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Background: Many women face disrespectful and abusive treatment during childbirth in facilities worldwide. Such treatment violates women's rights to respectful care and jeopardizes their rights to life, health, bodily integrity, and equality. This study aims at identifying the status of respectful maternity care (RMC) in selected hospitals in Rishikesh. Material and Methods: A mixed-method approach was adopted to explore RMC during normal vaginal delivery in a selected hospital in Rishikesh, Uttarakhand. In the quantitative part, 145 women were purposively selected, and data were collected by a pre-structured, validated RMC checklist, developed based on WHO RMC standards. Qualitative data were collected from 18 women, and a face-to-face semi-structured interview was conducted. Results: Forty-two elements of RMC categorized under eight domains show the type of mistreatment and its prevalence faced by women at a health care facility. Data showed that domain-7 (availability of competent and motivated human resources) had higher scoring (95%), and on the other hand, domain-4 (informed consent and effective communication) got lowest-scoring (68.45%). The overall mean percentage score of RMC was 85.68%. There was no statistically significant association between the total score of RMC and the selected socio-demographic variables. Conclusion: The overall RMC score was high, and there was no significant association with mothers' socio-demographic variables. The majority of mothers expressed that competent and motivated professionals were available during their delivery, but their communication skills were found to be lacking.
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INTRODUCTION: Heat therapy may help in reducing pain during labor as it blocks the receptors of pain, according to gate control theory. This systematic review and meta-analysis study aims to evaluate the effect of heat therapy (HT) systematically and critically on pain intensity, duration of labor during the first stage of labor and Apgar scores. METHODS: We searched for randomized controlled trials published until October 2020 in PubMed/Medline, EMBASE, ClinicalKey, Ovid Discovery, and other sources. Randomized controlled trials (RCTs) comparing heat therapy with standard treatment were selected. RESULTS: Out of 7625 screened, 10 studies met the inclusion criteria. The results of pooled data have shown that heat therapy was significantly effective in reducing pain intensity in the first stage of labor (standard mean difference, SMD= -1.31; 95% CI: -1.88 - -0.73; p<0.001). Heat therapy had significantly reduced the duration of the first stage of labor (pooled MD= -50.09; 95% CI: -89.70-10.48; p=0.01) and was also superior to the standard therapy group in terms of better Apgar scores at the 5th minute of birth of the newborn (pooled MD= -0.10; 95% CI: -0.19-0.02; p=0.02). CONCLUSIONS: Current evidence shows that heat therapy effectively decreases labor pain intensity and shortens the duration of labor in the first stage, and it can be used as nonpharmacological management for labor pain.
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It has been evidenced that very few systematic reviews have examined the effectiveness of ginger for pain duration and its severity among women with primary dysmenorrhea. This meta-analysis was therefore performed to methodically incorporate and significantly evaluate randomized controlled ginger studies for the treatment of primary dysmenorrhea. The literature was searched using PubMed, Embase, Ovid, ClinicalKey, Medline, and electronic database. We have analyzed clinical trials by comparing ginger with placebo and non-steroidal anti-inflammatory drugs in women with primary dysmenorrhea. The primary outcomes assessed in our meta-analysis were pain severity and pain duration. Secondary outcomes were change in bleeding, side effects of the drug, and rate of satisfaction. We have screened a total of 638 studies, out of which narrative synthesis was formulated for eight studies. We have performed a meta-analysis of five trials examining ginger with placebo and other two randomized controlled trials comparing ginger with a non-steroidal anti-inflammatory drug (NSAID); it seems to be more helpful for relieving menstrual pain than a placebo (mean difference [MD] = 2.67, 95% CI = 3.51-1.84, P = 0.0001, I2 = 86%), although it was found that ginger and NSAIDs were equally effective in pain severity (risk ratios [RR] = 1.15, 95% CI = 0.53-2.52, P = 0.72, I2 =77%). We have not observed any significant difference between ginger and placebo on pain duration among primary dysmenorrheic women (MD = -2.22, 95% CI = -7.62-3.18, P = 0.42, I2 = 56%). Accessible information proposes that oral ginger can be a compelling treatment for primary dysmenorrhea. This meta-analysis strongly supports the requirement for high methodological quality consistency for upcoming trials.