title: The effect of intermittent local heat and cold on labor pain and child birth outcome.
abstract: BACKGROUND
  Labor pain is one of the severest pains that cause many women request cesarean section for fear of pain. Thus, controlling labor pain is a major concern of maternity care. Nowadays, interest in non-pharmacological pain relief methods has been increased because of their lower side effects. The effects of discrete heat and cold on decreasing labor pain have been reported but there was no evaluation of the effects of simultaneous heat and cold. The aim of this study was to investigate the effect of intermittent heat and cold on pain severity and childbirth outcomes.
  
  
  METHODS
  This study was a randomized controlled trial. Sixty-four nulliparous women with term, One fetus, and low-risk pregnancy were divided into the intervention (32 participants) and the control group (32 participants) by random allocation. Excluding criteria were: administration of pain relief drugs, skin disease in the field of intervention, fetal distress, bleeding, fever, and disagreement with participation in the study. Warm and cold packs were used intermittently on low back and lower abdomen during the first phase and on perineum during the second phase of labor. Pain intensity was assessed with Visual Analogue Scale. Descriptive statistic, chi square, and t-test were used for data analysis.
  
  
  RESULTS
  There were no significant differences in demographic and midwifery characteristics and the baseline pain between two groups. The pain was significantly lower in intervention group during the first and second phases of labor. Duration of the first and third phases of labor was shorter in the case group. There were no significant differences in type of delivery, perineal laceration, oxytocin uptake, fetal heart rate, and APGAR between two groups.
  
  
  CONCLUSIONS
  Local warming with intermittent cold pack can reduce labor pain without adverse effects on maternal and fetal outcomes. It is an inexpensive and simple method.
  
  
  CONCLUSIONS
  Intermittent local heat and cold therapy is a no pharmalogical, safe and effective method to relief labor pain.
authors.affiliation: Department of Midwifery, Mazandran University of Medical Science, Sari, Iran.
authors.forename: Zhila
authors.initials: Z
authors.lastname: Ganji
authors.affiliation: Department of Midwifery, Mazandran University of Medical Science, Sari, Iran.
authors.forename: Marjan A
authors.initials: MA
authors.lastname: Shirvani
authors.affiliation: Department of Midwifery, Mazandran University of Medical Science, Sari, Iran.
authors.forename: Farideh
authors.initials: F
authors.lastname: Rezaei-Abhari
authors.affiliation: Department of Midwifery, Mazandran University of Medical Science, Sari, Iran.
authors.forename: Mahmonir
authors.initials: M
authors.lastname: Danesh
keywords: Child birth; cold temperature; hot temperature; labor pain