Thursday 22 November 2018

A new study by the Journal of Obstetrical, Gynecological and Neonatal Nurses has released an important finding that could change the way that women are treated for pain after C-sections in the hospital. The study, which examined 165 mothers in the Northeastern United States who had undergone unplanned C-sections, found that using massage as a post-op pain management strategy can be effective.

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Massages in the hospital? Yes, please!

How it worked

The study was performed at teaching hospitals in the Northeast and aimed to specifically examine how post-operative massage might impact a woman’s pain after a C-section. To complete the study, women in the hospitals were divided into three different groups: 1) One group of women all received 20-minute massages 2) One group got normal post-birth care and 3) One group was treated to 20 minutes of individualized attention (I’m assuming this meant something like a health professional talking to them, perhaps a distraction technique or someone to just listen to their concerns?)

Each patient in the program completed a questionnaire before their intervention and again one hour later to gather data about their overall pain, stress, and level of relaxation. The study authors also gathered the exact pain rating and medication administration times from the patients’ medical charts to correlate with the data.

Across the board, the study found that the group who received the post-birth massages reported decrease stress levels, decreased pain levels, and decreased opioid usage for mothers who had experienced received C-sections. Not only did the mothers report the decreased levels of stress and pain, but their medical charts supported the findings, with nurses’ charts showing that the mothers were able to control their pain more effectively with less medication.

Why it’s important 

Studies have found that many women are being prescribed too many opioids after receiving C-sections in the hospital and with the opioid crisis in America still a serious concern, it is an important healthcare initiative to provide effective pain management with lower risks of opioid dependency. There are, so far, no direct studies proving any correlation between the number of opioids prescribed to mothers specifically following a C-section and a later risk for dependency, but it is worrisome that women may be unnecessarily exposed to any risk at all. 

There has been a recent push to look for more effective strategies for pain management for women undergoing C-sections, such as medication-free interventions like massage, to patient-controlled pain pumps that may decrease the total amount of opioids delivered post-operatively.

What comes next

Odds are, it will take some time before doctors and midwives are routinely prescribing massages for patients fresh from the OR, but as a nurse, you could help encourage your patient and her partner, if applicable, to incorporate massage into her pain management strategy after birth. As her nurse, it is your job to help give her the best care possible and empower her to take her health into her own hands, or in this case, perhaps a willing partner’s hands.

Three options you may try:

1. Share the study findings with your patient. She may be surprised to see massage being so effective, especially for C-section pain.

2. Encourage her partner, if applicable, to perform a safe massage on the mother. Instruct him or her to avoid any medically-affected areas, such as the stomach area and epidural site, of course.

3. Offer to rub your patient’s feet. Many patient’s feet are swollen and uncomfortable after months of pregnancy and lots of fluid through surgery and IVs, so she will probably appreciate a nice foot rub. It’s a small gesture you can do to make a difference.

As the healthcare community works together to help curb the opioid crisis, new and alternative ways of pain management will become more important than ever. And if a completely free, safe, and healthy intervention like a 20-minute massage can help a woman be comfortable after going through a C-section, we should all be encouraging it. My only request would be that doctors also consider a recommendation for a prescription for maternal massages for say, the next 18 years because my kids have definitely continued to cause me a heck of a lot of pain.


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