title: Acupuncture with manual and electrical stimulation for labour pain: a two month follow up of recollection of pain and birth experience.
abstract: BACKGROUND
  In a previous randomised controlled trial we showed that acupuncture with a combination of manual- and electrical stimulation (EA) did not affect the level of pain, as compared with acupuncture with manual stimulation (MA) and standard care (SC), but reduced the need for other forms of pain relief, including epidural analgesia. To dismiss an under-treatment of pain in the trial, we did a long-term follow up on the recollection of labour pain and the birth experience comparing acupuncture with manual stimulation, acupuncture with combined electrical and manual stimulation with standard care. Our hypothesis was that despite the lower frequency of use of other pain relief, women who had received EA would make similar retrospective assessments of labour pain and the birth experience 2 months after birth as women who received standard care (SC) or acupuncture with manual stimulation (MA).
  
  
  METHODS
  Secondary analyses of data collected for a randomised controlled trial conducted at two delivery wards in Sweden. A total of 303 nulliparous women with normal pregnancies were randomised to: 40 min of MA or EA, or SC without acupuncture. Questionnaires were administered the day after partus and 2 months later.
  
  
  RESULTS
  Two months postpartum, the mean recalled pain on the visual analogue scale (SC: 70.1, MA: 69.3 and EA: 68.7) did not differ between the groups (SC vs MA: adjusted mean difference 0.8, 95% confidence interval [CI] -6.3 to 7.9 and SC vs EA: mean difference 1.3 CI 95% -5.5 to 8.1). Positive birth experience (SC: 54.3%, MA: 64.6% and EA: 61.0%) did not differ between the groups (SC vs MA: adjusted Odds Ratio [OR] 1.8, CI 95% 0.9 to 3.7 and SC vs EA: OR 1.4 CI 95% 0.7 to 2.6).
  
  
  CONCLUSIONS
  Despite the lower use of other pain relief, women who received acupuncture with the combination of manual and electrical stimulation during labour made the same retrospective assessments of labour pain and birth experience 2 months postpartum as those who received acupuncture with manual stimulation or standard care.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT01197950.
authors.affiliation: Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Retzius väg 13A, Karolinska Institutet, 171 77, Stockholm, Sweden. lvi@du.se.|School of Health and Social Studies, Dalarna University, 791 88, Falun, Sweden. lvi@du.se.
authors.forename: Linda
authors.initials: L
authors.lastname: Vixner
authors.affiliation: School of Health and Education, University of Skövde, P.O. Box 408, 541 28, Skövde, Sweden.
authors.forename: Lena B
authors.initials: LB
authors.lastname: Mårtensson
authors.affiliation: Department of Women's and Children's Health, Division of Reproductive Health, Karolinska Institutet, Retzius väg 13A, Karolinska Institutet, 171 77, Stockholm, Sweden.|Centre for Clinical Research Dalarna, Nissers väg 3, 791 82, Falun, Sweden.
authors.forename: Erica
authors.initials: E
authors.lastname: Schytt
mesh_terms: D015670:Acupuncture Therapy; D000328:Adult; D004558:Electric Stimulation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D048949:Labor Pain / Q000453:epidemiology / Q000628:therapy; D011247:Pregnancy; D012189:Retrospective Studies; D013548:Sweden / Q000453:epidemiology