Massage, reflexology and other manual methods for pain management in labour.
Study Goal
The researchers aimed to evaluate the effects of manual healing methods, specifically massage and reflexology, on pain management and maternal/perinatal morbidity during labor.
Results Summary
Massage was found to reduce pain during the first stage of labor compared to usual care and music, and it also decreased anxiety in one trial. However, no trial was rated as low risk of bias across all quality domains.
Population
Women in labor
Effective Dosage
Not specified
Duration
During the first stage of labor (specific duration not mentioned)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
massage | decrease | pain during labour | women | standardised mean difference (SMD) -0.82, 95% confidence interval (CI) -1.17 to -0.47 | Less pain during labour was reported | #1 |
massage | decrease | labour pain | women | risk ratio (RR) 0.40, 95% CI 0.18 to 0.89 | labour pain was reduced | #2 |
massage | decrease | anxiety during the first stage of labour | women | MD -16.27, 95% CI -27.03 to -5.51 | reduced anxiety during the first stage of labour | #3 |
massage | decrease | pain | women | - | may have a role in reducing pain | #4 |
massage | increase | emotional experience of labour | women | - | improving women's emotional experience of labour | #5 |
BACKGROUND: Many women would like to avoid pharmacological or invasive methods of pain management in labour, and this may contribute towards the popularity of complementary methods of pain management. This review examined currently available evidence supporting the use of manual healing methods including massage and reflexology for pain management in labour. OBJECTIVES: To examine the effects of manual healing methods including massage and reflexology for pain management in labour on maternal and perinatal morbidity. SEARCH METHODS: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 June 2011), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2011, Issue 2 of 4), MEDLINE (1966 to 30 June 2011), CINAHL (1980 to 30 June 2011), the Australian and New Zealand Clinical Trial Registry (30 June 2011), Chinese Clinical Trial Register (30 June 2011), Current Controlled Trials (30 June 2011), ClinicalTrials.gov, (30 June 2011) ISRCTN Register (30 June 2011), National Centre for Complementary and Alternative Medicine (NCCAM) (30 June 2011) and the WHO International Clinical Trials Registry Platform (30 June 2011). SELECTION CRITERIA: Randomised controlled trials comparing manual healing methods with standard care, no treatment, other non-pharmacological forms of pain management in labour or placebo. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trial quality and extracted data. We attempted to contact study authors for additional information. MAIN RESULTS: We included six trials, with data reporting on five trials and 326 women in the meta-analysis. We found trials for massage only. Less pain during labour was reported from massage compared with usual care during the first stage of labour (standardised mean difference (SMD) -0.82, 95% confidence interval (CI) -1.17 to -0.47), four trials, 225 women), and labour pain was reduced in one trial of massage compared with music (risk ratio (RR) 0.40, 95% CI 0.18 to 0.89, 101 women). One trial of massage compared with usual care found reduced anxiety during the first stage of labour (MD -16.27, 95% CI -27.03 to -5.51, 60 women). No trial was assessed as being at a low risk of bias for all quality domains. AUTHORS' CONCLUSIONS: Massage may have a role in reducing pain, and improving women's emotional experience of labour. However, there is a need for further research.