The Effectiveness of Aromatherapy in the Management ofLabor Pain and Anxiety: A Systematic Review

Introduction: Aromatherapy, as a non-pharmacologic and complementary andalternative therapy, is the application of essential oils from natural crops to relax and control themind and body through aromatic compounds and essential oils with the neurological andphysiological Evidence from different countries indicates rates of use of aromatherapy in pregnantwomen increasing from ۱۳% to ۷۸% . Although aromatherapy is widely used among pregnantwomen and several studies have been conducted to evaluate its anxiolytic and pain reducing effectduring labor, to our knowledge, there is no comprehensive systematic review to evaluate theefficacy of aromatherapy in reducing labor pain and anxiety. Therefore, the aim of this study wasto comprehensively and critically evaluate the available evidence regarding the effectiveness ofaromatherapy in the management of labor pain and anxiety. Methods: In a systematic review, ۵databases (PubMed, SCOPUS, Web of Science, Google Scholar and Scientific InformationDatabase [SID]) were searched, from database inception up to December ۲۰۱۹. Keywords usedincluded (aromatherapy OR “essential oil” OR aroma*) AND (pain OR anxiety) AND (labor ORdelivery). The languages of the studies were restricted to the Persian and English. For searching inPersian electronic databases, keywords equivalents in Farsi were used. Studies with high risk ofbias or those studies in which the effects of aromatherapy during labor were not the primaryoutcome of interest were excluded. Results: ۳۳ studies were been verified to meet our criteria forinclusion. : All the selected studies were published between ۲۰۰۳ and ۲۰۱۸. ۲۷ of the includedstudies were carried out in Iran, ۲ study in Korea, ۱ study in Egypt, ۱ study in Italy and ۲ studiesin India. All ۳۳ studies were planned in parallel group design. Inhalation, massage, footbath ,inhalation and footbath, birthing pool, points for acupressure and compress were the forms ofaromatherapy administration in the included studies. The most essential oil used in the studies waslavender (۱۳ studies). No significant aromatherapy-related side effects were reported in theincluded studies. Most of included studies confirmed the positive effect of aromatherapy inreducing labor pain and anxiety. Discussion Conclusion: Regardless of maternal group or type oflabor induction (spontaneous versus induced), women consistently identified aromatherapy as avaluable complement to their labor experience, and the aromatherapy group had a lower epidurallevel and opioid injection rate. Generally, aromatherapy can reduce contraction during delivery,alter functional delivery disorder and reduce delivery time. Although no serious aromatherapyrelated side effects during labor have been reported in our included studies, a careful attention should be paid by healthcare providers to potential adverse effects such as dermatitis