TO BATHE OR NOT TO BATHE DURING THE FIRST STAGE OF LABOR

Objective. Does a warm tub bath relieve labor pain? How is it experien ced by the parturient? Methods. Design: prospective randomised trial. Setting: labor ward of a teaching hospital with a uniform active labor management. Participants: one hundred and ten nulliparous low risk wo men, at term, in true spontaneous labor. Fifty-four women had a bath, 56 women served as controls. Mean outcome measures: labor pain (assess ed by means of a visual analogue scale) and post partum patients' bath ing experience (by means of a self-made questionnaire). Results. The s tudy group and the control group were comparable with respect to mater nal age, weight, length, duration of gestation, cervical status and la bor pain sensation before randomisation. Absolute values of labor pain were not statistically different between the two groups, yet this lat ter progressed differently: in the bathing group the initial pain sens ation (V.A.S.) was 6.8, and this remained stable during the first 25 m inutes (V.A.S. = 6.7) and then rose to 8.2 after a mean of 53 minutes. In the control group, labor pain rose progressively from 6.3 to 7.3 a fter 25 min and to 8.7 after a mean of 52 min (p < 0.01, Student t-tes t). There was no difference in the use of epidural analgesia. There we re no differences in labor duration nor in the frequencies of either o perative deliveries or neonatal complications. Eighty percent of the b athers experienced soothing of the pain and all but one reported body relaxation. Ninety percent wanted to bathe again during a next labor. Conclusion. Bathing provided no objective pain relief It had, however, a temporal pain stabilizing effect possibly mediated through the impr oved ability to relax in between contractions. No side effects were fo und. It gives great satisfaction to users. Bathing, in conjunction wit h other forms of analgesia, is recommended.