The Impact of Shiatsu Massage on Labour Pain and Anxiety: A Randomized Controlled Trial.

The short version

This randomized controlled trial with 80 first-time mothers tested whether shiatsu — the Japanese finger-pressure massage technique — can ease pain and anxiety during childbirth. Conducted across four low-risk maternity clinics in Samarinda, Indonesia, the study speaks directly to the many birth settings worldwide where epidurals and pain medications are scarce and midwives' hands are the main resource available. Women were randomized to receive shiatsu from certified midwives following standardized protocols, or standard care alone. Pain was scored on the 0–10 Numeric Rating Scale and anxiety on the Hamilton Anxiety Rating Scale at three moments: before the intervention, during early (latent) labour, and at the transition phase — the stage just before pushing, when contractions peak in intensity. What makes the results striking is the direction of travel. In the control group, pain did what labour pain does: it climbed, from 6.85 to 8.85 out of 10 by transition. In the shiatsu group, starting from the identical 6.85, pain fell — to 4.78 by transition (p<0.001). That is a four-point gap at labour''s hardest moment. Anxiety followed the same split: down from 28.5 to 20.7 on the Hamilton scale with shiatsu, up from 25.6 to 31.7 without it (p<0.001). No safety problems were reported for mothers or babies, and the intervention required nothing beyond trained hands and a repeatable protocol. For expectant mothers and midwives, this trial adds solid evidence that skilled pressure massage genuinely changes the experience of labour — not by numbing pain like a drug, but by reversing its expected escalation while calming the anxiety that amplifies it. The honest caveats: massage cannot be blinded, so comfort from focused human touch and attention is part of the package; the comparator was usual care rather than sham massage; and the participants were low-risk first-time mothers in one city, so high-risk pregnancies need separate study.

Key findings

• This trial randomized 80 first-time mothers in Indonesian maternity clinics to shiatsu massage from certified midwives or standard care during labour.
• Without massage, pain climbed from 6.85 to 8.85 out of 10 as labour reached the transition phase - the normal trajectory of first births.
• With shiatsu, pain moved the opposite way, falling from 6.85 to 4.78 by transition (p<0.001) - a four-point difference at labour's most intense stage.
• Anxiety split the same way: down 8 points on the Hamilton scale with shiatsu, up 6 points without it.
• Shiatsu was safe and required only trained hands and a protocol, making it especially valuable in settings with limited access to pharmaceutical pain relief.

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