Effect of acupuncture-like transcutaneous electrical nerve stimulation on labor pain in nulliparous women: a randomized controlled trial

Objective To examine the effect of acupuncture-like transcutaneous electrical nerve stimulation (ACUTENS) on labor pain in nulliparous women. Methods This randomized clinical trial was conducted at Razi Hospital in Qazvin, Iran between January and July in 2018. After the screening process, 144 out of 184 pregnant women were selected by convenience sampling and assigned into an intervention group or a control group by the block randomization method. The intervention group received ACUTENS at Hegu (LI4), Shenmen (HT7), Sanyinjiao (SP6), and Neimadian (Extra) during various stages of delivery in addition to routine labor care at the delivery room. For the control group, the same routine labor care was performed alone. The severity of pain was assessed in the two groups using the visual analog scale (VAS). The data were analyzed using R software (ver. 4.0.2) and repeated measurement analysis of variance. Results ACUTENS reduced the mean score of pain intensity in the first stage of labor in the intervention group more than that in the control group (P<0.001). Also, the mean scores of pain intensity in the second stage of labor, episiotomy, and one hour after delivery in the intervention group were significantly lower than those in the control group (P<0.001). Conclusion ACUTENS at Hegu (LI4), Shenmen (HT7), Sanyinjiao (SP6), and Neimadian (Extra) can decrease the intensity of labor pain in the nulliparous women. It can be used as a non-pharmacological method for reducing pain in and after labor.