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Published on: February 5, 2019
Nipple stimulation for labour augmentation: evidence from randomised and quasi-experimental studies
Matilda Videgård1, Louise Anderberg2, Michael B Wells2
1Department of Women's and Children's Health, Karolinska Institutet, Floor 8, Elevator 1, Tomtebodavägen 18A, Stockholm, 171 77, Sweden. matilda.videgard@gmail.com.
Background:
Physiological childbirth is associated with a safer birth, including reducing unnecessary medical interventions, and having a more positive birthing experience. Synthetic oxytocin, commonly used for labour augmentation, carries risks such as neonatal complications, uterine hyperstimulation, and postpartum haemorrhage. Nipple stimulation (NS) may offer a safe, non-pharmaceutical alternative for labour augmentation.
Aim:
To explore the effectiveness and safety of nipple stimulation used for labour augmentation in women with spontaneous contractions or rupture of the membranes.
Method:
A literature review was conducted using PubMed, CINAHL, Web of Science, PsycInfo, Google Scholar, and Consensus.app. A narrative synthesis was conducted following the ESRC guidance for synthesizing quantitative evidence, using thematic analysis and structured exploration of relationships across studies. Calculations of Odds Ratios and Confidence Intervals were made where permissible.
Results:
Ten studies (four RCTs, five quasi-experimental, one cross-sectional) involving 1251 women were included. NS was effective for augmenting labour in most studies, reducing synthetic oxytocin usage, increasing contraction frequency and Bishop scores, shortening the duration of labour stage one, and increasing the likelihood of spontaneous vaginal birth. NS appeared safe in the included studies, with few and reversible side effects reported. However, substantial heterogeneity in study designs, interventions, and measured outcomes limited comparability and precluded meta-analysis.
Conclusions:
Nipple stimulation appears to be safe and effective for labour augmentation. However, substantial heterogeneity in study designs and outcomes limits generalisability. Further large-scale randomised controlled trials are needed to establish clinical protocols and determine which populations benefit most.
