The effectiveness of heat therapy and cold therapy in labor pain intensity in primiparous women: A randomized controlled trial

Background: Labor pain (LP) is one of the most severe types of pain among women, and hence, effective LP management is a main goal of maternity care. Objectives: The aim of this study was to compare the effects of heat therapy (HT) and cold therapy (CT) on LP intensity among primiparous women. Methods: This randomized controlled trial was conducted in 2017–2018 on 99 primiparous women purposively selected from a teaching hospital in Iranshahr, Iran. Participants were allocated, through simple randomization, to an HT, a CT, and a control group. Participants in the HT group received HT using a warm-water bottle with a temperature of 38°C–40°C, and participants in the CT group received CT using an ice pack with a temperature of 0°C–5°C. HT and CT were applied to the lumbar area in the first phase of labor and to the perineal and suprapubic areas in the second phase. LP intensity was measured using the Visual Analog Scale at five time points, namely at a cervical dilation of 4 cm (i.e., before intervention onset), at a cervical dilation of 4–5, 6–7, and 8–9 cm (i.e., during the active labor phase), and in the second stage of labor. The SPSS software (v. 16.0) was used to analyze the data through the Chi-square test, the one-way analysis of variance, and the repeated measures analysis of variance. Results: A total of 93 participants completed the study. There was no significant difference among the groups respecting LP intensity at different measurement time points, except at the cervical dilation of 8–9 cm in which LP intensity in the CT group was significantly less than both the HT and the control groups (P < 0.05). Conclusion: CT is effective in significantly reducing LP intensity among primiparous women.