Effect of Intermittent Heat and Cold Therapy on Comfort During Labor

Heat Only Therapy A 2-liter rubber hot water bag will be utilized to provide heat to the lower back of primigravida women during the first stage of labor. The water in the bag will be maintained at a temperature of 40-42ºC. The application of heat will last for 20 minutes, and it will be repeated every hour until the cervix is fully dilated. To prepare the hot water, tap water will be boiled in a stainless steel pot until it reaches 70ºC. Before filling the hot water bag, its temperature will be verified using a laboratory thermometer. The bag will then be covered with a towel and applied to the laboring women, ensuring the heat is tolerable for her. If the temperature falls below the specified range, another hot water bag will be made ready for replacement. Intermittent Heat & Cold Therapy During the first stage of labor (from 4-5 to 10 cm of cervical dilation) for the experimental group, a cyclical method of alternating heat and cold application will be used on the lumbosacral and lower abdominal area of the laboring women. The process involves applying a hot pack with a temperature range of 38-40°C on their lower abdomen and low back for 30 minutes during contractions and a relaxing period using a 2-litre rubber hot water bag.

Subsequently, reusable ice packs typically contain water, covered with a towel and with a temperature range of 0-5°C will be applied to the same areas for 10 minutes. After a 30-minute interval, the heat application will be reapplied, and this alternating heat and cold cycle will be repeated throughout the first stage of the laboring process. After interventions 4-5, 7-8 and 9-10 cm of cervical dilation, we will assess the comfort including pain level and after 10 cm of cervical dilation, duration will be calculated to identify the total duration of first stage of labor

Inclusion criteria

Low-risk primigravida are those pregnant women who are between the ages of 18 to 35 years old admitted to Bhartpur hospitals and anticipated normal delivery.

• Completed 4 ANC visits
• Normal size fetus and without any complication by USG scan
• Weeks of gestation 37 to 41
• No history of abortions
• Who had not taken any analgesic and other regular medication
• Normal BMI (Pre-pregnancy 18.5-24.9)
• Women willing to participate
• Those mothers who are initial phase of labor

Exclusion criteria

('no any complication')

• Pregnant women who had a history of abortion
• Pregnancy-induced hypertension and heart conditions(pre/eclampsia)
• Antepartum haemorrhage
• Pregnancy with urinary system disease such as UTI
• Hyper or hypothyroidism
• Anemia
• Obesity
• Pregnancy with Diabetes
• Diagnosed Mental Illnesses such as Stress anxiety depression, Psychosis or epilepsy
• Any Physical Disability
• Fever during Labor
• Those pregnant women who did not have any antenatal visit
• Pregnant women who will not willing to participate
• Those women who develop complications during the study