Women who participated in additional exercise programs, received
acupuncture or OMT, or used a pillow or abdominal support
generally expressed satisfaction with the interventions and felt
they would consider them in subsequent pregnancies. In general,
women in the studies who received more than usual prenatal care
appeared to experience some pain relief, although the results varied.
Three pooled estimates of effect were moderate (SMD 0.5 to
< 0.8, Analysis 1.2; or large in size (SMD ≥ 0.8; Analysis 1.1;
Analysis 3.1; Cohen 1988) and would likely be considered clinically
significant. On the other hand, had the potential for risks of
bias been lower, the estimates of effect may also have been lower,
since it has been shown that trials with lower risks of bias have
lower effect sizes (Van Tulder 2009). This was bourne out by the
sensitivity analyses and re-analyses of Analysis 1.1