caused perineal tear grade II, III.18 This difference
may be due to the high prevalence of episiotomy in
our study while 60 out of 64 women underwent episiotomy.
This research reveals that heat therapy does
not decrease perineal tear.
Comparing the apgar score at 1 and 5 minutes between
the two groups, we found that the mean apgar
score in 1 and 5 minutes was similar between the two
groups. In a study in Finland (2005), the effect of heat
stress on the uterine contraction, fetal heart rate, and
fetal movement was researched, revealing that the fetal
heart rate increased from 146 beats per minute to a
maximum of 157 beats per minutes after thermal stress
and the newborns were all in a good condition at delivery.
19 Our results indicated that heat therapy had no
positive or negative effect on the neonate's apgar score.
Maternal bleeding status, uterine contraction and
the height of the fundus an hour after delivery showed
no difference between the two groups and most of the
cases had normal uterine contractions an hour after
delivery and the height of the fundus was under the
umbilicus after delivery. Geissbuehler et al. showed
that the mother’s blood loss is the lowest in water
birth.12 Also, Malarewicz et al. indicated that immersion
in warm water did not weaken uterine contraction.
16 As to our results, it was shown that bleeding
did not differ between the two groups, and heat therapy
with muscle relaxation does not cause inability in
uterine contraction and abnormal bleeding after delivery.
Probably heat therapy induces muscle relaxation,
increases the mother’s peace, induces endorphin release,
and increases the internal oxytocin, causing
uterine contraction and decreased bleeding after delivery.
Finally, it seems necessary to say that these are
just some theories of investigators from scientific
texts but the real mechanism is not exactly clear.
As shown by the findings of our study, heat therapy
with warm bag is very effective for pain during
labor, reducing pain severity in the first and 2nd labor
stages and the duration of 1st and 3rd labor stages. It
is hoped that the results of the present research contribute
to the improvement and promotion of the quality of obstetrical care.