Labor Pain

Özden Tandoğan et al. (2024) · Medicine

This randomized controlled trial with 113 first-time mothers explored whether the rebozo technique — a traditional Mexican bodywork practice using a long woven shawl to rock, sway, and reposition a laboring woman's body — could ease labor pain and improve the overall birth experience. The technique comes from Mexican folk obstetric care, where practitioners use rhythmic shawl movements to help relax the body and support positional changes, working on the idea that gentle external movement and steady physical support help labor progress more comfortably. Researchers compared it directly against a relaxing massage, a widely used comfort measure, to see whether rebozo offered any added benefit. The trial ran at a hospital in Istanbul, Turkey, from January to May 2021, enrolling 113 healthy, first-time mothers between 37 and 41 weeks pregnant who arrived in labor with at least 4 cm of cervical dilation. Fifty-eight women received the standardized rebozo technique from trained personnel; 55 received a relaxing massage instead. Labor pain was tracked at three labor stages using the 0-10 Visual Analog Scale (VAS, a simple self-rated pain-intensity score), and after birth, women rated their experience on a four-part scale covering decision-making involvement, the labor process itself, professional support received, and feelings of safety. Women in the rebozo group reported consistently lower pain throughout labor: VAS scores were 3.2 versus 5.0 in the early (latent) phase, 4.5 versus 6.5 in the active phase, and 5.8 versus 7.9 in the transition phase (rebozo versus control). Their overall childbirth experience score was also markedly higher — 68.5 versus 51.6 (P < .001, meaning this gap is very unlikely to be due to chance) — with gains across all four subdimensions, including feeling more involved in decisions and safer during labor. Labor also moved differently: the second stage of labor was roughly half as long for the rebozo group (about 16 minutes versus 32 minutes, P < .001), and active-phase cervical dilation progressed at a different pace (6.03 cm versus 6.68 cm, P < .001). Not every measure differed — fetal heart rate and head station were similar between groups throughout, suggesting the technique did not affect fetal well-being indicators. For expectant mothers and birth attendants, these results suggest the rebozo technique is a low-cost, equipment-light way to potentially ease pain and improve satisfaction during labor, alongside or instead of standard massage. Because participants and staff could not be blinded to which technique was used, and the study was conducted at a single center with practitioners of varying rebozo experience, the results should be confirmed in larger, multicenter trials with blinded assessors before the technique is recommended as routine intrapartum care.

Hestri Norhapifah et al. (2024) · International journal of community based nursing and midwifery

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.