Cochrane Summaries

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Sterile water injections for the relief of pain in labour

Derry S, Straube S, Moore RA, Hancock H, Collins SL
Published Online: 
14 November 2012

Labour is considered to be painful by many women. The pain is made worse by fear and anxiety, and if the women senses a loss of control. Some women feel the pain of contractions all around the uterus, some  feel them like intense period pains low down in the pelvis, and others as terrible back pain (possibly due to the baby’s position). It has been suggested that injections of small amounts of sterile water into, or just under, the skin of the lower back might be able to relieve some types of labour pain, especially the pain felt in the back. The were generally four injections given at the height of the contractions to reduce feeling of the pain from the injections themselves.

In this review we looked at the effectiveness of injections of small amounts of sterile water given into four spots on the woman’s lower back in labour. The review included seven studies with 766 participants; four used intracutaneous injections, two subcutaneous, and one both. All studies compared the injections of sterile water with injections of saline, whilst none compared the injection of sterile water with women using their own skills to manage pain in labour. Nor did the studies compare with other forms of pain management in labour, as this information is in other Cochrane reviews.

We found no good quality evidence that these simple water injections could provide a significant level of pain relief compared with simple saline injection for any type of pain experienced during labour. Women did report transient pain at the injection site. More research is needed on this possible form of pain management in labour.

This record should be cited as: 
Derry S, Straube S, Moore RA, Hancock H, Collins SL. Intracutaneous or subcutaneous sterile water injection compared with blinded controls for pain management in labour. Cochrane Database of Systematic Reviews 2012, Issue 1. Art. No.: CD009107. DOI: 10.1002/14651858.CD009107.pub2
Assessed as up to date: 
13 October 2011