Furthermore, duration of all stages was shorter in cold
therapy group. Severe pain increases fear and anxiety, so
stimulates sympathetic system and releases catecholamine
that result in prolonged labour (Sercekus & Okumus 2007,
El-Wahab & Robinson 2011). It seems that effective uterus
contractions produced by cold therapy persisted after birth,
as the third stage was also significantly shorter in the
experiment group. Curkovic and Vitulic reported cold
application increases pain threshold after 10–30 minutes
(Curkovic & Vitulic 1993). Pasero et al. reported higher
and longer efficacy of cold therapy in pain reduction compared
with heat application (Pasero & McCaffery 1999).
Consequently, the effect of cold may last up to the third
stage of labour after eliminating the source. Decrease in
duration of birth contributes to lower maternal fatigue,
decreased postpartum bleeding and prevention of unnecessary
interventions. It seems that reduction in pain and birthduration is independent of oxytocin consumption and rupture
of membranes, as they were similar in both groups.
Alehagen et al. showed that the amount of pain relief influences
the correlation between fear and duration of the second
phase of labour (Alehagen et al. 2001). As no other
pain-relieving method was applied and a doula was present
in control group, to eliminate the effect of supporter factor,
it seems that the cold therapy was the major effective factor.