Evaluation of a Maternity Cushion (Ozzlo Pillow) for Backache and Insomnia in Late Pregnancy

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Abstract
EDITORIAL COMMENT: Backache is an important common symptom in pregnancy although usually the topic is listed in textbooks with the other so called ‘Minor Disorders’. This paper evaluates the frequency of backache, its relationship to insomnia and its relief with a locally designed pillow. Unfortunately the ‘minor’ non‐lifethreatening disorders of pregnancy receive scant attention in medical journals, yet not only do they prevent patients enjoying their pregnancy (which should be the ideal), but they can be one reason for patients opting for induction of labour at term, when there is no bonaflde indication for such interference. The same is true of intractable ‘heartburn’ which is another cause of insomnia in late pregnancy. Although the authors provide much detail and many tables they did not tackle the difficult problems of type of backache, radiation of pain, need for analgesia and rest during the day. When backache is severe and incapacitating the patient should be referred for orthopaedic opinion, especially if the pain radiates to the leg along the distribution of one or more of the sciatic nerve roots. A visit to the physiotherapist for education and appropriate exercises is usually of more value than referral to an orthopaedic surgeon. However, the latter must be consulted in the rare patient (less than 1 in 1,000) with intractable pain, or coexistent neurological signs. In most patients backache is relieved by rest, usually in the lateral position, although some women who do not suffer from postural hypotension are more comfortable on their back, on a firm mattress. Backache after pregnancy is also an important problem; if still present at the postnatal visit, the patient's symptoms, morale and abdominal shape are often helped by exercises supervised by a physiotherapist. Summary: The effect of a wedge‐shaped pillow (Ozzlo pillow) was compared with a standard hospital pillow, used to support the abdomen of a pregnant woman while lying on her side, in preventing or alleviating backache and backache‐related insomnia; 92 women at 36 weeks' gestation completed the study. Backache was found to be very common (87%), the onset of pain occurring before 29 weeks in 59%. Age, parity, previous backache and type of bed used did not correlate with the backache scores during the period of study. Lower scores for backache were recorded by women in the week they used the Ozzlo pillow compared with the week they used the standard pillow. Sleeping was deemed better by the patient with the Ozzlo pillow, though actual sleeping scores did not corroborate this. While significantly more felt the Ozzlo pillow was superior to a standard pillow for backache and sleeping, some found both methods helpful. The simple measure of supporting the abdomen with a pillow when in lateral recumbency is likely to benefit many women in late pregnancy. A wedge‐shaped pillow of the Ozzlo type, conforming to the shape of the abdomen and supporting it more closely, may be of greater help than a standard cushion or pillow.

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