Terapias não farmacológicas aplicadas na gestação e no trabalho de parto: revisão integrativa

Biana, Camilla Benigno; Cecagno, Diana; Porto, Adrize Rutz; Cecagno, Susana; Marques, Vanessa de Araujo; Soares, Marilu Correa

Acessibilidade / Reportar erro

Brasil

Revista da Escola de Enfermagem da USP

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Brasil

Español English

sumário « anterior atual seguinte »

Sumário

REVISÃO • Rev. esc. enferm. USP 55 • 2021 • https://doi.org/10.1590/S1980-220X2019019703681 copiar

Terapias não farmacológicas aplicadas na gestação e no trabalho de parto: revisão integrativa

Autoria SCIMAGO INSTITUTIONS RANKINGS

RESUMO

Objetivo:

Identificar terapias não farmacológicas aplicadas na gestação e no trabalho de parto.

Método:

Revisão integrativa realizada nas bases de dados: PubMed, ScieLO e PEDro, buscando-se artigos de 2008 nos idiomas inglês, espanhol e português. Os descritores utilizados foram: gravidez, parto, fisioterapia, medicina alternativa e complementar, terapia alternativa, terapia não farmacológica, terapia biomecânica.

Resultados:

Foram analisados 41 artigos e subdivididos em 10 categorias de terapias não farmacológicas: massagem, massagem perineal, banho quente, cuidado de suporte, grupo de preparação para o parto, técnicas de respiração, exercícios de assoalho pélvico, eletroestimulação transcutânea, bola suíça e puxo espontâneo. Seis artigos (60%) apresentaram desfecho positivo para redução da dor no trabalho de parto e todos apresentaram algum desfecho positivo para diferentes variáveis do trabalho de parto, como redução do tempo, da ansiedade e das taxas de laceração do assoalho pélvico.

Conclusão:

O uso de terapias não farmacológicas foi eficiente para reduzir os efeitos do trabalho de parto e parto, como dor, duração do trabalho de parto, ansiedade, laceração e episiotomia.

Terapias Complementares; Terapia por Exercício; Gestação; Parto Normal; Enfermagem Obstétrica; Revisão

Autores	Profissão do terapeuta	Local do estudo	Desenho metodológico
Kimber, et al; 2008⁽¹²12 Kimber L, McNabb M, McCourt C, Haines A, Brocklehurst P. Massage or music for pain relief in labour: a pilot randomised placebo controlled trial. Eur J Pain. 2008;12(8):961-9. doi: 10.1016/j.ejpain.2008.01.004 https://doi.org/10.1016/j.ejpain.2008.01... ⁾	Obstetrizes e terapeutas	Centros pré-natais	Estudo piloto randomizado
Mei-dan, et al; 2008⁽¹³13 Mei-dan E, Walfisch A, Raz I, Levy A, Hallak M. Perineal massage during pregnancy: a prospective controlled trial. Isr Med Assoc J. 2008;10(7):499-502.⁾	Obstetrizes e auto aplicável	Clínicas pré-natal e maternidade	Estudo clínico controlado
Bergstrom, et al; 2009⁽¹⁴14 Bergström M, Kieler H, Waldenström U. Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial. BJOG. 2009;116(9):1167-76. doi: 10.1111/j.1471-0528.2009.02144.x https://doi.org/10.1111/j.1471-0528.2009... ⁾	Obstetrizes	Clínicas pré-natais	Estudo clínico randomizado
Davim, et al; 2009⁽³3 Davim RMB, Torres GV, Dantas JC. Effectiveness of non-pharmacological strategies in relieving labor pain. Rev Esc Enferm USP [Internet]. 2009 [cited 2018 March 03]; 43(2):438-41. Available from: http://www.scielo.br/pdf/reeusp/v43n2/a25v43n2.pdf http://www.scielo.br/pdf/reeusp/v43n2/a2... ⁾	Enfermeira	Maternidade	Estudo clínico de intervenção
Bahadoran, et al; 2010⁽¹⁵15 Bahadoran P, Asefi F, Oreyzi H, Valiani M. The effect of participating in the labor preparation classes on maternal vitality and positive affect during the pregnancy and after the labor. Iran J Nurs Midwifery Res [Internet]. 2010 [cited 2018 Dec 10];15 Suppl1:331-6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208940/ https://www.ncbi.nlm.nih.gov/pmc/article... ⁾	Não informada	Centros de saúde pública	Estudo clínico quase-experimental
Peng, et al; 2010⁽¹⁶16 Peng T, Li XT, Zhou SF, Xiong Y, Kang Y, Cheng HD. Transcutaneous electrical nerve stimulation on acupoints relieves labor pain: a non-randomized controlled study. Chin J Integr Med. 2010;16(3):234-8. doi: 10.1111/jog.12345 https://doi.org/10.1111/jog.12345... ⁾	Enfermeira	Maternidade	Estudo clínico não randomizado
Taghinejad, et al; 2010⁽¹⁷17 Taghinejad H, Delpisheh A, Suhrabi Z. Comparison between massage and music therapies to relieve the severity of labor pain. Womens Health (Lond). 2010;6(3):377-81. doi: /10.2217/WHE.10.15 https://doi.org//10.2217/WHE.10.15... ⁾	Obstetrizes	Maternidade	Estudo clínico randomizado
Dias, et al; 2011⁽¹⁸18 Dias LAR, Driusso P, Aita DLCC, Quintana SM, Bø K, Ferreira CHJ. Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial. Rev Bras Fisiot. 2011;15(6):487-93. doi: 10.1590/S1413-35552011005000011 https://doi.org/10.1590/S1413-3555201100... ⁾	Fisioterapeutas	Maternidade	Estudo clínico randomizado
Gau, et al; 2011⁽¹⁹19 Gau ML, Chang CY, Tian SH, Lin KC. Effects of birth ball exercise on pain and self-efficacy during childbirth: a randomised controlled trial in Taiwan. Midwifery. 2011;27(6):e293-300. doi: 10.1016/j.midw.2011.02.004 https://doi.org/10.1016/j.midw.2011.02.0... ⁾	Obstetrizes	Maternidade	Estudo clínico randomizado
Geranmayeh, et al; 2011⁽²⁰20 Geranmayeh M, Habibabadi ZR, Fallahkish B, Farahani MA, Khakbazan Z, Mehran A. Reducing perineal trauma through perineal massage with vaseline in second stage of labor. Arch Gynecol Obstet. 2012;285(1):77-81. doi: 10.1007/s00404-011-1919-5 https://doi.org/10.1007/s00404-011-1919-... ⁾	Obstetrizes	Maternidade	Estudo clínico randomizado
Dhany, et al; 2012⁽⁶6 Dhany AL, Mitchell T, Foy C. Aromatherapy and massage intrapartum service impact on use of analgesia and anesthesia in women in labor: a retrospective case note analysis. J Altern Complement Med. 2012;18(10):932-8. doi: 10.1089/acm.2011.0254 https://doi.org/10.1089/acm.2011.0254... ⁾	Não informada	Maternidade	Estudo clínico retrospectivo
Karacam, et al; 2012⁽²¹21 Karaçam Z, Ekmen H, Calisir H. The use of perineal massage in the second stage of labor and follow-up of postpartum perineal outcomes. Health Care Women Int. 2012;33(8):697-718. doi: 10.1080/07399332.2012.655385 https://doi.org/10.1080/07399332.2012.65... ⁾	Enfermeiras e obstetrizes	Maternidade	Estudo clínico randomizado
Low, et al; 2012⁽²²22 Low LK, Miller JM, Guo Y, Ashton-Miller JA, DeLancey JOL, Sampselle CM. Spontaneous pushing to prevent postpartum urinary incontinence: a randomized, controlled trial. Int Urogynecol J. 2013;2(3):453-60. doi: 10.1007/s00192-012-1884-y https://doi.org/10.1007/s00192-012-1884-... ⁾	Enfermeiras	Maternidade	Estudo clínico randomizado
Mortazavi, et al; 2012⁽²³23 Mortazavi SH, Khaki S, Moradi R, Heidari K, Rahimparvar SFV. Effects of massage therapy and presence of attendant on pain, anxiety and satisfaction during labor. Arch Gynecol Obstet. 2012;286(1):19-23. doi: 10.1007/s00404-012-2227-4 https://doi.org/10.1007/s00404-012-2227-... ⁾	Não informada	Maternidade	Estudo clínico randomizado
Ismail, et al; 2013⁽²⁴24 Ismail SIMF, Emery SJ. Patient awareness and acceptability of antenatal perineal massage. J Obstet Gynaecol. 2013;33(8):839-43. doi: 10.3109/01443615.2013.828027 https://doi.org/10.3109/01443615.2013.82... ⁾	Obstetrícias, obstetrizes e fisioterapeutas	Maternidade	Estudo descritivo
Gallo, et al; 2013⁽²⁵25 Gallo RBS, Santana LC, Ferreira CHJ, Marcolin AC, PoliNeto OB, Duarte G, et al. Massage reduced severity of pain during labour: a randomised trial. J Physiother. 2013;59(2):109-16. doi: 10.1016/S1836-9553(13)70163-2 https://doi.org/10.1016/S1836-9553(13)70... ⁾	Fisioterapeutas	Maternidade	Estudo clínico randomizado
Lee, et al; 2013⁽²⁶26 Lee SL, Liu CY, Gau ML. Efficacy of warm showers on labor pain and birth experiences during the first labor stage. J Obstet Gynecol Neonatal Nurs. 2013;42(1):19-28. doi: 10.1111/j.1552-6909.2012.01424.x https://doi.org/10.1111/j.1552-6909.2012... ⁾	Enfermeiras	Maternidade	Estudo clínico randomizado
Miquelutti, et al; 2013⁽²⁷27 Miquelutti MA, Cecatti JG, Makuch MY. Antenatal education and the birthing experience of Brazilian women: a qualitative study. BMC Pregnancy Childbirth. 2013;13:171. doi: 10.1186/1471-2393-13-171 https://doi.org/10.1186/1471-2393-13-171... ⁾	Fisioterapeuta	Maternidade	Estudo qualitativo
Akbarzadeh,et al; 2014⁽²⁸28 Akbarzadeh M, Masoudi Z, Hadianfard MJ, Kasraeian M, Zare N. Comparison of the effects of maternal supportive care and acupressure (BL32 acupoint) on pregnant women's pain intensity and delivery outcome. J Pregnancy. 2014;2014:129208. doi: 10.1155/2014/129208 https://doi.org/10.1155/2014/129208... ⁾	Doulas	Maternidade	Estudo clínico randomizado
Reilly, et al; 2014⁽²⁹29 Reilly ETC, Freeman RM, Waterfield AE, Steggles P, Pedlar F. Prevention of pospartum stress incontinence in primigravidae with increased blader neck mobility: a randomized controlled trial of antenatal pelvic floor exercises. BJOG.2014;121 Suppl 7:58-66. doi: https://doi.org/10.1111/1471-0528.13213 https://doi.org/10.1111/1471-0528.13213... ⁾	Fisioterapeuta	Clinica pré-natal	Estudo clínico randomizado
Adams, et al; 2015⁽³⁰30 Adams J, Frawley J, Steel A, Broom A, Sibbritt D. Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: examination of a nationally representative sample of 1835 pregnant women. Midwifery. 2015;31(4):458-63. doi: https://doi.org/10.1016/j.midw.2014.12.012 https://doi.org/10.1016/j.midw.2014.12.0... ⁾	Não informada	Retrospectivo: banco de dados	Estudo longitudinal
Demirel, et al; 2015⁽³¹31 Demirel G, Golbasi Z. Effect of perineal massage on the rate of episiotomy and perineal tearing. Int J Gynaecol Obstet. 2015;131(2):183-6. doi: https://doi.org/10.1016/j.ijgo.2015.04.048 https://doi.org/10.1016/j.ijgo.2015.04.0... ⁾	Não informada	Maternidade	Estudo clínico randomizado
Fritel, et al; 2015⁽³²32 Fritel X, Tayrac R, Bader G, Savary D, Gueye A, Deffieux X, et al. Preventing urinary incontinence with supervised prenatal pelvic floor exercises: a randomized controlled trial. Obstet Gynecol. 2015;126(2):370-7. doi: https://doi.org/10.1097/AOG.0000000000000972 https://doi.org/10.1097/AOG.000000000000... ⁾	Fisioterapeuta ou obstetrizes	Centros pré-natais	Estudo clínico randomizado
Gayeski, et al; 2015⁽⁵5 Gayeski ME, Brüggemann OM, Monticelli M, Santos EKA. Application of nonpharmacologic methods to relieve pain during labor: the point of view of primiparous women. Pain Manag Nurs. 2015;16(3):273-84. doi: 10.1016/j.pmn.2014.08.006 https://doi.org/10.1016/j.pmn.2014.08.00... ⁾	Enfermeira obstétrica	Maternidade	Estudo transversal
Hanjini, et al; 2015⁽³³33 Moghimi-Hanjini S, Mehdizadeh-Tourzani Z, Shoghi M. The effect of foot reflexology on anxiety, pain, and outcomes of the labor in primigravida women. Acta Med Iran [Internet]. 2015 [cited 2018 June 10];53(8):507-11. Available from: http://acta.tums.ac.ir/index.php/acta/article/view/4277 http://acta.tums.ac.ir/index.php/acta/ar... ⁾	Não informada	Maternidade	Estudo clínico randomizado
Akbarzadeh, et al; 2016⁽³⁴34 Akbarzadeh M, Masoudi Z, Zare N, Kasraeian M. Comparison of the effects of maternal supportive care and acupressure (at BL32 Acupoint) on labor length and infant's apgar score. Glob J Health Sci.2016;8(3):237-44. doi: https://doi.org/10.5539/gjhs.v8n3p236 https://doi.org/10.5539/gjhs.v8n3p236... ⁾	Doulas	Maternidade	Estudo clínico randomizado
Boaviagem, et al; 2016⁽³⁵35 Boaviagem A, Melo Junior E, Lubambo L, Sousa P, Aragão C, Albuquerque S, et al. The effectiveness of breathing patterns to control maternal anxiety during the first period of labor: a randomized controlled clinical trial. Complement Ther Clin Pract. 2017;26:30-5. doi: https://doi.org/10.1016/j.ctcp.2016.11.004 https://doi.org/10.1016/j.ctcp.2016.11.0... ⁾	Fisioterapeutas	Maternidade	Estudo clínico randomizado
Henrique, et al; 2016⁽³⁶36 Henrique AJ, Gabrielloni MC, Cavalcanti ACV, Melo PS, Barbieri M. Hydrotherapy and the Swiss ball in labor: randomized clinical trial. Acta Paul Enferm. 2016;29(6):686-92. doi: http://dx.doi.org/10.1590/1982-0194201600096 http://dx.doi.org/10.1590/1982-019420160... ⁾	Enfermeiras obstetras	Maternidade	Estudo clínico randomizado
Karimi, et al; 2016⁽³⁷37 Karimi S, Kazemi F, Masoumi SZ, Shobeiri F, Roshanaei G. Effect of consultation and educating in preparation classes for delivery on pregnancy consequences: a randomized controlled clinical trial. Electron Physician. 2016;8(11):3177-83. doi: http://dx.doi.org/10.19082/3177 http://dx.doi.org/10.19082/3177... ⁾	Não informada	Clínicas de pré-natal	Estudo clínico randomizado
Masoumi, et al; 2016⁽³⁸38 Masoumi SZ, Kazemi F, Oshvandi K, Jalali M, Esmaeli-Vardanjani A, Rafiei H. Effect of training preparation for childbirth on fear of normal vaginal delivery and choosing the type of delivery among pregnant women in Hamadan, Iran: a randomized controlled trial. J Family Reprod Health [Internet]. 2016 [cited 2016 Sep 10];1(3):115-21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241355/ https://www.ncbi.nlm.nih.gov/pmc/article... ⁾	Obstetrizes	Maternidade	Estudo clínico randomizado
Taavoni, et al; 2016⁽³⁹39 Taavoni S, Sheikhan F, Abdolahian S, Ghavi F. Birth ball or heat therapy? A randomized controlled trial to compare the effectiveness of birth ball usage with sacrum-perineal heat therapy in labor pain management. Complement Ther Clin Pract. 2016;24:99-102. doi: https://doi.org/10.1016/j.ctcp.2016.04.001 https://doi.org/10.1016/j.ctcp.2016.04.0... ⁾	Obstetrizes	Maternidade	Estudo clínico randomizado
Santana, et al; 2016⁽⁴⁰40 Santana LS, Gallo RBS, Ferreira CHJ, Duarte G, Quintana SM, Marcolin AC. Transcutaneous electrical nerve stimulation (TENS) reduces pain and postpones the need for pharmacological analgesia during labour: a randomised trial. J Physiother. 2016;62(1):29-34. doi: https://doi.org/10.1016/j.jphys.2015.11.002 https://doi.org/10.1016/j.jphys.2015.11.... ⁾	Fisioterapeutas	Maternidade	Estudo clínico randomizado
Sut, et al; 2016⁽⁴¹41 Sut HK, Kaplan PB. Effect of pelvic floor muscle exercise on pelvic floor muscle activity and voiding functions during pregnancy and the postpartum period. Neurourol Urodyn. 2016;35(3):417-22. doi: https://doi.org/10.1002/nau.22728 https://doi.org/10.1002/nau.22728... ⁾	Não informada	Centro obstétrico	Estudo clínico randomizado
Aziato, et al; 2017⁽⁴²42 Aziato L, Acheampong AK, Umoar KL. Labour pain experiences and perceptions: a qualitative study among post-partum women in Ghana. BMC Pregnancy Childbirth. 2017;17:73. doi: https://doi.org/10.1186/s12884-017-1248-1 https://doi.org/10.1186/s12884-017-1248-... ⁾	Enfermeira	Centro de saúde terciário	Estudo qualitativo descritivo exploratório
Cicek, et al; 2017⁽⁴³43 Cicek S, Basar F. The effects of breathing techniques training on the duration of labor and anxiety levels of pregnant women. Complement Ther Clin Pract. 2017;29:213-9. doi: https://doi.org/10.1016/j.ctcp.2017.10.006 https://doi.org/10.1016/j.ctcp.2017.10.0... ⁾	Não informada	Maternidade	Estudo clínico randomizado
Erdogan, et al; 2017⁽⁴⁴44 Erdogan SU, Yanikkerem E, Goker A. Effects of low back massage on perceived birth pain and satisfaction. Complement Ther Clin Pract. 2017;28:169-75. doi: https://doi.org/10.1016/j.ctcp.2017.05.016 https://doi.org/10.1016/j.ctcp.2017.05.0... ⁾	Enfermeiras	Maternidade	Estudo experimental com grupo controle
Miquelutti, et al; 2017⁽⁴⁵45 Miquelutti MA, Cecatii JG. Kinesio Taping for pain control during labor: protocol of a randomized, controlled trial. Nurs Health Sci. 2017;19(1):95-9. doi: https://doi.org/10.1111/nhs.12321 https://doi.org/10.1111/nhs.12321... ⁾	Fisioterapeuta e Obstetra	Maternidade	Estudo clínico randomizado
Shahoei, et al; 2017⁽⁴⁶46 Shahoei R, Shahghebi S, Rezaei M, Naqshbandi S. The effect of transcutaneous electrical nerve stimulation on the severity of labor pain among nulliparous women: a clinical trial. Complement Ther Clin Pract. 2017;28:176-80. doi: https://doi.org/10.1016/j.ctcp.2017.05.004 https://doi.org/10.1016/j.ctcp.2017.05.0... ⁾	Obstetrizes	Maternidade	Estudo clínico
Vanderlaan, et al; 2017⁽⁴⁷47 Vanderlaan J. Retrospective cohort study of hydrotherapy in labor. J Obstet Gynecol Neonatal Nurs. 2017:46(3)403-10. doi: https://doi.org/10.1016/j.jogn.2016.11.018 https://doi.org/10.1016/j.jogn.2016.11.0... ⁾	Enfermeiras e obstetrizes	Maternidade	Estudo retrospectivo de coorte
Yuksel, et al; 2017⁽⁴⁸48 Yuksel H, Cayir Y, Kosan Z, Tastan K. Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: a randomized controlled trial. J Integr Med. 2017;15(6):456-61. doi: https://doi.org/10.1016/S2095-4964(17)60368-6 https://doi.org/10.1016/S2095-4964(17)60... ⁾	Não informada	Maternidade	Estudo clínico randomizado
Ugwu, et al; 2018⁽⁴⁹49 Ugwu EO, Iferikigwe ES, Obi SN, Eleje GU, Ozumba BC. Effectiveness of antenatal perineal massage in reducing perineal trauma and post-partum morbidities: a randomized controlled trial. J Obstet Gynaecol Res. 2018;44(7):1252-8. doi: https://doi.org/10.1111/jog.13640 https://doi.org/10.1111/jog.13640... ⁾	Auto aplicável	Clínicas de pré-natal	Estudo clínico randomizado

TNF	Desfecho positivo	Desfecho inconclusivo ou negativo
Massagem	Redução da dor no TP⁽³3 Davim RMB, Torres GV, Dantas JC. Effectiveness of non-pharmacological strategies in relieving labor pain. Rev Esc Enferm USP [Internet]. 2009 [cited 2018 March 03]; 43(2):438-41. Available from: http://www.scielo.br/pdf/reeusp/v43n2/a25v43n2.pdf http://www.scielo.br/pdf/reeusp/v43n2/a2... ^,⁵5 Gayeski ME, Brüggemann OM, Monticelli M, Santos EKA. Application of nonpharmacologic methods to relieve pain during labor: the point of view of primiparous women. Pain Manag Nurs. 2015;16(3):273-84. doi: 10.1016/j.pmn.2014.08.006 https://doi.org/10.1016/j.pmn.2014.08.00... ^,¹⁷17 Taghinejad H, Delpisheh A, Suhrabi Z. Comparison between massage and music therapies to relieve the severity of labor pain. Womens Health (Lond). 2010;6(3):377-81. doi: /10.2217/WHE.10.15 https://doi.org//10.2217/WHE.10.15... ^, ²³23 Mortazavi SH, Khaki S, Moradi R, Heidari K, Rahimparvar SFV. Effects of massage therapy and presence of attendant on pain, anxiety and satisfaction during labor. Arch Gynecol Obstet. 2012;286(1):19-23. doi: 10.1007/s00404-012-2227-4 https://doi.org/10.1007/s00404-012-2227-... ^,²⁵25 Gallo RBS, Santana LC, Ferreira CHJ, Marcolin AC, PoliNeto OB, Duarte G, et al. Massage reduced severity of pain during labour: a randomised trial. J Physiother. 2013;59(2):109-16. doi: 10.1016/S1836-9553(13)70163-2 https://doi.org/10.1016/S1836-9553(13)70... ^,³⁰30 Adams J, Frawley J, Steel A, Broom A, Sibbritt D. Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: examination of a nationally representative sample of 1835 pregnant women. Midwifery. 2015;31(4):458-63. doi: https://doi.org/10.1016/j.midw.2014.12.012 https://doi.org/10.1016/j.midw.2014.12.0... ^,⁴⁴44 Erdogan SU, Yanikkerem E, Goker A. Effects of low back massage on perceived birth pain and satisfaction. Complement Ther Clin Pract. 2017;28:169-75. doi: https://doi.org/10.1016/j.ctcp.2017.05.016 https://doi.org/10.1016/j.ctcp.2017.05.0... ⁾ Redução da ansiedade no TP⁽²³23 Mortazavi SH, Khaki S, Moradi R, Heidari K, Rahimparvar SFV. Effects of massage therapy and presence of attendant on pain, anxiety and satisfaction during labor. Arch Gynecol Obstet. 2012;286(1):19-23. doi: 10.1007/s00404-012-2227-4 https://doi.org/10.1007/s00404-012-2227-... ^,³³33 Moghimi-Hanjini S, Mehdizadeh-Tourzani Z, Shoghi M. The effect of foot reflexology on anxiety, pain, and outcomes of the labor in primigravida women. Acta Med Iran [Internet]. 2015 [cited 2018 June 10];53(8):507-11. Available from: http://acta.tums.ac.ir/index.php/acta/article/view/4277 http://acta.tums.ac.ir/index.php/acta/ar... ⁾ Maior satisfação com o parto⁽²³23 Mortazavi SH, Khaki S, Moradi R, Heidari K, Rahimparvar SFV. Effects of massage therapy and presence of attendant on pain, anxiety and satisfaction during labor. Arch Gynecol Obstet. 2012;286(1):19-23. doi: 10.1007/s00404-012-2227-4 https://doi.org/10.1007/s00404-012-2227-... ^,⁴⁴44 Erdogan SU, Yanikkerem E, Goker A. Effects of low back massage on perceived birth pain and satisfaction. Complement Ther Clin Pract. 2017;28:169-75. doi: https://doi.org/10.1016/j.ctcp.2017.05.016 https://doi.org/10.1016/j.ctcp.2017.05.0... ⁾ Redução do uso de analgesia epidural, espinhal e anestesia⁽⁶6 Dhany AL, Mitchell T, Foy C. Aromatherapy and massage intrapartum service impact on use of analgesia and anesthesia in women in labor: a retrospective case note analysis. J Altern Complement Med. 2012;18(10):932-8. doi: 10.1089/acm.2011.0254 https://doi.org/10.1089/acm.2011.0254... ⁾ Redução do tempo de TP⁽³³33 Moghimi-Hanjini S, Mehdizadeh-Tourzani Z, Shoghi M. The effect of foot reflexology on anxiety, pain, and outcomes of the labor in primigravida women. Acta Med Iran [Internet]. 2015 [cited 2018 June 10];53(8):507-11. Available from: http://acta.tums.ac.ir/index.php/acta/article/view/4277 http://acta.tums.ac.ir/index.php/acta/ar... ⁾ Redução da percepção de tempo do TP⁽⁴⁴44 Erdogan SU, Yanikkerem E, Goker A. Effects of low back massage on perceived birth pain and satisfaction. Complement Ther Clin Pract. 2017;28:169-75. doi: https://doi.org/10.1016/j.ctcp.2017.05.016 https://doi.org/10.1016/j.ctcp.2017.05.0... ⁾ Associou-se com aumento da amamentação⁽³⁰30 Adams J, Frawley J, Steel A, Broom A, Sibbritt D. Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: examination of a nationally representative sample of 1835 pregnant women. Midwifery. 2015;31(4):458-63. doi: https://doi.org/10.1016/j.midw.2014.12.012 https://doi.org/10.1016/j.midw.2014.12.0... ⁾ Aumento da frequência de parto vaginal⁽³³33 Moghimi-Hanjini S, Mehdizadeh-Tourzani Z, Shoghi M. The effect of foot reflexology on anxiety, pain, and outcomes of the labor in primigravida women. Acta Med Iran [Internet]. 2015 [cited 2018 June 10];53(8):507-11. Available from: http://acta.tums.ac.ir/index.php/acta/article/view/4277 http://acta.tums.ac.ir/index.php/acta/ar... ⁾	Associou-se ao aumento da laceração e uso de fórceps⁽³⁰30 Adams J, Frawley J, Steel A, Broom A, Sibbritt D. Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: examination of a nationally representative sample of 1835 pregnant women. Midwifery. 2015;31(4):458-63. doi: https://doi.org/10.1016/j.midw.2014.12.012 https://doi.org/10.1016/j.midw.2014.12.0... ⁾ Dor e satisfação no parto⁽¹²12 Kimber L, McNabb M, McCourt C, Haines A, Brocklehurst P. Massage or music for pain relief in labour: a pilot randomised placebo controlled trial. Eur J Pain. 2008;12(8):961-9. doi: 10.1016/j.ejpain.2008.01.004 https://doi.org/10.1016/j.ejpain.2008.01... ⁾
Massagem perineal	Redução da frequência de episiotomia⁽¹⁴14 Bergström M, Kieler H, Waldenström U. Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial. BJOG. 2009;116(9):1167-76. doi: 10.1111/j.1471-0528.2009.02144.x https://doi.org/10.1111/j.1471-0528.2009... ^,²⁰20 Geranmayeh M, Habibabadi ZR, Fallahkish B, Farahani MA, Khakbazan Z, Mehran A. Reducing perineal trauma through perineal massage with vaseline in second stage of labor. Arch Gynecol Obstet. 2012;285(1):77-81. doi: 10.1007/s00404-011-1919-5 https://doi.org/10.1007/s00404-011-1919-... ^,³¹31 Demirel G, Golbasi Z. Effect of perineal massage on the rate of episiotomy and perineal tearing. Int J Gynaecol Obstet. 2015;131(2):183-6. doi: https://doi.org/10.1016/j.ijgo.2015.04.048 https://doi.org/10.1016/j.ijgo.2015.04.0... ⁾ Redução do segundo estágio do TP⁽²⁰20 Geranmayeh M, Habibabadi ZR, Fallahkish B, Farahani MA, Khakbazan Z, Mehran A. Reducing perineal trauma through perineal massage with vaseline in second stage of labor. Arch Gynecol Obstet. 2012;285(1):77-81. doi: 10.1007/s00404-011-1919-5 https://doi.org/10.1007/s00404-011-1919-... ⁾ Boa aceitação da técnica⁽²⁴24 Ismail SIMF, Emery SJ. Patient awareness and acceptability of antenatal perineal massage. J Obstet Gynaecol. 2013;33(8):839-43. doi: 10.3109/01443615.2013.828027 https://doi.org/10.3109/01443615.2013.82... ⁾ Aumento da incidência de períneo integro⁽⁴⁹49 Ugwu EO, Iferikigwe ES, Obi SN, Eleje GU, Ozumba BC. Effectiveness of antenatal perineal massage in reducing perineal trauma and post-partum morbidities: a randomized controlled trial. J Obstet Gynaecol Res. 2018;44(7):1252-8. doi: https://doi.org/10.1111/jog.13640 https://doi.org/10.1111/jog.13640... ⁾	Aumento de laceração grau 1 e 2⁽²⁰20 Geranmayeh M, Habibabadi ZR, Fallahkish B, Farahani MA, Khakbazan Z, Mehran A. Reducing perineal trauma through perineal massage with vaseline in second stage of labor. Arch Gynecol Obstet. 2012;285(1):77-81. doi: 10.1007/s00404-011-1919-5 https://doi.org/10.1007/s00404-011-1919-... ⁾ Não apresentou diferença com relação à incontinência urinária no pós-parto⁽¹³13 Mei-dan E, Walfisch A, Raz I, Levy A, Hallak M. Perineal massage during pregnancy: a prospective controlled trial. Isr Med Assoc J. 2008;10(7):499-502.^,²²22 Low LK, Miller JM, Guo Y, Ashton-Miller JA, DeLancey JOL, Sampselle CM. Spontaneous pushing to prevent postpartum urinary incontinence: a randomized, controlled trial. Int Urogynecol J. 2013;2(3):453-60. doi: 10.1007/s00192-012-1884-y https://doi.org/10.1007/s00192-012-1884-... ⁾ Não apresentou diferenças com relação aos traumas perineais em geral⁽¹³13 Mei-dan E, Walfisch A, Raz I, Levy A, Hallak M. Perineal massage during pregnancy: a prospective controlled trial. Isr Med Assoc J. 2008;10(7):499-502.^,²¹21 Karaçam Z, Ekmen H, Calisir H. The use of perineal massage in the second stage of labor and follow-up of postpartum perineal outcomes. Health Care Women Int. 2012;33(8):697-718. doi: 10.1080/07399332.2012.655385 https://doi.org/10.1080/07399332.2012.65... ⁾
Banho quente	Redução da dor no TP⁽³3 Davim RMB, Torres GV, Dantas JC. Effectiveness of non-pharmacological strategies in relieving labor pain. Rev Esc Enferm USP [Internet]. 2009 [cited 2018 March 03]; 43(2):438-41. Available from: http://www.scielo.br/pdf/reeusp/v43n2/a25v43n2.pdf http://www.scielo.br/pdf/reeusp/v43n2/a2... ^,²⁶26 Lee SL, Liu CY, Gau ML. Efficacy of warm showers on labor pain and birth experiences during the first labor stage. J Obstet Gynecol Neonatal Nurs. 2013;42(1):19-28. doi: 10.1111/j.1552-6909.2012.01424.x https://doi.org/10.1111/j.1552-6909.2012... ^,³⁰30 Adams J, Frawley J, Steel A, Broom A, Sibbritt D. Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: examination of a nationally representative sample of 1835 pregnant women. Midwifery. 2015;31(4):458-63. doi: https://doi.org/10.1016/j.midw.2014.12.012 https://doi.org/10.1016/j.midw.2014.12.0... ^,³⁶36 Henrique AJ, Gabrielloni MC, Cavalcanti ACV, Melo PS, Barbieri M. Hydrotherapy and the Swiss ball in labor: randomized clinical trial. Acta Paul Enferm. 2016;29(6):686-92. doi: http://dx.doi.org/10.1590/1982-0194201600096 http://dx.doi.org/10.1590/1982-019420160... ^,⁴⁷47 Vanderlaan J. Retrospective cohort study of hydrotherapy in labor. J Obstet Gynecol Neonatal Nurs. 2017:46(3)403-10. doi: https://doi.org/10.1016/j.jogn.2016.11.018 https://doi.org/10.1016/j.jogn.2016.11.0... ⁾ Associou-se com aumento da amamentação⁽³⁰30 Adams J, Frawley J, Steel A, Broom A, Sibbritt D. Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: examination of a nationally representative sample of 1835 pregnant women. Midwifery. 2015;31(4):458-63. doi: https://doi.org/10.1016/j.midw.2014.12.012 https://doi.org/10.1016/j.midw.2014.12.0... ⁾ Melhora da experiência do parto⁽³⁰30 Adams J, Frawley J, Steel A, Broom A, Sibbritt D. Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: examination of a nationally representative sample of 1835 pregnant women. Midwifery. 2015;31(4):458-63. doi: https://doi.org/10.1016/j.midw.2014.12.012 https://doi.org/10.1016/j.midw.2014.12.0... ⁾ Aumento da frequência das contrações uterinas durante o TP⁽³⁶36 Henrique AJ, Gabrielloni MC, Cavalcanti ACV, Melo PS, Barbieri M. Hydrotherapy and the Swiss ball in labor: randomized clinical trial. Acta Paul Enferm. 2016;29(6):686-92. doi: http://dx.doi.org/10.1590/1982-0194201600096 http://dx.doi.org/10.1590/1982-019420160... ⁾ Redução da duração do TP⁽³⁶36 Henrique AJ, Gabrielloni MC, Cavalcanti ACV, Melo PS, Barbieri M. Hydrotherapy and the Swiss ball in labor: randomized clinical trial. Acta Paul Enferm. 2016;29(6):686-92. doi: http://dx.doi.org/10.1590/1982-0194201600096 http://dx.doi.org/10.1590/1982-019420160... ⁾	Associou-se ao aumento da laceração⁽³⁰30 Adams J, Frawley J, Steel A, Broom A, Sibbritt D. Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: examination of a nationally representative sample of 1835 pregnant women. Midwifery. 2015;31(4):458-63. doi: https://doi.org/10.1016/j.midw.2014.12.012 https://doi.org/10.1016/j.midw.2014.12.0... ⁾ Aumento da frequência cardíaca fetal⁽³⁶36 Henrique AJ, Gabrielloni MC, Cavalcanti ACV, Melo PS, Barbieri M. Hydrotherapy and the Swiss ball in labor: randomized clinical trial. Acta Paul Enferm. 2016;29(6):686-92. doi: http://dx.doi.org/10.1590/1982-0194201600096 http://dx.doi.org/10.1590/1982-019420160... ⁾
Cuidado de suporte	Redução da dor no TP⁽²³23 Mortazavi SH, Khaki S, Moradi R, Heidari K, Rahimparvar SFV. Effects of massage therapy and presence of attendant on pain, anxiety and satisfaction during labor. Arch Gynecol Obstet. 2012;286(1):19-23. doi: 10.1007/s00404-012-2227-4 https://doi.org/10.1007/s00404-012-2227-... ^,²⁸28 Akbarzadeh M, Masoudi Z, Hadianfard MJ, Kasraeian M, Zare N. Comparison of the effects of maternal supportive care and acupressure (BL32 acupoint) on pregnant women's pain intensity and delivery outcome. J Pregnancy. 2014;2014:129208. doi: 10.1155/2014/129208 https://doi.org/10.1155/2014/129208... ⁾ Aumento da incidência de parto vaginal⁽²⁸28 Akbarzadeh M, Masoudi Z, Hadianfard MJ, Kasraeian M, Zare N. Comparison of the effects of maternal supportive care and acupressure (BL32 acupoint) on pregnant women's pain intensity and delivery outcome. J Pregnancy. 2014;2014:129208. doi: 10.1155/2014/129208 https://doi.org/10.1155/2014/129208... ⁾ Redução da duração do TP⁽³⁴34 Akbarzadeh M, Masoudi Z, Zare N, Kasraeian M. Comparison of the effects of maternal supportive care and acupressure (at BL32 Acupoint) on labor length and infant's apgar score. Glob J Health Sci.2016;8(3):237-44. doi: https://doi.org/10.5539/gjhs.v8n3p236 https://doi.org/10.5539/gjhs.v8n3p236... ⁾ Resultou em escores de Apgar maior que 8⁽³⁴34 Akbarzadeh M, Masoudi Z, Zare N, Kasraeian M. Comparison of the effects of maternal supportive care and acupressure (at BL32 Acupoint) on labor length and infant's apgar score. Glob J Health Sci.2016;8(3):237-44. doi: https://doi.org/10.5539/gjhs.v8n3p236 https://doi.org/10.5539/gjhs.v8n3p236... ⁾ Redução da ansiedade⁽²³23 Mortazavi SH, Khaki S, Moradi R, Heidari K, Rahimparvar SFV. Effects of massage therapy and presence of attendant on pain, anxiety and satisfaction during labor. Arch Gynecol Obstet. 2012;286(1):19-23. doi: 10.1007/s00404-012-2227-4 https://doi.org/10.1007/s00404-012-2227-... ⁾
Grupos de preparação para o parto	Controle da ansiedade e sensação de segurança⁽²⁷27 Miquelutti MA, Cecatti JG, Makuch MY. Antenatal education and the birthing experience of Brazilian women: a qualitative study. BMC Pregnancy Childbirth. 2013;13:171. doi: 10.1186/1471-2393-13-171 https://doi.org/10.1186/1471-2393-13-171... ⁾ Aumento do conforto e mobilidade durante o parto⁽²⁷27 Miquelutti MA, Cecatti JG, Makuch MY. Antenatal education and the birthing experience of Brazilian women: a qualitative study. BMC Pregnancy Childbirth. 2013;13:171. doi: 10.1186/1471-2393-13-171 https://doi.org/10.1186/1471-2393-13-171... ⁾ Aumento da satisfação com o parto⁽²⁷27 Miquelutti MA, Cecatti JG, Makuch MY. Antenatal education and the birthing experience of Brazilian women: a qualitative study. BMC Pregnancy Childbirth. 2013;13:171. doi: 10.1186/1471-2393-13-171 https://doi.org/10.1186/1471-2393-13-171... ⁾ Redução do medo do parto vaginal⁽⁴³43 Cicek S, Basar F. The effects of breathing techniques training on the duration of labor and anxiety levels of pregnant women. Complement Ther Clin Pract. 2017;29:213-9. doi: https://doi.org/10.1016/j.ctcp.2017.10.006 https://doi.org/10.1016/j.ctcp.2017.10.0... ⁾ Redução da ansiedade⁽⁴³43 Cicek S, Basar F. The effects of breathing techniques training on the duration of labor and anxiety levels of pregnant women. Complement Ther Clin Pract. 2017;29:213-9. doi: https://doi.org/10.1016/j.ctcp.2017.10.006 https://doi.org/10.1016/j.ctcp.2017.10.0... ⁾ Aumento do pensamento positivo⁽¹⁵15 Bahadoran P, Asefi F, Oreyzi H, Valiani M. The effect of participating in the labor preparation classes on maternal vitality and positive affect during the pregnancy and after the labor. Iran J Nurs Midwifery Res [Internet]. 2010 [cited 2018 Dec 10];15 Suppl1:331-6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3208940/ https://www.ncbi.nlm.nih.gov/pmc/article... ⁾ Aumento da escolha por parto vaginal⁽³⁷37 Karimi S, Kazemi F, Masoumi SZ, Shobeiri F, Roshanaei G. Effect of consultation and educating in preparation classes for delivery on pregnancy consequences: a randomized controlled clinical trial. Electron Physician. 2016;8(11):3177-83. doi: http://dx.doi.org/10.19082/3177 http://dx.doi.org/10.19082/3177... ^-³⁸38 Masoumi SZ, Kazemi F, Oshvandi K, Jalali M, Esmaeli-Vardanjani A, Rafiei H. Effect of training preparation for childbirth on fear of normal vaginal delivery and choosing the type of delivery among pregnant women in Hamadan, Iran: a randomized controlled trial. J Family Reprod Health [Internet]. 2016 [cited 2016 Sep 10];1(3):115-21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241355/ https://www.ncbi.nlm.nih.gov/pmc/article... ⁾ Aumento das taxas de parto não instrumentalizados⁽³⁸38 Masoumi SZ, Kazemi F, Oshvandi K, Jalali M, Esmaeli-Vardanjani A, Rafiei H. Effect of training preparation for childbirth on fear of normal vaginal delivery and choosing the type of delivery among pregnant women in Hamadan, Iran: a randomized controlled trial. J Family Reprod Health [Internet]. 2016 [cited 2016 Sep 10];1(3):115-21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241355/ https://www.ncbi.nlm.nih.gov/pmc/article... ⁾ Aumento do peso do bebê⁽³⁷37 Karimi S, Kazemi F, Masoumi SZ, Shobeiri F, Roshanaei G. Effect of consultation and educating in preparation classes for delivery on pregnancy consequences: a randomized controlled clinical trial. Electron Physician. 2016;8(11):3177-83. doi: http://dx.doi.org/10.19082/3177 http://dx.doi.org/10.19082/3177... ^-³⁸38 Masoumi SZ, Kazemi F, Oshvandi K, Jalali M, Esmaeli-Vardanjani A, Rafiei H. Effect of training preparation for childbirth on fear of normal vaginal delivery and choosing the type of delivery among pregnant women in Hamadan, Iran: a randomized controlled trial. J Family Reprod Health [Internet]. 2016 [cited 2016 Sep 10];1(3):115-21. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5241355/ https://www.ncbi.nlm.nih.gov/pmc/article... ⁾	Experiência com o parto⁽¹⁴14 Bergström M, Kieler H, Waldenström U. Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial. BJOG. 2009;116(9):1167-76. doi: 10.1111/j.1471-0528.2009.02144.x https://doi.org/10.1111/j.1471-0528.2009... ⁾ Uso de analgesia⁽¹⁴14 Bergström M, Kieler H, Waldenström U. Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial. BJOG. 2009;116(9):1167-76. doi: 10.1111/j.1471-0528.2009.02144.x https://doi.org/10.1111/j.1471-0528.2009... ⁾ Estresse da maternidade⁽¹⁴14 Bergström M, Kieler H, Waldenström U. Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial. BJOG. 2009;116(9):1167-76. doi: 10.1111/j.1471-0528.2009.02144.x https://doi.org/10.1111/j.1471-0528.2009... ⁾
Técnicas de respiração	Redução da dor⁽³3 Davim RMB, Torres GV, Dantas JC. Effectiveness of non-pharmacological strategies in relieving labor pain. Rev Esc Enferm USP [Internet]. 2009 [cited 2018 March 03]; 43(2):438-41. Available from: http://www.scielo.br/pdf/reeusp/v43n2/a25v43n2.pdf http://www.scielo.br/pdf/reeusp/v43n2/a2... ^,⁴³43 Cicek S, Basar F. The effects of breathing techniques training on the duration of labor and anxiety levels of pregnant women. Complement Ther Clin Pract. 2017;29:213-9. doi: https://doi.org/10.1016/j.ctcp.2017.10.006 https://doi.org/10.1016/j.ctcp.2017.10.0... ^,⁴⁸48 Yuksel H, Cayir Y, Kosan Z, Tastan K. Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: a randomized controlled trial. J Integr Med. 2017;15(6):456-61. doi: https://doi.org/10.1016/S2095-4964(17)60368-6 https://doi.org/10.1016/S2095-4964(17)60... ⁾ Redução da duração do TP⁽⁴⁸48 Yuksel H, Cayir Y, Kosan Z, Tastan K. Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: a randomized controlled trial. J Integr Med. 2017;15(6):456-61. doi: https://doi.org/10.1016/S2095-4964(17)60368-6 https://doi.org/10.1016/S2095-4964(17)60... ⁾ Redução da ansiedade no TP⁽⁴³43 Cicek S, Basar F. The effects of breathing techniques training on the duration of labor and anxiety levels of pregnant women. Complement Ther Clin Pract. 2017;29:213-9. doi: https://doi.org/10.1016/j.ctcp.2017.10.006 https://doi.org/10.1016/j.ctcp.2017.10.0... ⁾	Não apresentou diferença para ansiedade, dor, fadiga, satisfação, tipo de parto, duração do parto e escores de Apgar⁽³⁵35 Boaviagem A, Melo Junior E, Lubambo L, Sousa P, Aragão C, Albuquerque S, et al. The effectiveness of breathing patterns to control maternal anxiety during the first period of labor: a randomized controlled clinical trial. Complement Ther Clin Pract. 2017;26:30-5. doi: https://doi.org/10.1016/j.ctcp.2016.11.004 https://doi.org/10.1016/j.ctcp.2016.11.0... ⁾
Exercícios de AP	Menor suscetibilidade à incontinência urinária no pós-parto⁽²⁹29 Reilly ETC, Freeman RM, Waterfield AE, Steggles P, Pedlar F. Prevention of pospartum stress incontinence in primigravidae with increased blader neck mobility: a randomized controlled trial of antenatal pelvic floor exercises. BJOG.2014;121 Suppl 7:58-66. doi: https://doi.org/10.1111/1471-0528.13213 https://doi.org/10.1111/1471-0528.13213... ⁾ Aumento da força da musculatura do AP⁽⁴¹41 Sut HK, Kaplan PB. Effect of pelvic floor muscle exercise on pelvic floor muscle activity and voiding functions during pregnancy and the postpartum period. Neurourol Urodyn. 2016;35(3):417-22. doi: https://doi.org/10.1002/nau.22728 https://doi.org/10.1002/nau.22728... ⁾	Incontinência urinária no pós-parto⁽³²32 Fritel X, Tayrac R, Bader G, Savary D, Gueye A, Deffieux X, et al. Preventing urinary incontinence with supervised prenatal pelvic floor exercises: a randomized controlled trial. Obstet Gynecol. 2015;126(2):370-7. doi: https://doi.org/10.1097/AOG.0000000000000972 https://doi.org/10.1097/AOG.000000000000... ⁾ Tipo de parto, frequência de laceração perineal e variáveis neonatais⁽¹⁸18 Dias LAR, Driusso P, Aita DLCC, Quintana SM, Bø K, Ferreira CHJ. Effect of pelvic floor muscle training on labour and newborn outcomes: a randomized controlled trial. Rev Bras Fisiot. 2011;15(6):487-93. doi: 10.1590/S1413-35552011005000011 https://doi.org/10.1590/S1413-3555201100... ⁾
TENS	Redução da dor no TP⁽¹⁶16 Peng T, Li XT, Zhou SF, Xiong Y, Kang Y, Cheng HD. Transcutaneous electrical nerve stimulation on acupoints relieves labor pain: a non-randomized controlled study. Chin J Integr Med. 2010;16(3):234-8. doi: 10.1111/jog.12345 https://doi.org/10.1111/jog.12345... ^,⁴⁰40 Santana LS, Gallo RBS, Ferreira CHJ, Duarte G, Quintana SM, Marcolin AC. Transcutaneous electrical nerve stimulation (TENS) reduces pain and postpones the need for pharmacological analgesia during labour: a randomised trial. J Physiother. 2016;62(1):29-34. doi: https://doi.org/10.1016/j.jphys.2015.11.002 https://doi.org/10.1016/j.jphys.2015.11.... ^,⁴⁶46 Shahoei R, Shahghebi S, Rezaei M, Naqshbandi S. The effect of transcutaneous electrical nerve stimulation on the severity of labor pain among nulliparous women: a clinical trial. Complement Ther Clin Pract. 2017;28:176-80. doi: https://doi.org/10.1016/j.ctcp.2017.05.004 https://doi.org/10.1016/j.ctcp.2017.05.0... ⁾ Postergação do uso de analgesia epidural⁽⁴⁰40 Santana LS, Gallo RBS, Ferreira CHJ, Duarte G, Quintana SM, Marcolin AC. Transcutaneous electrical nerve stimulation (TENS) reduces pain and postpones the need for pharmacological analgesia during labour: a randomised trial. J Physiother. 2016;62(1):29-34. doi: https://doi.org/10.1016/j.jphys.2015.11.002 https://doi.org/10.1016/j.jphys.2015.11.... ⁾ Redução da perda de sangue no pós-parto⁽¹⁶16 Peng T, Li XT, Zhou SF, Xiong Y, Kang Y, Cheng HD. Transcutaneous electrical nerve stimulation on acupoints relieves labor pain: a non-randomized controlled study. Chin J Integr Med. 2010;16(3):234-8. doi: 10.1111/jog.12345 https://doi.org/10.1111/jog.12345... ⁾
Bola suíça	Redução da dor no TP⁽¹⁹19 Gau ML, Chang CY, Tian SH, Lin KC. Effects of birth ball exercise on pain and self-efficacy during childbirth: a randomised controlled trial in Taiwan. Midwifery. 2011;27(6):e293-300. doi: 10.1016/j.midw.2011.02.004 https://doi.org/10.1016/j.midw.2011.02.0... ^,³⁹39 Taavoni S, Sheikhan F, Abdolahian S, Ghavi F. Birth ball or heat therapy? A randomized controlled trial to compare the effectiveness of birth ball usage with sacrum-perineal heat therapy in labor pain management. Complement Ther Clin Pract. 2016;24:99-102. doi: https://doi.org/10.1016/j.ctcp.2016.04.001 https://doi.org/10.1016/j.ctcp.2016.04.0... ⁾ Aumento da confiança com relação ao TP⁽¹⁹19 Gau ML, Chang CY, Tian SH, Lin KC. Effects of birth ball exercise on pain and self-efficacy during childbirth: a randomised controlled trial in Taiwan. Midwifery. 2011;27(6):e293-300. doi: 10.1016/j.midw.2011.02.004 https://doi.org/10.1016/j.midw.2011.02.0... ⁾ Redução da duração do TP⁽³⁶36 Henrique AJ, Gabrielloni MC, Cavalcanti ACV, Melo PS, Barbieri M. Hydrotherapy and the Swiss ball in labor: randomized clinical trial. Acta Paul Enferm. 2016;29(6):686-92. doi: http://dx.doi.org/10.1590/1982-0194201600096 http://dx.doi.org/10.1590/1982-019420160... ⁾ Aumento da frequência das contrações uterinas durante o TP⁽³⁶36 Henrique AJ, Gabrielloni MC, Cavalcanti ACV, Melo PS, Barbieri M. Hydrotherapy and the Swiss ball in labor: randomized clinical trial. Acta Paul Enferm. 2016;29(6):686-92. doi: http://dx.doi.org/10.1590/1982-0194201600096 http://dx.doi.org/10.1590/1982-019420160... ⁾	Aumento da frequência cardíaca fetal⁽³⁶36 Henrique AJ, Gabrielloni MC, Cavalcanti ACV, Melo PS, Barbieri M. Hydrotherapy and the Swiss ball in labor: randomized clinical trial. Acta Paul Enferm. 2016;29(6):686-92. doi: http://dx.doi.org/10.1590/1982-0194201600096 http://dx.doi.org/10.1590/1982-019420160... ⁾
Puxo espontâneo	Redução da incidência de laceração perineal⁽²²22 Low LK, Miller JM, Guo Y, Ashton-Miller JA, DeLancey JOL, Sampselle CM. Spontaneous pushing to prevent postpartum urinary incontinence: a randomized, controlled trial. Int Urogynecol J. 2013;2(3):453-60. doi: 10.1007/s00192-012-1884-y https://doi.org/10.1007/s00192-012-1884-... ⁾	Incontinência urinaria pós-parto⁽²²22 Low LK, Miller JM, Guo Y, Ashton-Miller JA, DeLancey JOL, Sampselle CM. Spontaneous pushing to prevent postpartum urinary incontinence: a randomized, controlled trial. Int Urogynecol J. 2013;2(3):453-60. doi: 10.1007/s00192-012-1884-y https://doi.org/10.1007/s00192-012-1884-... ⁾

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[1] Autor correspondente: Camilla Benigno Biana Universidade Federal de Pelotas Rua Quinze de Novembro, 1611, Apto. 302, Centro CEP 96015-000 - Pelotas, RS, Brasil camillacbb@gmail.com