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ARTICLE IN PRESS
Complementary Therapies in Clinical Practice (2008) 14, 105–115

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Yoga during pregnancy: Effects on maternal comfort, labor pain and birth outcomes
Songporn Chuntharapata,Ã, Wongchan Petpichetchianb, Urai Hatthakitc
Department of Obstetric Gynecological Nursing and Midwifery, Faculty of Nursing, Prince of Songkla University, Hat Yai,Songkhla 90112, Thailand b Department of Surgical Nursing, Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkhla, Thailand c Department of Administration of Nursing Education and Nursing Service, Faculty of Nursing, Prince of Songkla University, Hat Yai, Songkhla, Thailand
a

KEYWORDS
Yoga; Maternal comfort; Labor pain; Birth outcomes

Summary This study examined the effects of ayoga program during pregnancy, on maternal comfort, labor pain, and birth outcomes. A randomized trial was conducted using 74-primigravid Thai women who were equally divided into two groups (experimental and control). The yoga program involved six, 1-h sessions at prescribed weeks of gestation. A variety of instruments were used to assess maternal comfort, labor pain and birth outcomes. Theexperimental group was found to have higher levels of maternal comfort during labor and 2 h post-labor, and experienced less subject evaluated labor pain than the control group. In each group, pain increased and maternal comfort decreased as labor progressed. No differences were found, between the groups, regarding pethidine usage, labor augmentation or newborn Apgar scores at 1 and 5 min. Theexperimental group was found to have a shorter duration of the first stage of labor, as well as the total time of labor. & 2007 Elsevier Ltd. All rights reserved.

Introduction
Childbirth pain evokes a generalized stress response, which has widespread physiological effects on a woman’s parturient and fetus. Maternal catecholamine production increases, which affects the labor process by reducing thestrength, duration and coordination of uterine contractions. The
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fetus also is affected, as demonstrated by nonreassuring changes in fetal heart rate patterns.1,2 As a result of these changes, an increase in the length of labor, as well as a decrease in the Apgar score of the newborn can occur.3

Review of literature
Pain relief in labor is a uniqueproblem.4 Relieving labor pain requires the use of analgesics and anesthesia, as well as monitoring of possible

fax: +66 74 212901. E-mail address: songporn.c@psu.ac.th (S. Chuntharapat).

1744-3881/$ - see front matter & 2007 Elsevier Ltd. All rights reserved. doi:10.1016/j.ctcp.2007.12.007

ARTICLE IN PRESS
106 undesirable side effects. For example, epidural analgesia can lead to aprolonged first and second stage of labor, an increase in administration of oxygen, malrotation of the fetus, an instrumental delivery or a cesarean section.5 Thus, the possible presence of such medication side effects suggests analgesics and anesthesia alone may not adequately manage labor pain.6,7 It behooves healthcare providers to deal with labor pain via use of a multiple convergent approach thatincludes both pharmacological and non-pharmacological methods.8,9 Non-pharmacological methods address physical aspects of pain, as well as psycho-emotional and spiritual factors. A woman’s ability to maintain control of her pain, emotions, decisions and actions, while in the labor and delivery process, is an important aspect of a good childbirth experience.10,11 Facilitation of a good childbirthexperience requires use of self-comforting techniques that can help relieve pain and enhance labor progress. Research has suggested women, who perceive they have successfully coped with the pain and stress of labor, have been able to transcend pain and experience psychological and spiritual comfort.12 Alleviation of pain has been identified as a major source of comfort and support to women in...