Massage, reflexology and other manual methods for pain management in labour [Intervention Review]

Caroline A. Smith, Kate M. Levett, Carmel T. Collins, Hannah G. Dahlen, Carolyn C. Ee, Machiko Suganuma

Research output: Contribution to journalArticlepeer-review

39 Citations (SciVal)

Abstract

This review is an update of the review first published in 2012. It looked at whether massage, reflexology and other manual therapies would help with reducing pain and improve women’s experiences of childbirth. We collected and analysed all the relevant trials to answer this question (search date: 30 June 2017). Why is this important? The pain of labour can be intense, with tension, anxiety and fear making it worse. Many women would like to labour without using drugs such as narcotics or epidurals, and are interested in complementary therapies to help them manage the pain of labour. In this review we have looked to see if massage, reflexology and other manual methods are effective. Other complementary therapies like acupuncture, mind-body techniques, hypnosis and aromatherapy have been studied in other Cochrane reviews. Massage involves manipulating the body’s soft tissues and it can be done by the midwife or partner. It helps women relax and so reduces tension which in turn may reduce pain in labour. Reflexology is gentle manipulation or pressing on certain parts of the foot to produce an effect elsewhere in the body. Other manual methods include warm packs, osteopathy, shiatsu and zero balancing. It is important to examine if these therapies work and are safe, to enable women to make informed decisions about their care. What evidence did we find? This updated review now includes 14 trials. We were able to use data from 10 of the trials, involving a total of 1055 women. We found no trials on reflexology, osteopathy, shiatsu and zero balancing therapy. In the various included trials, massage was given either by the woman’s birth companion, a student midwife, a physiotherapist or a massage therapist (though some trials did not report who gave the massage). Three trials involved a two- to three-hour prebirth course attended by women and their partners, and delivered by a qualified practitioner. In three trials, the intervention was delivered by a qualified health practitioner (massage therapist, physiotherapist or nurse/researcher with unspecified qualifications). In one trial, nurses taught women’s partners in the labour ward. There was insufficient reporting of the qualifications of the practitioner teaching massage. We found that massage and thermal packs, in comparison to usual care or music, may help women manage labour pain intensity during the first stage when the cervix is dilating. However, the quality of this evidence was very low. The effects of massage on assisted vaginal birth, caesarean section rate, the length of labour and use of drugs for pain relief were less clear, and the quality of the evidence was also very low. Two small trials showed increased satisfaction with childbirth, and a greater sense of control for women receiving massage. Warm packs were associated with reduced pain in the first stage of labour and reduced length of labour (very low-quality evidence).
Original languageEnglish
Article numberCD009290
Number of pages96
JournalCochrane Database of Systematic Reviews
Volume2018
Issue number3
DOIs
Publication statusPublished - 2018

Keywords

  • childbirth
  • massage
  • pain management
  • pregnancy
  • reflexology (therapy)

Fingerprint

Dive into the research topics of 'Massage, reflexology and other manual methods for pain management in labour [Intervention Review]'. Together they form a unique fingerprint.

Cite this