You will be provided with the titles and abstracts of a collection of medical RCT reports studying a clinical question -- for instance, the efficacy of an intervention on some medical outcome. Please write a few sentences synthesizing the findings of these reports, which could serve as a conclusion section for a systematic review article. Your response should not include any other text. The RCT reports are below.



Title 1:
CLINICAL TRIAL OF AUDIO-ANALGESIA IN CHILDBIRTH.
Abstract 1:
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Title 2:
[The use of respiration and relaxation techniques for pain and anxiety relief in the parturition process].
Abstract 2:
This study aimed to evaluate the effect of respiration and relaxation techniques on pain and anxiety during labor. Seventeen parturients (Control Group--CG) received routine care and nineteen (Experimental Group--EG) were orientated and stimulated to perform respiration and relaxation techniques. Pain was evaluated by means of the visual analogy scale and anxiety by means of the anxiety inventories--trait and state. Pain intensity increased along with the evolution of the delivery for both groups. In the latent phase, anxiety levels were low for both groups; in the active phase, levels were average for CG and low for EG. In the transition phase, levels were average and, in the immediate post-labor phase, low for both groups. It was concluded that the techniques used did not reduce pain intensity, but provided EG with lower anxiety levels for a longer time during labor.


Title 3:
Effects of natural childbirth preparation versus standard antenatal education on epidural rates, experience of childbirth and parental stress in mothers and fathers: a randomised controlled multicentre trial.
Abstract 3:
To examine the effects of antenatal education focussing on natural childbirth preparation with psychoprophylactic training versus standard antenatal education on the use of epidural analgesia, experience of childbirth and parental stress in first-time mothers and fathers.
                Randomised controlled multicentre trial.
                Fifteen antenatal clinics in Sweden between January 2006 and May 2007.
                A total of 1087 nulliparous women and 1064 of their partners.
                Natural group: Antenatal education focussing on natural childbirth preparation with training in breathing and relaxation techniques (psychoprophylaxis). Standard care group: Standard antenatal education focussing on both childbirth and parenthood, without psychoprophylactic training. Both groups: Four 2-hour sessions in groups of 12 participants during third trimester of pregnancy and one follow-up after delivery.
                Epidural analgesia during labour, experience of childbirth as measured by the Wijma Delivery Experience Questionnaire (B), and parental stress measured by the Swedish Parenthood Stress Questionnaire.
                The epidural rate was 52% in both groups. There were no statistically significant differences in the experience of childbirth or parental stress between the randomised groups, either in women or men. Seventy percent of the women in the Natural group reported having used psychoprophylaxis during labour. A minority in the Standard care group (37%) had also used this method, but subgroup analysis where these women were excluded did not change the principal findings.
                Natural childbirth preparation including training in breathing and relaxation did not decrease the use of epidural analgesia during labour, nor did it improve the birth experience or affect parental stress in early parenthood in nulliparous women and men, compared with a standard form of antenatal education.


Title 4:
Effects of music therapy on labour pain and anxiety in Taiwanese first-time mothers.
Abstract 4:
The purpose of the study was to investigate the effects of music on pain reaction and anxiety during labour.
                Music therapy has been used on clinical medicine. Only few scientific studies validate the value on labour women.
                Randomised controlled trial.
                Sixty primiparas expected to have a normal spontaneous delivery were randomly assigned to either the experimental group (n = 30) or the control group (n = 30). The experimental group received routine care and music therapy, whereas the control group received routine care only. A self-report visual analogue scale for pain and a nurse-rated present behavioural intensity were used to measure labour pain. Anxiety was measured with a visual analogue scale for anxiety and finger temperature. Pain and anxiety between groups were compared during the latent phase (2-4 cm cervical dilation) and active phase (5-7 cm) separately.
                Our results revealed that compared with the control group, the experimental group had significantly lower pain, anxiety and a higher finger temperature during the latent phase of labour. However, no significant differences were found between the two groups on all outcome measures during the active phase.
                This study provides evidence for the use of music as an empirically based intervention of women for labour pain and anxiety during the latent phase of labour.
                The findings support that music listening is an acceptable and non-medical coping strategy for labouring women. Especially, apply in reducing the pain and anxiety for women who are at the early phase of labour.


Title 5:
Yoga during pregnancy: effects on maternal comfort, labor pain and birth outcomes.
Abstract 5:
This study examined the effects of a yoga program during pregnancy, on maternal comfort, labor pain, and birth outcomes. A randomized trial was conducted using 74-primigravid Thai women who were equally divided into two groups (experimental and control). The yoga program involved six, 1-h sessions at prescribed weeks of gestation. A variety of instruments were used to assess maternal comfort, labor pain and birth outcomes. The experimental group was found to have higher levels of maternal comfort during labor and 2h post-labor, and experienced less subject evaluated labor pain than the control group. In each group, pain increased and maternal comfort decreased as labor progressed. No differences were found, between the groups, regarding pethidine usage, labor augmentation or newborn Apgar scores at 1 and 5 min. The experimental group was found to have a shorter duration of the first stage of labor, as well as the total time of labor.


Title 6:
The effect of breathing and skin stimulation techniques on labour pain perception of Turkish women.
Abstract 6:
To determine the effect of breathing techniques and nurse-administered massage on the pain perception of pregnant woman during labour.
                The present study was conducted among pregnant women (75% primiparous) admitted to the SSK Bakirkoy Women and Children's Hospital (Istanbul, Turkey) between January 1, and September 1, 2000. The patients were in their 38th to 42nd week of pregnancy, not at high risk and expected to have normal vaginal delivery. They were selected from volunteers by nonrandom sampling.
                The present study involved 40 cases, with 20 in the experimental group and 20 in the control group. Data were obtained through the visual analogue scale, inspection form, observation form and postnatal interview form. The study investigators provided information about labour, breathing techniques and massage to the pregnant women assigned to the experimental group at the beginning of labour (latent phase). A study investigator also accompanied them during labour. These women received nurse-administered massage and were encouraged to breathe and perform self-administered massage. They were also instructed to change their positions and to relax.
                Study results demonstrated that nursing support and patient-directed education concerning labour and nonpharmacological pain control methods (eg, breathing and cutaneous stimulation techniques) were effective in reducing the perception of pain by pregnant women (when provided in the latent labour phase before delivery), leading to a more satisfactory birth experience.


Title 7:
The effect of music as a conditioning aid in prepared childbirth education.
Abstract 7:
The addition of self-selected music as a conditioning aid during prepared childbirth education and subsequent family performance in labor within a musical environment were examined. Thirty primigravida couples received the same psychoprophylactic instruction, with 15 randomly selected couples receiving the added musical conditioning aid. Medication use remained minimal, without significant difference, for couples who did and couples who did not use music. However, the value of music to both the family and the health care staff is felt to be of enough subjective significance to warrant its use as a normal component of prepared childbirth education.
Relaxation and yoga may have a role with reducing pain, increasing satisfaction with pain relief and reducing the rate of assisted vaginal delivery. There was insufficient evidence for the role of music and audio-analgesia. However, there is a need for further research.