Effects of Hot Sacral Massage and Shower Application With Partner Support on Labor

Official title

The Effect of Hot Sacral Massage With Cherry Pits and Shower Application With Partner Support on Perceived Labor Pain, Birth Experience, and Birth Comfort

Overview

This study was designed to determine the effect of warm sacral massage with cherry pits and showering with partner support on perceived labor pain, birth experience, and birth comfort. A total of 150 pregnant women, 50 in each group, were planned to be included in the study. Volunteers who agreed to participate in the study were expected to have spontaneous vaginal delivery, with an ultrasound-estimated fetal weight between 2500-4000 grams, a single fetus in cephalic presentation, at term (between 37-42 weeks of gestation), in the active phase of labor (4 cm cervical dilation), primiparous women who did not receive analgesia or anesthesia during the first stage of labor and who did not have any skin disease or open wound that would prevent massage or showering. Pregnant women participating in the study will be randomly divided into three groups. The massage group will receive massage twice during the first stage of labor for at least 20 minutes, either standing or sitting, using a bag filled with cherry pits on the sacral region (the lumbar region including your tailbone). Pregnant women in the shower group will receive a shower with water at a temperature between 32-37°C for at least 20 minutes twice during the first stage of labor, either standing or sitting with partner support, according to their preference. Pregnant women in the control group will not receive any intervention other than the routine hospital protocol (midwifery care). After providing information about the study to the pregnant women, written informed consent will be obtained. The pain scale (VAS) will be administered to women in the shower group, massage group, and control group by a midwife working in the delivery room who is not involved in the study. The VAS will be administered four times during labor to pregnant women in the massage group and shower group, and four times to pregnant women in the control group. Before transfer to the ward after delivery, all participants in the groups will be administered the "Birth Experience Scale (BES) and Birth Comfort Scale (BCS)" by a midwife who is not involved in the study and is working in the delivery room that day.

Detailed description

This study aims to determine the effect of warm sacral massage with cherry pits and shower application with partner support on perceived labor pain, birth experience, and birth comfort. The study includes three groups: massage group, shower group, and control group. A total of 150 pregnant women, 50 in each group, were included in the study.

Steps for the Partner-Assisted Shower Application: Participants in this group will receive a shower administered by their partner in the delivery room (when dilation is 4-5 cm) for at least 20 minutes. The water temperature will be between 32-37 °C (the woman's preferred temperature will be used), and the shower will be administered to the lower back, abdomen, or entire body, depending on the woman's preference, while she is standing or sitting, under the observation of the researcher midwife. The application will be repeated when dilation reaches 7-8 cm. To ensure the safety of pregnant women before showering, non-slip sandals or slippers will be provided, and a non-slip bath mat will be placed under the stool. Blood pressure will be checked before and after showering.

Cherry Pit Hot Sacral Massage Group: The sacral massage will be performed using 20x20 cm pouches filled with cherry pits. The pouches will be cover-shaped, and 100% cotton fabric will be preferred. Each pregnant woman will receive a massage with a washed, clean pouch. Like the shower application, the massage will be performed upon admission to the delivery room (when dilation is 4-5 cm) and repeated when dilation is 7-8 cm. It will begin when contractions start and will last approximately 20 minutes.

Control group application steps: Participants in this group will not receive any application other than the routine hospital protocol (midwifery care).

The vital signs (blood pressure, pulse) of all pregnant women in the groups will be measured hourly by the midwife and recorded in each participant's file.

The VAS will be administered to women in the shower group, massage group, and control groups by a midwife working in the delivery room who is not involved in the study. The VAS will be measured four times during the first stage of labor for pregnant women in the shower and massage groups.

After delivery, before transfer to the ward, the "Birth Experience Scale (BES) and Birth Comfort Scale (BCS)" will be administered to all participants in the groups by a midwife who is not involved in the study and who is working in the delivery room that day.

Interventions

• Other Shower
  Participants in this group will receive a shower administered by their partner on their back, abdomen, or entire body while standing or sitting, with the water temperature maintained between 32-37°C (the woman's preferred temperature will be applied) for at least 20 minutes upon admission to the labor room (when dilation is 4-5 cm). This will be performed under the observation of the researcher midwife. The application will be repeated when dilation reaches 7-8 cm.
• Other Massage
  Sacral Massage Application will be performed using 20x20 cm pouches filled with cherry pits. Like the shower application, massage will be performed upon admission to the delivery room (when dilation is 4-5 cm) and repeated when dilation reaches 7-8 cm. Unless the pregnant woman requests otherwise, massage will be performed while she is in the left lateral position.
• Other Midwifery Care
  Care provided by a midwife in the delivery room

Primary outcome measures

• visual analog scale [Time frame: Before the shower and massage at 4-5 cm dilation, After the shower and massage at 4-5 cm dilation, Before the shower and massage at 6-8 cm dilation, After the shower and massage at 6-8 cm dilation. Control group: at 4-5 cm dilation and 6-8 cm dilation]

Secondary outcome measures (2)

• Childbirth Experience Questionnaire [Time frame: Before the transfer from the delivery room to the maternity ward after birth]
• Childbirth Comfort Questionnaire [Time frame: Before the transfer from the delivery room to the maternity ward after birth]

Eligibility criteria

Inclusion criteria

• Volunteering to participate in the study
• Expectation of spontaneous vaginal delivery
• Estimated fetal weight between 2500-4000 grams by ultrasound
• Single fetus and cephalic presentation,
• Term pregnancy (between 37-42 weeks of gestation)
• Being in the active phase of labor (cervical dilation of 4 cm)
• No analgesia or anesthesia used during the first stage of labor,
• No skin disease or open wound preventing massage or showering

Exclusion criteria

• Having undergone infertility treatment,
• Delivery by cesarean section for any reason during labor,
• Being multiparous
• Having any systemic, chronic, or neurological disease (Diabetes Mellitus, Hypertension, Thyroid disorders, Multiple Sclerosis, Epilepsy, etc.)
• Regular medication use due to any illness,
• Active psychiatric treatment (pharmacotherapy/psychotherapy),
• Any induction that may affect uterine contractions and dilation,
• Any pregnancy complications (such as placenta previa, preeclampsia, premature rupture of membranes, oligohydramnios, and polyhydramnios)
• Interventional delivery (forceps, vacuum)
• Any problem that hinders communication (such as not knowing Turkish, hearing, speech, and comprehension disorders)

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Supportive care

Study locations

Turkey (Türkiye) · 1 center

• Istanbul University-Cerrahpaşa — Istanbul

Identifiers

NCT: NCT07165405 · 12/32

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗