Reduction of Perineal Pain after Vaginal Birth with Black Tea: A Pilot RCT Karmjit Kaur Sandhu, RN, PI; Catherine Burns, RN, Co-PI; Mildred Janzen CI
Introduction Perineal trauma is common during vaginal birth. The discomfort this causes can interfere with a woman's recovery and early motherhood (Steen, 2010). Mothers are offered a standard treatment after childbirth, water soaked frozen peripads (ice packs), to alleviate the discomfort. However, a Cochrane review questions the efficacy of ice packs treatment (East et al., 2007). An alternative treatment that may be more comfortable and effective for women is warm water soaked black tea bags. Medicinal use of black tea bags has been based on their astringent (shrinking or constricting) properties (Isreal, 2006) and have been used for various medical applications.
Methods A pilot Randomized Controlled Trial (RCT) was conducted with 43 participants (intervention group; tea bags; n=19, control group; Ice pads; n=24, mean age= 26) at Abbotsford regional Hospital (ARH). The goal of this pilot was to test the feasibility of a larger RCT by assessing recruitment, testing the protocol, and evaluating a proposed objective primary outcome of analgesic use during hospitalization as an indicator of pain. This RCT pilot study was expected to demonstrate feasibility for a large scale RCT to formally evaluate the efficacy of use of black tea bags to reduce perineal pain in this patient population.
Research Question What is the feasibility of studying the use of black tea bags for reducing perineal pain in women after childbirth?
Selection Criteria Inclusion: Primaparous, 19 year or over delivered vaginally at at ARH Exclusion: Multiparous, VBAC, STIs, vulvar varicosities, 3rd & 4th degree tear, hematoma, retained products, substance abuse, medical conditions requiring analgesia
Data Collection A unique study code was used to identify participants. Data was collected using a demographic sheet, Wong-Baker Faces Pain Rating Scale (1-10) and satisfaction scale (0-6). Pain scale was administered at 2, 12 & 24 hours; Satisfaction scale was administered at 12 & 24 hours.
Results
Discussion To our knowledge, this is the first pilot RCT testing black tea on the perineum after childbirth.
Recommendations: Perform a full scale RCT with a large sample size.
References East, C. E., Begg, L., & Henshall, N. E., Marchant, P., & Wallis, K. (2007). Cochrane Database Systematic Reviews, 4, 1-26. Isreal, S., Schwetz, N., Boyar, R., & McNicol, A. (2006). Bleeding disorders: Characterization, dental considerations and management. Journal of Canadian Dental Association, 72(9), 827. Steen, M. (2010). Care and consequences of perineal trauma British Journal of Midwifery, 18(11), 710-718.
Acknowledgements BC Nursing Research Initiative, Michael Smith Foundation for Health Research, Fraser Health: Professional Practice and Integration, Department of Research and Evaluation, Dr. Maggie Theron (Mentor), Lynn Palmer, CNS (Consultant), Maternity Staff at ARHCC, and most importantly the Study participants