The Effectiveness of Lavender Aromatherapy in the Management of Labor Pain and

Anxiety

ABSTRACT

Background: Aromatherapy as an alternative and complementary medicine is a well-known

method for reducing the symptoms of various physiological processes such as labor experience.
The aim of this study was to systematically review the currently available evidences evaluating
the use of aromatherapy for management of labor pain and anxiety.

Purpose: Reduce pain and anxiety during childbirth.

Method: In this randomised controlled trial, 160 participants were divided into two groups. The
aroma group received 0.1ml of lavender essential oil mixed with 1ml of distilled water via
tissues attached to their gowns close to their nostrils. Meanwhile, the control group received 2ml
of distilled water in a similar way. Pain intensity perception was measured by Visual Analogue
Scale (VAS) before the intervention and at 30 and 60 minutes afterwards.

Result: The mean of pain intensity perception in the aroma group was lower than that of the
control group at 30 and 60 minutes after the intervention.

This study
Conclusion: This study revealed that aromatherapy decreased the labour pain and anxiety.

INTRODUCTION

Pain is an unavoidable reality of labor and the most noticeable determinant of the labor
experience. The perception of pain during labor is due to cervical dilation, contractions of the
uterus and the uterine extension for vaginal delivery. Inadequate labor pain management can be
associated with negative physiological and psychological consequences. Additionally, it has been
previously indicated that there is an association between labor anxiety and pain. Anxiety
stimulates the sympathetic nervous system and releases stress related hormones such as
noradrenaline, cortisol and adrenaline, which consequently increase the severity of labor pain as
well as the duration of labor. Therefore, finding a way to provide a maximum pain relief feeling
and calmness, with the minimum complications, is one of the most important issues during labor.
Pharmacological and non-pharmacological approaches are two general methods that currently
used to alleviate labor pain and anxiety. Nowadays, non-pharmacological approaches such as
relaxation techniques, acupuncture, acupressure, massage therapy and aromatherapy have been
identified a prominent area in midwifery science due to their price-effectiveness, popularity,
simplicity of use and low risks.

Aromatherapy, as a non-pharmacologic and complementary and alternative therapy, is

the application of essential oils from natural crops to relax and control the mind and body
through aromatic compounds and essential oils with the neurological and physiological effects.
Using aromatherapy in the care of women has a long history. Among pregnant women,
complementary and alternative therapies are common approaches. Evidence from different
countries indicates rates of use of aromatherapy in pregnant women increasing from 13% to
78%. Also, use of aromatherapy is suggested during labor, with no significant reported side
effects in the mothers and neonates.

Although aromatherapy is widely used among pregnant women and several studies have
been conducted to evaluate its anxiolytic and pain reducing effect during labor, to our
knowledge, there is no comprehensive systematic review to evaluate the efficacy of
aromatherapy in reducing labor pain and anxiety. Therefore, the aim of this study was to
comprehensively and critically evaluate the available evidence regarding the effectiveness of
aromatherapy in the management of labor pain and anxiety.

DISCUSSION

The intense fear of labour pain could be a risk factor affecting the fetus as well
as the mother’s life, as stress can cause vasoconstriction which can decrease the blood supply
to the uterus and fetus (Hadi, 2006). Therefore, suitable planning and performing midwifery
interventions to control the pain during delivery seem to be necessity. The first objective of the
present study was to determine the effect of lavender aromatherapy on pain severity. The
results of the current study demonstrated a significant difference between the aroma and the
control groups regarding the intensity of labour pain at 30 and 60 minutes after the intervention
(p<0.001) and the least intensity of pain was observed at the 30th minute after the intervention.
Similar results were also obtained by Han et al (2006) studying the aromatherapic scent on
dysmenorrhoea.

Burns et al. (2007) studied the effect of aromatherapy on the level of anxiety and
the intensity of labour pain in primiparous and multiparous women. They reported that
aromatherapic scent had little effect on the pain realisation of the primiparous women. In
addition, the pain intensity realization continued in the multiparous women and pain and
anxiety increased by the progress of delivery in both groups. The difference between the
results might be due to the fact that two groups of primiparous and multiparous women were
compared in the study by Burns et al. (2007), while the present study only compared the
primiparous women.

Memory is one of the important factors related to the effect of scent. Because
different scents provoke memories and make the individuals review the details of the
events (Goldberg, 2001), it seems that the scent of lavender resulted in less concentration and
stopped the pain realisation in the aroma group.

Aromatherapy affects the body in three ways: pharmacological effects of the hormones
and enzymes that can cause chemical changes in the body; psychological effects, including
relaxation and sedative effects on the body; and physiological effects resulting from the
brain’s response to inhaling aromas (Trevelyan and Booth, 1994). The studies conducted
on the issue have shown that lavender aroma might suppress the activity of the sympathetic
nervous system (Heuberger et al, 2004; Toda et al, 2008). Volatile compounds may enter the
bloodstream through the nasal or lung mucosa, or directly diffuse into the olfactory nerve and
pass up to the limbic system which can influence the sympathetic nervous system (Toda
and Morimoto, 2008). Anxiety influences the pain intensity and mothers’ anxiety during
labour is an important factor in the severity of labour pain (Lang et al, 2006; Curzik and
Jokic-Begic, 2011). Aromatherapy oils reduce the stress hormones and increase the secretion
of beta-endorphins; thus, pain perception is reduced (Burns et al, 2000). Rho et al (2006)
demonstrated that aromatherapy, particularly with lavender, decreased anxiety in elderly
women and increased self-confidence.

The second objective of the present study was to determine the effect of lavender
aromatherapy on the duration of the first and second stages of labour. The findings of the study
indicated no significant difference between the two groups regarding the duration of the first and
second stages, which is in agreement with the results obtained by Burns et al (2007). However,
Hur and Park (2003) reported that aromatherapy with lavender and rose reduced the labour
duration.

Evaluation of the women’s contentment was the fourth objective of this study. According
to the findings, the women in the aroma group were significantly more content compared to
the control group. Although the study subjects did not have any previous experience of the
lavender scent, inhaling it was pleasing for them. Kim et al (2006) conducted a study on the
effect of lavender on treating post-operative pain after breast biopsy and revealed that the
contentment of pain control in aromatherapy by lavender was higher than that in the control
group. Also, in the previous study by Burns et al (2000), most women had chosen the scent of
lavender as their preferred pain reliever among all the scents.