Comparison of the effect of mechanical massage and warm mechanical massage application on perceived labor pain and childbirth experience: A randomized clinical trial

Effect of Heat Therapy on Pain During the First Stage of Labor Among Primigravid Women: A Pilot Study

Background Labor pain is often one of the most severe pains a woman may feel in her lifetime, and childbirth is usually considered one of the most physically demanding experiences a woman may have. An effective and safe midwifery intervention for reducing labor pain in pregnant women is the administration of heat. Aim The objective of the article is to compare the effectiveness of lumbosacral heat application on pain throughout the active first stage of labor between the interventional and control groups. Method A randomized controlled trial among 10 low-risk primigravid women admitted to Bharatpur Hospital in Chitwan, Nepal, was carried out to evaluate the intensity of pain and duration of the active first phase of labor by allocating them randomly into intervention (5) and control groups (5); one group received heat therapy on the lumbosacral region, while the other received standard care. The Visual Analog Scale (VAS) was applied as an instrument to assess pain four times: before heat therapy at 4-5 cm of cervix dilation and three times after heat application at 4-5, 7-8, and 9-10 cm. The data were analyzed descriptively and inferentially using a repeated measures ANOVA test. Results The mean age of the mothers was 21.80±3.327, most of them belonged to the low socioeconomic class, all of them were living in joint families, 80% of participants had less than 18.5 body mass index, all participants had visited an antenatal clinic for check-ups, and 60% had spontaneous labor started. The findings show a higher labor pain score before intervention (mean=6.80) which progressively decreased after an intervention: post-test 2 (M=6.20; SD=0.83), post-test 3 (M=5.60; SD=0.89), and post-test 4 (M=5.00; SD=0.70). The mean, standard deviation, and F-value of labor pain before and after the application of heat therapy among primigravid women indicated a significant mean difference in labor pain (F (3,12)=4.500; MES=0.66; p=0.025; η2=0.53) with a large effect size in contrast to the control group. The p-value for post-test 4 was 0.025, representing that the null hypothesis was rejected. This acclaims that heat therapy has an effect on labor pain. Conclusion It is concluded that the application of heat on the lower back during labor lowered the pain level experienced by primigravid women in the interventional group compared to those in the control group. Thus, heat therapy can be considered a viable method for managing labor pain.

The effect of acupressure and massage on labor pain and birth satisfaction: a randomized controlled trial

OBJECTIVE

This randomized controlled trial was conducted to determine the effect of acupressure and massage used for the management of labor pain in the latent, active, and transition phases of the first stage of labor on labor pain and birth satisfaction.

METHODS

The study was conducted with 66 pregnant women who met the sampling criteria and participated voluntarily at a public hospital in Nicosia. The participants were randomly assigned to one of three groups: a massage group, an acupressure group, or a control group. Participants in the massage group received 10 min of sacral massage during contraction and 10 min of endorphin massage during rest, for a total of 30 min of massage per phase. Participants in the acupressure group received 3 min of acupressure to the LI 4 point at the same dilation intervals, when the contraction was most intense. The control group received no intervention. Pain perceived by the pregnant woman was evaluated with the Visual Comparison Scale (VAS) at the beginning and end of each phase. Postpartum, the Birth Satisfaction Scale was applied.

RESULTS

Massage application was found to be more effective in reducing labor pain than acupressure or the control group. Massage and acupressure did not negatively affect APGAR scores. The lowest oxytocin use was found in the massage group. The group with the highest birth satisfaction scores was also the massage group.

CONCLUSION

Massage application is more effective than acupressure application in reducing labor pain and increasing birth satisfaction.

The Effect of Labor Dance in the First Stage of Labor on Labor Pain, Anxiety, Duration of Labor, and Maternal Satisfaction with Labor: A Randomized Controlled Study

Objective: The study aimed to examine the effects of labor dance applied in the first stage of labor on perceived labor pain, anxiety, duration of labor, and maternal satisfaction with labor. Design: This study is a randomized controlled trial. Methods: A sample size of 128 pregnant women was randomly assigned to a control (n = 64) or experimental (n = 64) group while ensuring equal numbers of primiparous and multiparous participants in each group. After admission to the hospital for parturition, and during the first stage of labor, the women in the experimental group were exposed to a 15-min labor dance every hour when the cervical dilation was between 3 and 8 cm. The labor dance included movements of the sacrum and waist massaged by a partner using a massage glove, which was accompanied by self-selected music. Outcome measures included the Visual Analogue Scale (VAS), the State Anxiety Scale (SAS), and the Scale for Measuring Maternal Satisfaction (SMMS)-normal birth and labor duration. These were administered before the labor dance and at the end of the labor dance at three points of cervical dilation: 3, 5-6, and 7-8 cm for the experimental group, and at similar points in the control group: at the start of dilation and 15 min later. The data were analyzed using the generalized linear model and Mann-Whitney U tests. Results: In comparison to the control group, for the group performing the labor dance, the mean VAS scores were lower (p < 0.05) at each evaluation period, and the mean scores of total SMMS and some of its subdivisions were significantly higher in the experimental group (p < 0.05). There was no statistically significant difference between the SAS scores at any evaluation point, including postpartum (p > 0.05). Similarly, there were no significant differences in labor time (p > 0.05) between groups. Conclusions: The practice of labor dance was found to be effective in reducing the perceived labor pain in pregnant women and increasing maternal satisfaction at birth, but not on the duration of labor, and anxiety. Trial registration: ClinicalTrials.gov (NCT04746170).

Electric massage chairs reduce labor pain in nulliparous patients: a randomized crossover trial

BACKGROUND

Labor pain varies significantly among pregnant women, ranging from mild to extremely distressing. Nonpharmacologic pain relief methods during vaginal birth are increasingly popular, either as a complement to pharmacologic agents or, at times, as the primary method of pain relief. Multiple trials have reported that manual or by-hand massage reduces labor pain. The effectiveness of full-body mechanical massage using electric massage chairs on labor pain remains unexplored.

OBJECTIVE

This study aimed to evaluate mechanical massage using an electric massage chair on labor pain in nulliparous women.

STUDY DESIGN

A randomized counterbalanced crossover trial was conducted in a university hospital in Malaysia from August 2022 to February 2023. Eligible nulliparas in labor with a minimum labor pain score of 5 (0-10 numerical rating scale) were enrolled. Participants were randomized to 30 minutes on the massage chair with mechanical massage followed by 30 minutes on the massage chair without mechanical massage or the other way around in the massage sequence. The primary outcome was a change in pain score comparing pain with and without mechanical massage as a paired comparison for the entire trial participants. The secondary outcomes were across arms analyses of maternal and neonatal outcomes. The paired t test, t test, Mann-Whitney U test, chi-square test, and Fisher exact test were used as appropriate for the data.

RESULTS

Overall, 208 women were randomized: 104 to each intervention. Data were available from 204 participants (103 randomized to massage first and 101 to no massage first). The primary outcomes of change in labor pain scores (0-10 numerical rating scale) after massage and no massage (all participants included after crossover, paired t test analysis) were 4.51±2.30 and 5.38±2.10, respectively (mean difference, -0.87; 95% confidence interval, -1.14 to -0.59; P<.001), a significant reduction in pain score after electric chair mechanical massage compared with no massage. On the across randomized arms secondary analyses, labor pain scores after their first massage chair session were 4.35±2.52 (randomized to massage first, received massage as initial intervention) and 5.66±1.73 (randomized to no massage first, received no massage as initial intervention) (mean difference, -1.31; 95% confidence interval, -1.91 to -0.748; P<.001), a significant reduction after mechanical massage. Other distal maternal outcomes (mode of delivery, labor analgesia, duration of labor, and maternal agreement that mechanical massage is effective for labor pain) and neonatal outcomes (Apgar scores at 1 and 5 minutes, cord artery blood pH and base excess, and neonatal admission) were not different across randomized arms.

CONCLUSION

Mechanical massage using an electric massage chair significantly reduced labor pain, offering a potential nonpharmacologic pain management option during labor.

Nonpharmacological Methods to Reduce Pain During Active Labor in A Real-life Setting

OBJECTIVE

 To evaluate the association between pain intensity in the active phase of the first stage of labor with the use or not of nonpharmacological methods for pain relief in a real-life scenario.

METHODS

 This was an observational cross-sectional study. The variables analyzed were obtained by a questionnaire with the mothers (up to 48 hours postpartum) to investigate the intensity of pain during labor using the visual analog scale (VAS). The nonpharmacological pain relief methods routinely used in obstetric practice were evaluated by consulting medical records. The patients were separated into two groups: Group I - patients who did not use nonpharmacological methods for pain relief and Group II -patients who used these methods.

RESULTS

 A total of 439 women who underwent vaginal delivery were included; 386 (87.9%) used at least 1 nonpharmacological method and 53 (12.1%) did not. The women who did not use nonpharmacological methods had significantly lower gestational age (37.2 versus 39.6 weeks, p < 0.001) and shorter duration of labor (24 versus 114 min, p < 0.001) than those who used the methods. There was no statistically significant difference in the pain scale score using the VAS between the group that used nonpharmacological methods and the group that did not (median 10 [minimum 2-maximum 10] versus 10 [minimum 6-maximum 10] p = 0.334).

CONCLUSION

 In a real-life setting, there was no difference in labor pain intensity between the patients who used nonpharmacological methods and those who did not use them during the active phase of labor.

Effects of Heat and Massage Applications to the Lumbosacral Area on Duration of Delivery and Perception of Labor Pain: A Randomized Controlled Experimental Trial

Objective: This study was carried out to determine the effects of massage and hot-pack applications in the first stage of labor on perceptions of labor pain and duration of delivery. Methods: This randomized controlled experimental trial was conducted in an obstetrics and pediatrics hospital. The research sample comprised 120 pregnant women, 40 of whom were in the massage group, 40 of whom were in the hot-pack application group, and 40 of whom were in the control group. Patient identification forms, labor process monitoring forms, and a visual analogue scale (VAS) were used to collect data. Results: It was determined that the massage and hot-pack applications shortened the durations of the active and transition phases of labor. The massage and hot-pack applications also reduced perceptions of pain in the active and transition phases. Mean VAS scores of the massage and hot-pack application groups were lower than those of the control group (p

A comparison of the effect of Swedish massage with and without chamomile oil on labor outcomes and maternal satisfaction of the childbirth process: a randomized controlled trial

PURPOSE OF STUDY

Massage is widely used as a traditional technique during labor and delivery. The aim of this study was to evaluate the effect of Swedish massage with and without chamomile oil on delivery outcomes.

METHODS

The present study was a randomized clinical trial on 154 primiparous pregnant women who were selected by random sampling method and divided into 3 groups: massage with chamomile oil (n = 53), massage without chamomile oil (n = 51), and control group (n = 50). Data collection tools included demographic and delivery information questionnaire, Visual Analogue Scale (VAS), maternal satisfaction with delivery scale, and Partograph form. In the two intervention groups, Swedish massage techniques (i.e., Effleurage, Petrissage, Vibration, and Superficial stroke) were performed with and without the use of chamomile oil since the active phase of labor (5 cm dilatation), while the control group received only routine labor care during labor.

RESULTS

Swedish massage with chamomile oil significantly reduced the labor pain score, reduced the length of active phase and the second stage of labor, and increased the score of maternal satisfaction with the labor process (P < 0.001). In addition, there was a significant relationship between the type of study groups and the type of delivery (P < 0.043).

CONCLUSION

The results of the study showed that using Swedish massage techniques with or without chamomile oil can improve labor outcomes. Swedish massage using chamomile oil was associated with better results compared to the same massage without using chamomile oil. Clinical trial code IRCT20200513047430N1.

The Effect of Listening to the Recitation of the Surah Al-Inshirah on Labor Pain, Anxiety and Comfort in Muslim Women: A Randomized Controlled Study

This study aimed to identify whether listening to the recitation of the Surah Al-Inshirah (94th Chapter of the Holy Qur'an) during labor had any effect on women's pain, anxiety and comfort levels. Designed as a randomized controlled trial, the study was performed with the participation of 126 pregnant Muslim women. The study showed that listening to the recitation of the Surah Al-Inshirah during labor had positive effects on the women's pain, anxiety and comfort levels. In this respect, it is recommended that based on individuals' religious beliefs, spiritual elements such as surahs, prayers and hymns be integrated into the midwifery care offered during labor.