The Effect of Ice Massage Applied to the SP6 Point on Labor Pain, Labor Comfort, Labor Duration, and Anxiety: A Randomized Clinical Trial.

INTRODUCTION: Acupressure and cold application are nonpharmacologic methods that midwives can use for labor pain. The purpose of this study was to determine the effects of ice massage applied to the SP6 acupressure point during labor on labor pain, labor comfort, labor duration, and anxiety. METHODS: A single-masked, randomized controlled trial was conducted with 100 nulliparous women, including 50 in the intervention group and 50 in the control group. Rotational ice massage was applied to the SP6 point on both legs of the pregnant women in the intervention group at 4 to 5 cm, 6 to 7 cm, and 8 to 9 cm dilation amounts during 3 contractions. Routine oxytocin was administered to all pregnant women to promote progress of labor. Standard midwifery care was provided to the control group. Data were collected using a Personal Information Form, the Visual Analog Scale (VAS), a partograph form, the Childbirth Comfort Questionnaire (CCQ), and the State-Trait Anxiety Inventory State subscale. RESULT: The VAS pain scores of the pregnant women in the intervention group were significantly lower compared with the control group following the intervention at dilatations of 4 to 5 cm, 6 to 7 cm, and 8 to 9 cm (P = .001, P = .003, P <.001, respectively). The total CCQ and comfort level scores of the pregnant women in the intervention group at 8 to 9 cm cervical dilatation were significantly higher than the control group (P = 0.044, P = .027, respectively). Additionally, as the anxiety levels of the pregnant women increased, their total comfort scores decreased (P <.05). DISCUSSION: Ice application to the SP6 point during stage 1 of childbirth reduced labor pain, increased comfort, and reduced anxiety levels. No adverse events were found in the intervention group with ice massage applied to the SP6 point. Therefore, this method can be used as a safe and effective midwifery intervention in childbirth.

The Effect of Perineal Warm Application on Perineal Pain, Perineal Integrity, and Postpartum Comfort in the Second Stage of Labor: Randomized Clinical Trial.

BACKGROUND: Protection of perineum and reduction of perineal pain is important in the second stage of labor. AIM: The aim of this study was to determine the effect of perineal warm application on perineal pain, perineal integrity, and postnatal comfort in the second stage of labor. METHODS: A single blind randomized and controlled experimental study was conducted with a total of 100 primiparous pregnant women in the warm application (n = 50) and control groups (n = 50). The warm application group was given a damp and warm application to the perineal region during the second stage of labor and only the standard midwifery care was given to the control group. Pregnant Introductory Form was used in the collection of data. Perineal pain level was measured prior to and after the intervention, after delivery, and 2 h from delivery by means of Visual Analogue Scale. In the postpartum period, the perineal condition was evaluated by the midwife with Questionnaire to Determine the Perineal Condition. Two hours from the delivery, Postpartum Comfort Questionnaire was used to determine the comfort level of the women. RESULTS: It was found that there was a decrease in the pain levels of the warm application group compared to pre-intervention pain levels (p < 0.0001). When the warm application and control groups were compared, we found statistically significant differences between the pain levels immediately after the intervention (perineal pain: 8.54 ± 1.38 vs. 9.56 ± 0.57, p < 0.0001), after delivery (perineal pain: 2.20 ± 1.72 vs. 3.64 ± 2.07, p < 0.0001), and 2 h after delivery (perineal pain: 0.30 ± 0.78 vs. 0.68 ± 0.98, p = 0.028). In the study, the intactness of perineum was found to be significantly higher in the warm application group compared to the control group (p = 0.003). The suture need for perinea was significantly higher in the control group than in the warm application group (p = 0.016). In the study, the physical comfort level of the warm application group was found to be significantly higher than the control group (56.06 ± 4.61 vs. 54.30 ± 4.73, p = 0.012). CONCLUSIONS: In the second stage of labor, it was found that the application of warmth decreases perineal pain, maintains the perineal integrity, and improves postpartum comfort.

Effect of Focusing on Maryam's Flower During the First Stage of the Labor on the Labor Pain, Labor Duration, and Levels of Comfort and Satisfaction.

This randomized controlled experimental study was conducted with an intervention group (n = 61) and a control group (n = 63) consisting of primipara pregnant women. The pregnant women in the intervention group were asked to focus their attention on Maryam's flower opening its leaf buds and imagine the labor's progress during the course of their labor. The VAS was administered to each group at specific times (at 4-5 cm, 6-7 cm, 8-9 cm cervical dilatation) to determine their level of labor pain. A statistically significant difference was found between the groups' mean pain scores at 4-5 cm, 6-7 cm, and 8-9 cm cervical dilatation (p < .05). The labor duration of the pregnant women in the intervention group was significantly shorter than that of the pregnant women in the control group (p = .017). The physical comfort level of the intervention group was significantly higher than that of the control group at 8-9 cm cervical dilatation (p = .039).