The most appropriate cervical dilatation for massage to reduce labor pain and anxiety: a randomized clinical trial.
Study Goal
The researchers aimed to determine the optimal cervical dilatation (5 cm, 7 cm, or 9 cm) for performing massage to reduce labor pain and anxiety in nulliparous women.
Results Summary
Massage significantly reduced pain intensity at 7 cm cervical dilatation (p < 0.0001) and significantly decreased maternal anxiety (from severe to moderate). No significant pain reduction was observed at 5 cm or 9 cm dilatation.
Population
60 nulliparous pregnant women in the active phase of labor.
Effective Dosage
Massage performed three times (at 5 cm, 7 cm, and 9 cm cervical dilatation) for 20 minutes each session.
Duration
Duration of labor (intervention administered during active phase).
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
massage | decrease | pain intensity | nulliparous pregnant women | - | effectively decreased | #1 |
massage | decrease | difference between the mean pains | nulliparous pregnant women | p < 0.0001 | was significant | #2 |
massage | no change | difference between the mean pains | nulliparous pregnant women | p = 0.084 | was not significant | #3 |
massage | no change | difference between the mean pains | nulliparous pregnant women | p = 0.591 | was not significant | #4 |
massage | no change | mean maternal anxiety | nulliparous pregnant women | - | was not significant | #5 |
massage | decrease | mean maternal anxiety | nulliparous pregnant women | p < 0.0001 | was significant | #6 |
massage | decrease | anxiety score | nulliparous pregnant women | from 63.36 ± 5.28 (severe anxiety) to 42.60 ± 5.83 (moderate anxiety) | decreased | #7 |
routine care (except massage) | increase | anxiety score | nulliparous pregnant women | from 66.33 ± 7.66 to 67.1 ± 5.65 | increased | #8 |
BACKGROUND: Managing labor pain by performing massage is one of the useful strategies to reduce the rate of cesarean section and increase the tendency of women for pregnancy. Therefore, it is necessary to determine the best time for massage therapy to reduce the labor pain and anxiety. In this regard, the present study was conducted to determine the cervical dilatation appropriate for performing massage in order to reduce the labor pain and anxiety. METHODS: This randomized clinical trial study was conducted on 60 nulliparous pregnant women. Eligible participants with active phase of labor were divided randomly into two groups. The intervention group received the massage three times in of dilatation 5-7-9 cm for 20 min each time by same person without the use of oil in the LDR, based on Kimber massage instructions. In the control group, all routine care was performed except massage. Pain intensity was assessed using pain ruler. Demographic and anxiety data were collected through questionnaires. RESULTS: The difference between the mean pains in the studied groups was significant in 7 cm (p < 0.0001) of cervical dilatation but was not significant in 5 cm (p = 0.084) and 9 cm (p = 0.591) dilatation. Massage effectively decreased pain intensity. The mean maternal anxiety was not significant at the beginning of the study, but was significant after performing massage (p < 0.0001) and anxiety score in the massage group decreased from 63.36 ± 5.28 (severe anxiety) at the beginning to 42.60 ± 5.83 (moderate anxiety) at the end of the study. In the control group, it increased from 66.33 ± 7.66 to 67.1 ± 5.65. CONCLUSION: The appropriate dilatation of cervix for massage in order to reduce labor pain was observed in 7 cm. Also, massage had a significant effect on reducing anxiety. Therefore, massage is recommended as a routine care in 7 cm cervical dilatations. TRIAL REGISTRATION: This trial was registered with the Iran Trial Center (trial ID: IRCT20140118016255N5). https://en.irct.ir/trial/28120.