Effect of acupressure on childbirth outcomes in nulliparous women: A randomized clinical trial

Non-pharmaceutical method is one of the conventional methods of reducing labor pain. Acupressure is suggested as an effective method for reducing labor pain with favorable effects on the outcome of childbirth. Different acupressure methods are suggested for this purpose; the most effective one has to be investigated. Therefore, the present study compared the effect of two of the most effective acupressure methods, namely lumbar rotation in a standing position and the 6^th splenic point (SP6) acupressure, in the active phase of labor on pain intensity, duration of labor, and childbirth experience among nulliparous women.

In this semi-experimental randomized clinical trial, 126 nulliparous women in Bint Al-Huda Hospital, Bojnourd, Iran, February-June 2021, were enrolled (by convenient sampling based on the inclusion criteria) and assigned to two interventions and a control group (no intervention). Baseline pain intensity was measured by VAS at a dilatation of 4 cm, immediately after intervention, and at dilation of 8 cm. Group "A" received lumbar rotation in standing position and group "B" received SP6 acupressure; once at 4 and once at 8 cm dilatation. The length of the active phase and the second stage of labor and the total duration of labor were calculated in minutes. The mothers completed the Walker Birth Experience Questionnaire within 2 h after the labor. Mean values were compared using the one-way analysis of variance (ANOVA, for three groups, with posthoc tests for significant differences) and independent samples t-test (for two groups) using SPSS v.16 and considered significant at P values < 0.05.

After the intervention, groups A and B had a lower mean pain intensity (5.80 ± 1.83 and 4.82 ± 2.14, respectively) than the control group (7.70 ± 1.91, P < 0.001) and after the second intervention (8.06 ± 1.55, 7.68 ± 1.60, 9.92 ± 0.36 in groups A, B, and control, respectively; P < 0.001). Labor duration was longer in the control group (228.11 ± 82.31 min active phase; 58.38 ± 23.86 min second stage, and 372.92 ± 114.41 min total) than group B (180.66 ± 60.68, 40.00 ± 18.56, and 310.39 ± 89.66 min, respectively, P < 0.05). The mean total birth experience scores were lower in the control group (63.59 ± 6.59), compared with those in groups A and B (73.14 ± 7.95 and 72.84 ± 8.29, respectively, P < 0.001), and in three dimensions of own capacity, perceived safety, and participation (P < 0.05).

Lumbar rotation in the standing position and SP6 acupressure had a positive effect on pain intensity, duration of labor, and birth experience.