title: Implementation of a Hydrotherapy Protocol to Improve Postpartum Pain Management.
abstract: BACKGROUND
  A growing number of women are seeking alternatives to traditional pharmacologic pain management during birth. While there has been an extensive array of nonpharmacologic options developed for labor, there are limited offerings in the postpartum period. The purpose of this quality improvement project was to implement a hydrotherapy protocol in the early postpartum period to improve pain management for women choosing a nonmedicated birth.
  
  
  METHODS
  The postpartum hydrotherapy protocol was initiated in a certified nurse-midwife (CNM) practice in an urban academic medical center. All women who met criteria were offered a 30-minute warm water immersion bath at one hour postpartum. Pain scores were assessed prior to the bath, at 15 minutes after onset, and again at the conclusion (30 minutes). Women who completed the bath were also asked to complete a brief survey on their experience with postpartum hydrotherapy.
  
  
  RESULTS
  In women who used the bath (N = 45), there was a significant reduction in pain scores (P < .001) between the onset of the bath and scores at both 15 minutes and 30 minutes. There was no significant difference between pain scores at 15 minutes and 30 minutes (P = .97). Of those women who completed a survey (n = 43), 97.7% reported both that the bath reduced their pain and improved their birth experience. One hundred percent reported they would use it again in another birth.
  
  
  CONCLUSIONS
  This project demonstrated successful implementation of a hydrotherapy protocol as an alternative or adjunct to medication for early postpartum pain management that significantly reduced pain and improved the birth experience for those who used it. It offers a nonpharmacologic alternative where there have traditionally been limited options.
authors.forename: Meghann
authors.initials: M
authors.lastname: Batten
authors.forename: Eleanor
authors.initials: E
authors.lastname: Stevenson
authors.forename: Deb
authors.initials: D
authors.lastname: Zimmermann
authors.forename: Christine
authors.initials: C
authors.lastname: Isaacs
mesh_terms: D002985:Clinical Protocols; D005260:Female; D006801:Humans; D006875:Hydrotherapy; D007101:Immersion; D009321:Natural Childbirth; D009721:Nurse Midwives; D007744:Obstetric Labor Complications; D010146:Pain / Q000209:etiology*; D059408:Pain Management; D010147:Pain Measurement; D017060:Patient Satisfaction; D049590:Postpartum Period; D011247:Pregnancy; D014867:Water
chemical_list: D014867:Water
keywords: complementary and alternative therapies; hydrotherapy; normal birth; pain management; postpartum care