Pain management during labor has transitioned from traditional natural methods to modern pharmacological interventions, such as epidurals and opioids. While effective, these methods are associated with significant side effects and risks, driving interest in nonpharmacological pain management (NPPM) techniques such as acupressure, aromatherapy, massage, and water immersion. This systematic review evaluates the effectiveness, safety, and implementation challenges of these approaches.
A comprehensive search was conducted across five major databases (Scopus, PubMed, Web of Science, Cochrane Library, and Google Scholar) to identify studies published between January 2015 and July 2024. The review synthesized findings from 82 studies using a narrative approach, focusing on various NPPM techniques categorized into physical, psychological, and complementary or alternative methods.
The results highlight that techniques, such as water immersion and acupressure, consistently reduce labor pain and enhance maternal satisfaction. However, challenges, including insufficient healthcare provider training, resource limitations, and cultural perceptions, hinder the widespread adoption of NPPM strategies. These approaches offer distinct advantages over pharmacological methods, such as fewer side effects, enhanced maternal empowerment, and reduced medical interventions.
Despite their potential, the evidence for some NPPM techniques, particularly acupuncture and virtual reality, remains limited, underscoring the need for more randomized controlled trials. Additionally, standardizing protocols and addressing barriers in resource-limited settings are critical for promoting equitable access to safe and effective labor pain management worldwide.
Key words: Non-pharmacological pain management, labor pain, acupressure, aromatherapy, water immersion, childbirth
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