Efficacy of non-pharmacological interventions for labor pain reduction: A systematic review and meta-analysis

Amani A. Mohammed(1), Zahara H. Hazazi(2), Bandar N. Alhumaidi(3), Shadaid Alanezi(4), Fares Alshammari(5), Alanoud Alobaidly(6), Daniel M. Mamanao(7), Amal zaman(8), Manal H. Suliman(9), Afaf AA. Abdalla(10), Nagat SY. Eltaher(11), Warda E. Hamed(12), Amani AE. Taha(13), Ghadeer AM. Sharawi(14), Veerabhadra Swamy(15), Hammad A. Fadlalmola(16),


(1) Department of Nursing, College of Nursing and Health Sciences, Jazan University, Saudi Arabia
(2) Department of Nursing, College of Nursing and Health Sciences, Jazan University, Saudi Arabi
(3) Department of Community health nursing, Taibah University, Saudi Arabia
(4) College of Applied Medical Sciences, University of Hafr Albatin, Saudi Arabia
(5) College of Applied Medical Sciences, University of Hafr Albatin, Saudi Arabia
(6) College of nursing and health sciences, Flinders University, Australia
(7) Department of Community health nursing, Taibah University, Saudi Arabia
(8) Department of obstetrics and gynecology, College of Medicine, Taibah University, Saudi Arabia
(9) Department of Nursing, College of Nursing and Health Sciences, Jazan University, Saudi Arabi
(10) Department of Nursing, College of Nursing and Health Sciences, Jazan University, Saudi Arabi
(11) Department of Nursing, College of Nursing and Health Sciences, Jazan University, Saudi Arabi
(12) Department of Nursing, College of Nursing and Health Sciences, Jazan University, Saudi Arabi
(13) Department of Nursing, College of Nursing and Health Sciences, Jazan University, Saudi Arabi
(14) Department of Nursing, College of Nursing and Health Sciences, Jazan University, Saudi Arabi
(15) Department of Nursing Sciences, College of Applied Medical Sciences, University of Bisha, P.O. Box 551, Bisha 61922, Saudi Arabia
(16) Department of Community health nursing, Taibah University, Saudi Arabia
Corresponding Author

Abstract


Labor pain is often managed with pharmacological interventions, which can lead to several adverse effects for mothers and neonates. Consequently, non-pharmacological interventions are gaining attention as safer alternatives for pain relief during labor. This systematic review aimed to assess the effectiveness of non-pharmacological methods in reducing labor pain. A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Cochrane Library databases up to September 2024. Only randomized controlled trials (RCTs) evaluating non-pharmacological interventions for labor pain relief were included, with pain intensity during cervical dilatation as the primary outcome. Data synthesis was performed using RevMan (V5.3). Seventy-seven RCTs involving 8,805 pregnant women were analyzed. The results indicated that non-pharmacological methods significantly reduced pain at 3-4 cm cervical dilatation compared to control groups (M.D. = -1.63, 95% C.I. [-2.05 to -1.21], P < 0.0001). Notably, subgroup analysis showed that body acupressure (M.D. = -2.08, 95% C.I. [-2.76 to -1.40], P < 0.0001) and foot reflexology (M.D. = -2.48, 95% C.I. [-2.84 to -2.13], P < 0.0001) were particularly effective. High heterogeneity (I² > 90%) was noted, partly reflecting differences in intervention types, protocols, and participant characteristics. Overall, non-pharmacological interventions provided substantial relief in labor pain compared to standard care, suggesting their potential utility in obstetric practice. Further large-scale studies are warranted to confirm these findings

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