Evaluation of the Bonapace Method: a specific educational intervention to reduce pain during childbirth

Julie Bonapace,¹ Nils Chaillet,² Isabelle Gaumond,^3,4 Émilie Paul-Savoie,⁵ Serge Marchand<sup>3,4

1</sup>Département des Sciences de l'Éducation, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, ²Centre de Recherche de l'Hôpital Sainte-Justine, Université de Montréal, Montréal, Québec, ³Département de chirurgie, Faculté de Médecine et des Sciences de la Santé, Université de Sherbrooke, Sherbrooke, Québec, ⁴Département des Sciences de la Santé, Université du Québec en Abitibi-Témiscamingue, Rouyn-Noranda, Québec, ⁵École des sciences infirmières, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, Québec, Canada

Objective: As pain during childbirth is very intense, several educational programs exist to help women prepare for the event. This study evaluates the efficacy of a specific pain management program, the Bonapace Method (BM), to reduce the perception of pain during childbirth. The BM involves the father, or a significant partner, in the use of several pain control techniques based on three neurophysiological pain modulation models: (1) controlling the central nervous system through breathing, relaxation, and cognitive structuring; (2) using non-painful stimuli as described in the Gate Control Theory; and (3) recruiting descending inhibition by hyperstimulation of acupressure trigger points.
Methods: A multicenter case control study in Quebec on pain perception during labor and delivery compared traditional childbirth training programs (TCTPs) and the BM. Visual analog scales were used to measure pain perception during labor. In all, 25 women (TCTP: n = 12; BM: n = 13) successfully reported their perceptions of pain intensity and unpleasantness every 15 minutes.
Results: A positive correlation between the progression of labor and pain was found (pain intensity: P < 0.01; pain unpleasantness: P < 0.01). When compared to TCTP, the BM showed an overall significant lower pain perception for both intensity (45%; P < 0.01) and unpleasantness (46%; P < 0.01).
Conclusion: These significant differences in pain perception between TCTP and the BM suggest that the emphasis on pain modulation models and techniques during labor combined with the active participation of a partner in BM are important variables to be added to the traditional childbirth training programs for childbirth pain management.

Keywords: labor pain, yoga, perinatal care, DNIC, gate control theory, cognitive structuring, massage, father