Delivery Pain and Postpartum Comfort

Effects of Acupressure and Shower Applied in the Delivery on the Intensity of Labor Pain and Postpartum Comfort

In this study was aimed that acupressure applied on the BL32 point and shower application reduced the intensity of labor pain experienced by the pregnant women in the active phase of labor and increased their postpartum comfort

Study Overview

• Status: Completed
• Conditions: Labor Pain; Hydrotherapy; Postpartum Period; Acupressure
• Intervention / Treatment: Other: Acupressure; Other: Shower

Detailed Description

Acupressure and shower are methods that can help reduce pain severity. This study thus aims to determine the effects of acupressure and shower on labour pain and postpartum comfort. This study was a randomized controlled trial (RCT). This study was the control group consisted of 40 pregnant women, while the experimental groups (acupressure and shower) consisted of 80 pregnant women in total. The experimental groups received routine labour care and either acupressure or showers upon reaching three cervical dilations (4-5, 6-7 and 8-10 cm). The control group only received routine labour care. A maternal information form (MIF), the Visual Analog Scale for Pain (VASP) and the Postpartum Comfort Questionnaire (PPCQ) were used to collect data. CONSORT checklist was used to report the current study.

• Study Type: Interventional
• Enrollment (Actual): 120
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey, 34180
    • Medipol University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 20 years to 40 years (Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: Female

Description

Inclusion Criteria:

• The inclusion criteria were being 20-40 years of age;
• Having a foetus in vertex presentation
• Having a foetus weighing 2.5-4 kg, as determined through ultrasonography
• Being primiparous
• Being between 37 and 42 gestational weeks with a single foetus
• Having planned to have a spontaneous vaginal delivery
• Not having used nonpharmacological pain control methods previously
• Having a cervical dilation less than 5 cm (Dabiri et al., 2014)
• Not having received analgesia or anaesthesia.

Exclusion Criteria:

• Were having a systemic disease during pregnancy (gestational diabetes, hypertension)
• Taking medication regularly
• Having a problem that prevented the woman from communicating
• Undergoing psychiatric treatment (pharmacotherapy or psychotherapy)
• Requiring an operative vaginal delivery (forceps, vacuum)
• Receiving pharmacological interventions for labour pain.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Acupressure group; In the acupressure uterine contractions were checked before the care application began. Acupressure was applied when the women's cervical dilation reached 4-5 cm, 6-7 cm and 8-10 cm. This method was applied 18 times during uterine contractions. The application stopped at the end of each contraction and resumed once another contraction started. No application was performed between contractions.	Other: Acupressure; A researcher sat behind the women to comfortably access the sacral area and be in the appropriate position. The researcher then applied deep rotational pressure on the BL32 points until her nail bed colour changed to prevent any discomfort in the participants
Experimental: Shower Group; The shower group, uterine contractions were checked before the care application began. A shower was applied when the women's cervical dilation reached 4-5 cm, 6-7 cm and 8-10 cm. This method was applied 18 times during uterine contractions. The application stopped at the end of each contraction and resumed once another contraction started. No application was performed between contractions.	Other: Shower; During uterine contractions, these participants took a shower while standing, with a researcher on hand to assist her (average time: 20 minutes). The water's temperature was between 22°C and 26°C.
No Intervention: Control group; The women in the control group underwent routine hospital care. They were administered neither pharmacological nor nonpharmacological methods to reduce labour pain.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Reduce labor pain	The participants were applicated acupressure, and shower as for birth pain. Pain has been evaluated with VASP.	Evaluation was done until delivery (on average between 8-12 hours)
Postpartum comfort levels	Postpartum comfort levels of the groups who received acupressure and shower in the postpartum period were evaluated.Postpartum comfort level has been evaluated with PPCQ.	2 hours after birth
A maternal information form	This form consisted of 13 items asking for the participants' sociodemographic characteristics	before birth
Visual Analog Scale for Pain (VASP)	This scale is a 0-10 cm ruler developed by Bond and Pilowsky (Hawker et al., 2011; Aslan and Öztürk, 2014; Kömürcü and Ergin, 2014; Bond and Pilowsky, 1996). VASP is a 10 cm ruler which assessment with "no pain" at one end and "worst pain" at the other end. A Turkish validity and reliability study of the VASP was performed by Aslan and Öztürk (Aslan and Öztürk, 2014; Kömürcü and Ergin, 2014; Aslan, 2004).	Evaluation was done until delivery (on average between 8-12 hours)
Postpartum Comfort Questionnaire (PPCQ)	The 48-item General Comfort Scale, developed by Kolcaba (Kolcaba, 1994), was first adapted into Turkish in 2008 by Kuğuoğlu and Karabacak, who also conducted a Turkish validity and reliability study on the scale (Kuğuoğlu and Karabacak, 2008). Based on the Turkish version of the GCS, Karakaplan and Yıldız (Karakaplan and Yıldız, 2010) developed the PPCQ. The PPCQ is a 5-point questionnaire with 34 items. Participants give items between 1 (strongly agree) and 5 points (strongly disagree). The lowest score possible is 34, and the highest score is 170, with higher scores indicating higher comfort levels.	2 hours after birth
Evalution labour pain	VASP was evaluated before and after acupressure and shower applications.	Evaluation was done until delivery (on average between 8-12 hours)
Evalution postpartum comfort	Postpartum Comfort levels were evaluated in the postpartum period.	2 hours after birth

Collaborators and Investigators

• Sponsor: Kırklareli University
• Investigators: Principal Investigator: AYCA SOLT KIRCA, Phd, Kırklareli University; Principal Investigator: DERYA KANZA GÜL, Md, Phd, Medipol University

Study record dates

Study Major Dates

• Study Start (Actual): May 15, 2019
• Primary Completion (Actual): January 25, 2020
• Study Completion (Actual): January 31, 2020

Study Registration Dates

• First Submitted: June 25, 2021
• First Submitted That Met QC Criteria: July 15, 2021
• First Posted (Actual): July 27, 2021

Study Record Updates

• Last Update Posted (Actual): July 27, 2021
• Last Update Submitted That Met QC Criteria: July 15, 2021
• Last Verified: July 1, 2021

More Information

Terms related to this study

• Keywords: labor pain; acupressure; midwife; shower; postpartum comfort
• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Labor Pain
• Other Study ID Numbers: KırklareliAS-4

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No