email: Chehr@nkums.ac.ir.
This Project was approved and funded by the North Khorasan University of Medical Sciences (Project number: 349). This clinical trial is registered
on the site plan No: 2012111811515N1
Copyright © 2015 by Tabriz University of Medical Sciences
Effect of Inhalation of Aroma of Geranium Essence on Anxiety and
Physiological Parameters during First Stage of Labor in Nulliparous
Women: a Randomized Clinical Trial
Fahimeh Rashidi Fakari1, Mahbubeh Tabatabaeichehr1*, Hossian Kamali2, Farzaneh Rashidi
Fakari3, Maryam Naseri4
1Departement of Midwifery, Faculty of Nursing and Midwifery, North Khorasan University of Medical Sciences, Bojnord, Iran
2Departement of Chemistry Engineer, Research Center of Natural Products Health, North Khorasan University of Medical
Sciences, Bojnurd, Iran
3Departement of Midwifery, Research Committee, Mashhad University of Medical Sciences, Mashhad, Iran
4Departement of Pharmacognosy, Faculty of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
ARTICLE INFO
ABSTRACT
Article Type:
Original Article
Introduction: Anxiety increases significantly during labor, especially among
nulliparous women. Such anxiety may affect the progress of labor and physiological
parameters. The use of essential oils of aromatic plants, or aromatherapy, is a non-
invasive procedure that can decrease childbirth anxiety. This study examined the effect
of inhalation of the aroma of geranium essential oil on the level of anxiety and
physiological parameters of nulliparous women in the first stage of labor.
Methods: In study, was carried out on 100 nulliparous women admitted to Bent al-
Hoda Hospital in the city of Bojnord in North Khorasan province of Iran during 2012-
2013. The women were randomly assigned to two groups of equal size, one
experimental group (geranium essential oil) and one control (placebo) group. Anxiety
levels were measured using Spielberger’s questionnaire before and after intervention.
Physiological parameters (systolic and diastolic blood pressure, respiratory rate, pulse
rate) were also measured before and after intervention in both groups. Data analysis
was conducted using the x2 test, paired t-test, Mann-Whitney U test, and Wilcox on test
on SPSS 11.5.
Results: The mean anxiety score decreased significantly after inhalation of the aroma
of geranium essential oil. There was also a significant decrease in diastolic blood
pressure.
Conclusion: Aroma of essential oil of geraniums can effectively reduce anxiety during
labor and can be recommended as a non-invasive anti-anxiety aid during childbirth.
Article History:
Received: 19 Aug. 2014
Accepted: 20 Nov. 2014
ePublished: 1 Jun. 2015
Keywords:
Anxiety
Aromatherapy
Childbirth
Geranium
Essence
Introduction
During labor, the level of anxiety increases
significantly, especially among nulliparous
women. This can affect normal muscle
contractions in response to changes in the
sympathetic nervous system and may
increase physiological parameters, resulting
in higher oxygen demand. If anxiety persists,
it can cause maternal and fetal hypoxia.1
Relaxation techniques, specific breathing
patterns, listening to music, and
complementary medicine are the most
common non-pharmaceutical and non-
invasive procedures used to help reduce
anxiety during labor. Complementary
medicine as an effective non-
pharmacological method has increased in
recent years.2 Complementary and
alternative medicine comprises a wide range
of health care practices, products and
therapies that includes the use of medicinal
plants and their essences,3 and
Rashidi Fakari et al.
136 | Journal of Caring Sciences, Jun 2015; 4 (2), 135-141 Copyright © 2015 by Tabriz University of Medical Sciences
aromatherapy.4 Studies have shown that
aromatherapy can reduce anxiety in patients
undergoing coronary angiography,
dentistry, and in menstruation-related
anxiety.5-7 Tahmasbi et al., reported that
aromatherapy can effectively reduce anxiety
and the physiological parameters of blood
pressure, pulse and respiratory rate in
patients undergoing angiography.7 Essential
oils of aromatic plants have also been used to
control anxiety and stress during labor;
however, the number of studies is limited,
their outcomes inconsistent, and the number
of essential oils studied limited. Mirzaei et
al., found herbal essential oils useful in
reducing anxiety during labor8, Hur et al.,
reported that aromatherapy had no effect on
reducing anxiety levels during childbirth.9
Pelargonium graveolens (rose geranium) is
an herbaceous plant in the genus Geranium
with a height of 40-100 cm having a scent
resembling that of roses.10 Apart from its
pleasant aroma, geranium essential oil has
anti-inflammatory, antidepressant, sedative,
anxiety-reducing, and muscle-relaxing
properties.11 It also facilitates blood
circulation and eases breathing.4 Kim et al.,
reported that geranium essential oil is one of
the most effective herbal essences for
reducing menstrual-related anxiety.5
The general effect of aromatherapy in
reducing anxiety during childbirth has not
been comprehensively explored. The present
study examined the effect of inhalation of the
aroma of geranium essential oil on the level
of anxiety and physiological parameters of
nulliparous women in the first stage of labor.
Materials and methods
This study was conducted as a randomized
clinical trial. The study population
comprised all nulliparous women admitted
to the maternity ward of Bint al-Hoda
Hospital in the city of Bojnordin, North
Khorasan province, Iran from August 2012
and 2013.
The inclusion criteria used were: being
nulliparous, being full-term pregnant, being
18 to 35 years of age, showing cervical
dilatation measuring 3-5 cm on vaginal
examination, no history of or current chronic
diseases (such as hypertension (≥140/90
mmHg), migraine, epilepsy, and asthma),
absence of olfactory impairment, no allergies
or previous unpleasant experiences to
specific scents, no use analgesic or anxiolytic
medicine for at least 3 h before the onset of
intervention, no symptoms of fetal distress
or high risk pregnancy. Exclusion criteria
were lack of desire to continue, symptoms of
fetal distress or disturbance during labor,
any use of analgesics during the
intervention.
The size of the groups (50 each) was
determined from a preliminary study at a
95% confidence interval (80% power,
variance of 6) with a clinically-acceptable
rate difference of 3 and replacements in the
formula of averages for comparison. To
prevent duplicate samples and unwanted
effects of geranium essential oil on the
control group, only one type of intervention
was applied to any one patient (geranium
essence or placebo) during a single work
shift in a single day. Similar envelopes used
for both treatment groups to randomize
allocation during each work shift.
Pelargonium graveolens, is a rose-scented
species of the genus Geranium. The 2%
concentrated essential oil was extracted and
prepared by the Medicinal Plants Research
Center of North Khorasan. The extraction
process was done using a Clevenger hydro
distillation device on the aerial parts of the
pelargonium graveolens. The extracted oil
was kept in a refrigerator in appropriate air-
tight opaque containers.
The Ethics Committee granted permission
for the study and issued a letter of referral to
North Khorasan University of Medical
Sciences in 2012. The sampling phase then
began at Bint-al-Hoda Hospital. After
preliminary selection based on the
aforementioned inclusion criteria, all
Geranium on anxiety and physiological parameters
Copyright © 2015 by Tabriz University of Medical Sciences Journal of Caring Sciences, Jun 2015; 4 (2), 135-141|137
qualified individuals completed a written
consent form along with a demographic
questionnaire. Some patients who did not
meet study eligibility requirements asked to
participate in the study. Out of ethical
considerations, their requests were not
denied, but their respective data was
excluded from final analysis. Two drops of
2% concentrated geranium essential oil and
the equal amounts of distilled water were
used for the experimental and control
groups, respectively. The essences were
dropped onto similar odorless non-absorbent
pieces of fabric attached to the participant’s
collar. Upon measurement of cervical
dilatation of 3-5 cm and in the intervals
between contractions, the anxiety level and
physiological parameters of systolic and
diastolic blood pressure, pulse and
respiratory rate were recorded before and 20
min after intervention for all participants.
This period (20 min) was chosen because the
olfactory receptors of participants became
insensitive to inhaling the aroma of the
undiluted essential oils at the bedside by 20
min after intervention.12 During the
examinations, blood pressure was always
measured using the same device on the same
arm. Respiratory and pulse rates were
counted during a 1 min interval.
Spielberger’s State-Trait Anxiety Inventory
(STAI) was used to determine the level of
anxiety of the participants.8,13 STAI
questionnaires consist of 40 questions; in the
present study, only the first 20 questions
focusing on anxiety were used. Scores of
between 20 and 80 were recorded for
questions about state anxiety. STAI is a
popular anxiety measurement question-
naire2,14 and Spielberger's validity is
approved for use in Iran.2 The reliability of
the Spielberg state anxiety questionnaire as
assessed by Cronbach's alpha at α= 0.90.
Blinding was not possible in this study
because of the diffusion of oil molecules in
the air. During the study, 2 participants in
the control group and 1 participant in the
experimental group were unwilling to
continue; therefore, final analysis was based
on 97 participants (Figure 1).
Figure 1. Consort flow chart of participants
Rashidi Fakari et al.
138 | Journal of Caring Sciences, Jun 2015; 4 (2), 135-141 Copyright © 2015 by Tabriz University of Medical Sciences
Data analysis was conducted using the x2
test, paired t-test, MannWhitney U test, and
Wilcox on test on SPSS 11.5. In all
calculations, P<0.05 was considered to be
significant.
Results
There were no significant differences
between the experimental and control
groups in terms of the demographic
characteristics of age, education level,
employment status, spouse employment
status and fetal gender (Table 1).
The Kolmogorov-Smirnov test was used to
evaluate the normality of the main variables
measured pre-test and post-test. For normal
variables, parametric tests were used and, for
non-normal variable, nonparametric tests
were used.
Table 1. Compared demographic characteristics in the Geranium and control groups
Variables
Geranium group
Control group
P
Age (year)
23 (7)*
21 (5)*
0.06
Level education (%)
Illiterate
2 (4.1)
2 (4.2)
0.06**
Less than diploma
17 (34.7)
29 (60.4)
Diploma
22 (44.9)
9 (18.8)
Higher than diploma
8 (16.3)
8 (16.7)
Fetal sex (%)
Male
24 (49)
21 (43.8)
Female
25 (51)
27 (56.2)
0.6**
Woman employment status (%)
Housewife
44 (89.8)
42 (87.5)
Employed
3 (6.1)
3 (6.2)
0.88**
Student
2 (4.1)
3 (6.2)
Spouse employment status (%)
Self - employed
28 (57.1)
26 (54.2)
Workman
12 (24.5)
14 (29.2)
Staff
6 (12.2)
3 (6.2)
0.54**
Unemployed
1 (2)
0 (0)
Farmer
1 (2)
4 (8.3)
Student
1 (2)
1 (2.1)
*Middle (interquartile range),Mann-Whitney U test,**Chi-square test
In the experimental group, mean anxiety
scores before and after intervention were
56.75 (9.9(, 52.73 (11.7), respectively, which
showed a significant decrease (P =0.001) in
state anxiety. In the placebo group, mean
anxiety scores before and after the
intervention were 53.45 (6.1) and 52.31 (6.2),
respectively, which also showed a significant
decrease (P =0.003). Anxiety levels before
and after intervention showed differences of
-4.02 and -1.14 for the experimental and
control groups, respectively.
Table 2 shows that there were no
significant differences in the physiological
parameters measured, except for diastolic
blood pressure, which changed significantly
between groups (P <0.05) after the
intervention.
Discussion
Aromatherapy during childbirth is a safe
and non-invasive method of easing anxiety.
Burns et al., reported that the use of
aromatherapy during labor produced no
significant differences in neonatal or
maternal outcomes such as caesarean section,
vaginal delivery and vacuum use.
Quality of life, Elderly people, Related factors
Copyright © 2014 by Tabriz University of Medical Sciences Journal of Caring Sciences, December 2014; 3 (4), 135-141|139
Table 2. Intra-group comparison of anxiety level and physiological parameters before
and after receiving the Geranium essential oil with control group
Variables
Before
After
P
MD (SD)**
MD (SD)**
Geranium group
Anxiety
56.75 (9.9)
52.73 (11.7)
0.001*
Systolic blood pressure (mmHg) ***
110 (20)
110 (12)
0.08
Diastolic blood pressure (mmHg) ***
70 (10)
70 (10)
0.005
Pulse rate***
84 (9)
82 (8)
0.056
Respiration rate***
18 (4)
18 (4)
0.52
Control group***
Anxiety***
53.45 (6.1)
52.31 (6.2)
0.003*
Systolic blood pressure (mmHg) ***
100 (10)
100 (18)
0.28
Diastolic blood pressure (mmHg) ***
65 (10)
60 (20)
0.03
Pulse rate***
80 (16)
80 (10)
0.13
Respiration rate***
16 (4)
16 (4)
0.79
* Paired test, **Mean (Standard deviation), *** Middle (interquartile range), Wilcoxon test
On the other hand, the numbers of infants
hospitalized in the NICU was lower for the
aromatherapy treatment group;15
moreover, mothers and midwifes generally
approve of the use of aromatherapy during
childbirth.16
The present study showed that state
anxiety (anxiety during labor) decreased
over that for the control group. Diastolic
blood pressure (as a physiological
parameter) decreased significantly after
inhalation of the aroma of geranium
essential oil. No similar study has been
found that used this particular essence.
Mirzaei et al., examined the effects of
inhalation of the aroma of lavender essence
under similar conditions. They concluded
that anxiety decreased significantly in the
experimental group.8 Tafazoli et al.,
reported similar results using herbal
essential oil.2 Their study investigated both
state and trait anxiety, whereas the present
study investigated only state anxiety,
which better reflects anxiety in a specific
situation. The results of these studies are
consistent with those of the present study.
Hur et al., evaluated the effects of
aromatherapy on anxiety during labor in
nulliparous women and found no
difference in anxiety levels.9 The reason for
this inconsistency could related to
differences in the intervals used to evaluate
state anxiety using the STAI.
Of the physiological parameters used in
the present study, only diastolic blood
pressure showed a significant decrease.
Mirzaei et al., investigated additional
physiological parameters of systolic and
diastolic BP and heart rate after
intervention and reported no significant
change in theseparameters.8 Kim et al.,
examined the effects of aromatherapy using
different essences including geranium oil
on the first clinical experience of nursery
students to intravenous injection. They
reported that of the parameters of systolic
and diastolic BP and pulse rate, only pulse
rate had showed a significant decrease.14
The different and sometimes inconsistent
reports on changes in physiological
parameters that have been reported
(including this one) may relate to the type
of essence, its concentration, the duration of
inhalation, precision of measurement and
of the equipment used. The decrease in
anxiety in the control group in this study
could be the influence of the physical
presence of the investigator during study
and the ongoing care and monitoring
during that period, which was likely to
reassure patients and reduce anxiety in the
Rashidi Fakari et al.
140 | Journal of Caring Sciences, Jun 2015; 4 (2), 135-141 Copyright © 2015 by Tabriz University of Medical Sciences
control group. It must be noted that these
factors held true for both the intervention
and control groups. Although the influence
of these factors could account for part of
the result in the intervention group, this
group showed a greater decrease in anxiety
with appears to relate to the use of
aromatherapy using geranium essential oil.
One limitation of this study was the
impossibility of blinding because of the
diffusion of oil molecules into the
environment
Conclusion
There is a clear advantage to inhalation of
aroma instead of applying the oil to the
skin of the patient. Application risks
irritation for individuals with sensitive skin
and patients may be disinclined to apply a
substance to their skin during labor. The
results of this study along with the pleasant
aroma of geranium essential oil means
aromatherapy using geranium essential oil
during labor is an effective method of
reducing state anxiety.
Acknowledgments
The authors would like to thank all the
mothers who participated in this study and
the Research Deputy of North Khorasan
University of Medical Sciences for the
financial support for this project.
Ethical issues
None to be declared.
Conflict of interest
The authors declare no conflict of interest in
this study.
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Aromatherapy is a practice applied in different sectors such as post-operative care, pain treatment and anxiety reduction. However, in Brazil, the legislation allows the use of aromatherapy by nurses since 2018, but the use of essential oils during labor is not regulated. The aim of the study was to analyze the records of the benefits of using aromatherapy during labor and the chemical components of aromatic plants that contribute to the reducing pain, duration of contractions, anxiety and stress effects resulting from childbirth. The integrative review carried out in the Scopus, MEDLINE / PubMed and Science Direct databases specified between 2010 and 2020, in Portuguese, English and Spanish. The PICo methodology (Population, Interest and Context) was used to construct the research question and select controlled and uncontrolled descriptors, which were combined with the Boolean operators "AND", "OR" and "NOT". 17 articles were selected using aromatherapy during labor, individually or in conjunction with other therapies. The most used essential oil was Lavandula officinalis (53%), and the effects were related to the decrease in the pain of contractions and childbirth, followed by Rosa x damascena oil (23.5%), although the effect of the plant is more related to the reduction in the parturient’s anxiety and stress. Aromatherapy acts both on the physiological aspects of women in labor and on their subjectivity. Chemical evidence supports the relationship between the major compounds present in the essential oils of the aromatic plants used in the study and the beneficial effects of aromatherapy in labor.
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(1) Background: Essential oils have long been used as therapeutic agents. Lavender (Lavandula angustifolia) oil (LO) is an antispasmodic, anticonvulsant, relaxant, painkilling, and antimicrobial essential oil investigated as a natural substance for biomedical therapies. Nanoparticles have shown significant promise in improving drug delivery and efficacy. Considering these benefits, the aim of this study was to evaluate the toxicity of LO and lavender oil niosomes (LONs) in stem cells and myofibroblast models cultured in vitro. (2) Methods: Adipose tissue-derived stem cells and myometrial cells were cultured with LO or LONs at different concentrations (0, 0.016%, 0.031%, and 0.063%) and toxicity was evaluated with PrestoBlue™ and live/dead assay using calcein and ethidium homodimer. (3) Results: Cell viability was similar to controls in all groups, except in 0.063% LO for myometrial cells, which showed lower viability than the control medium. (4) Conclusion: These results suggest that both LO and LONs are safe for cell culture and may be used for pharmaceutical and biomedical therapies in future applications in regenerative medicine. View Full-Text
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Aromas have a powerful influence in our everyday life and are known to exhibit an array of pharmacological properties, including anxiolytic, anti-stress, relaxing, and sedative effects. Numerous animal and human studies support the use of aromas and their constituents to reduce anxiety-related symptoms and/or behaviours. Although the exact mechanism of how these aromas exert their anxiolytic effects is not fully understood, the GABAergic system is thought to be primarily involved. The fragrance emitted from a number of plant essential oils has shown promise in recent studies in modulating GABAergic neurotransmission, with GABAA receptors being the primary therapeutic target. This review will explore the anxiolytic and sedative properties of aromas found in common beverages, such as coffee, tea, and whisky as well aromas found in food, spices, volatile organic compounds, and popular botanicals and their constituents. In doing so, this review will focus on these aromas and their influence on the GABAergic system and provide greater insight into viable anxiety treatment options.
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Background: Anxiety among patients experiencing coronary angiography increases within invasive studies including angiography. Anxiety as an intensifier at cardiovascular reactions can endanger patients in angiography clinics. Studies indicate that lavendula spica L. inhalation can decrease anxiety. The purpose of this study is to determine the impact of aromatherapy on the anxiety level of patients experiencing coronary angiography. Materials and Methods: This research is a clinical trial study performed on a group of 96 patients hospitalized in Sari Fatemeh-Zahra Hospital for coronary angiography who were randomly selected. They were divided in two subject (45 patients) and control (46 patients) groups. Demographic data sheets, recording sheet of homodynamic variables and Spielberger state-trait anxiety inventory were distributed among the two groups before and after aromatherapy. The data were analyzed using SPSS-16 as well as statistical T-test and chi-square test. Results: The two groups were homogenous in terms of gender, marital status, level of education, sickness background, age and health insurance. The data indicated that anxiety level decreased significantly in the subject group compared with the control group after aromatherapy (P < 0.0001). There was also a significant difference in systolic and diastolic blood pressure and respiratory rate as well as heartbeat parameters in these two groups. (P
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The goal of this study was to investigate the impact of the essential oils of orange and lavender on anxiety, mood, alertness and calmness in dental patients. Two hundred patients between the ages of 18 and 77 years (half women, half men) were assigned to one of four independent groups. While waiting for dental procedures patients were either stimulated with ambient odor of orange or ambient odor of lavender. These conditions were compared to a music condition and a control condition (no odor, no music). Anxiety, mood, alertness and calmness were assessed while patients waited for dental treatment. Statistical analyses revealed that compared to control condition both ambient odors of orange and lavender reduced anxiety and improved mood in patients waiting for dental treatment. These findings support the previous opinion that odors are capable of altering emotional states and may indicate that the use of odors is helpful in reducing anxiety in dental patients.
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Aim: The purpose of this study was to investigate the effect of self-aromatherapy massage on menstrual pain and anxiety. Participants and methods: The subjects were 63 female nurses who rated their menstrual pain >5 on a 10-point visual analogue scale. Subjects were non-randomly allocated into three groups: an experimental group (N=26) who performed self-aromatherapy massage, a placebo group (N=18), and a no-treatment control group (N=19). Eleven participants dropped out of the study either because of nausea (experimental group, N=1) or because they took medication during the trial (placebo group, N=3; control group, N=4). The final analysis included 25 in the experimental group, 15 in the placebo group, and 15 in the no-treatment control group. Menstrual pain and anxiety levels were assessed using a visual analogue scale, and we assessed the menstrual pain 4 times during a short time period. Results: The menstrual pain was significantly lower in the aromatherapy group than in the other two groups after 24. h. Using multiple regression analysis, the use of aromatherapy was found to be associated with the changes in menstrual pain levels (Beta = -1.74, 95% CI: -2.64 to -0.85, P<0.001) and the level of anxiety (Beta = -0.53, 95% CI: -0.76 to -0.31, P=0.001). Conclusion: These findings suggest that self-aromatherapy massage of the abdomen using topically applied essential oils may be an effective treatment that decreases menstrual pain and the level of anxiety.
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This study was designed to investigate the effect of delivery nursing care using essential oils on labor stress response, labor anxiety and postpartum status anxiety for primipara. This study used nonequivalent control group pretest-posttest design. The subjects of this experiment consisted of forty eight primipara with single gestation, full term, & uncomplicated pregnancies. Twenty four primipra were in the experimental and control group each. Their mean age was 27.9 years old, their mean gestation period 279.9 days. As a treatment, delivery nursing care using essential oils was applied by nurses. Data collected epinephrine, norepinephrine, anxiety during labor. In the 24 hours after birth, the data for the postpartum mother's status anxiety was collected. Data was analyzed by t-test, repeated measures ANOVA, Mann-Whitney U test, & Wilcoxon signed ranks test with SPSS Program. Plasma epinephrine, norepinephrine were significantly low in the experimental group (P=0.001, P=0.033, respectively). There was no significant difference between the two groups in anxiety during labor and postpartum mother's status anxiety. These findings indicate that delivery nursing care using essential oils could be effective in decreasing plasma epinephrine, norepinephrine. But, that could not be verified in decreasing mother's anxiety.
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A wide variety of pain relief measures are available to women in labor. This retrospective, descriptive survey design study examined which nonpharmacologic pain-relief techniques laboring women use most often and the effectiveness of the chosen techniques. Of the 10 nonpharmacological strategies rated by the sample (N = 46), breathing techniques, relaxation, acupressure, and massage were found to be the most effective. However, no specific technique or techniques were helpful for all participants. The results provide directions for childbirth educators in designing and implementing an effective childbirth education curriculum that assists women to have empowered birth experiences.
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We aimed to determine the feasibility of conducting a randomised controlled trial (RCT) on the use of aromatherapy during labour as a care option that could improve maternal and neonatal outcomes. RCT comparing aromatherapy with standard care during labour. District general maternity unit in Italy. Two hundred and fifty-one women randomised to aromatherapy and 262 controls. Participants randomly assigned to administration of selected essential oils during labour by midwives specifically trained in their use and modes of application. Intrapartum outcomes were the following: operative delivery, spontaneous delivery, first- and second-stage augmentation, pharmacological pain relief, artificial rupture of membranes, vaginal examinations, episiotomy, labour length, neonatal wellbeing (Apgar scores) and transfer to neonatal intensive care unit (NICU). There were no significant differences for the following outcomes: caesarean section (relative risk [RR] 0.99, 95% CI: 0.70-1.41), ventouse (RR 1.5, 95% CI: 0.31-7.62), Kristeller manoeuvre (RR 0.97, 95% CI: 0.64-1.48), spontaneous vaginal delivery (RR 0.99, 95% CI: 0.75-1.3), first-stage augmentation (RR 1.01, 95% CI: 0.83-1.4) and second-stage augmentation (RR 1.18, 95% CI: 0.82-1.7). Significantly more babies born to control participants were transferred to NICU, 0 versus 6 (2%), P = 0.017. Pain perception was reduced in aromatherapy group for nulliparae. The study, however, was underpowered. This study demonstrated that it is possible to undertake an RCT using aromatherapy as an intervention to examine a range of intrapartum outcomes, and it provides useful information for future sample size calculations.
Effect of massage on physiologic responses on primiparous women. The Horizon of
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