AIM: The aim of this study was to determine the effects of sacral massage and heat application on the perceptions of labor pain and comfort level in pregnant women. METHODS: This was a quasi-randomized controlled experimental study. The data were collected under three groups in 2016: the heat application group (HAG), the massage group (MG), and the control group (CG). Each group included 30 primiparous pregnant women (range of age: 17-35) whose cervix was dilated to 4-5 cm. At 4-5 cm, 6-7 cm, and 8-9 cm cervical dilation, sacral massage was applied to MG, and sacral heat application was applied to HAG. Each group received standard midwifery care during labor. The data were collected using the Childbirth Comfort Questionnaire (CCQ) and the Numerical Rating Scale (NRS). The data were analyzed by using the Chi-square test, the Friedman test, Paired sample t-test, ANOVA, the Kruskal-Wallis test, and Wilcoxon signed-ranks test RESULTS: The mean pain score in HAG (4.56±0.67) during 4-5 cm of cervical dilation was significantly lower than those in MG (5.03±1.06) or CG (5.23±0.72) (p < 0.05). The mean pain scores in HAG (6.80±0.7) and MG (7.30±0.8) during 6-7 cm of cervical dilation were significantly lower than that in CG (7.70±0.5) (p < 0.001). Moreover, a statistically significant difference was found between the mean CCQ total scores (HAG: 31.06±3.46, CG: 27.66±3.85, p < 0.05), mean CCQ physical comfort scores (HAG: 13.16±1.89, CG: 11.03±1.80, p < 0.001), mean CCQ relief comfort level score (HAG: 11.23±1.43, CG: 10.00±2.01, p < 0.05) and mean CCQ transcendence comfort level scores (HAG: 19.83±2.37, CG: 17.66±2.15, p < 0.05) and both HAG and CG during 8-9 cm of cervical dilation. CONCLUSIONS: Heat application and massage can be used as a safe and effective midwifery intervention to reduce the perception of pain in pregnant women and provide comfort during labor.