Nonpharmacological Methods Used in the Management of Labor Pain

Abstract views: 40 / PDF downloads: 23


  • Remziye GÜLTEPE



Birth, Labor Pain, Management of Labor Pain, Nonpharmacological Methods


Although childbirth is a physiological process for women, it also affects the health of the mother physically, spiritually and socially and is seen as a unique experience that is important for a woman's transition to the role of motherhood. The fears that pregnant women experience about childbirth can lead to the formation of fear and pain of childbirth along with physiological, hormonal and psychological changes. In cases where the pain during childbirth, which is a natural process, cannot be tolerated, the health of both the mother and the fetus can be negatively affected. Circulatory, respiratory, neuroendocrine and limbic systems are negatively affected in the mother, while complications due to hypoxia may be observed in the fetus. There are many complementary and alternative methods used in the management of birth pain and supported by clinacally controlled research. According to studies, it is emphasized that 73% of women worldwide use at least one nonpharmacological method to reduce pain during childbirth. These techniques: They can be grouped as applied techniques including physical stimulation, mental stimulation and relaxation techniques, position changes and breathing techniques. Studies have reported that with these methods used during birth, women's attention is directed to different areas during pain, their pain thresholds increase, they relax, the utero-placental circulation is relieved, and the perception of labor pain decreases. As a result, many studies have reported that the use of non-pharmacological methods in the management of labor pain is quite effective, but it has been determined that more studies are needed on some methods.

Author Biography

Remziye GÜLTEPE,




ACOG. (2006). American Collage of Obstetricians and Gynecologists Commitee on Obstetric Practice: ACOG Commitee Opinion. Analgesia and Cesarean Delivery rates. Obstetric Gynecology, 107,1487-1488.

Akdeniz, D. (2021). Lumbosakral Bölgeye Uygulanan İntradermal ve Subkutan Steril Su Enjeksiyonunun Doğumda Ağrı Algısı Üzerine Etkisi (Yüksek lisans tezi). YÖK Tez. (664582)

Altınayak Öztürk, S. (2020). Doğum Eyleminde Ele Uygulanan Farklı Akupresure Uygulamalarının Endorfin Seviyesi ve Doğum Ağrısı Algısı Üzerine Etkisi (Doktora tezi). YÖK Tez. ( 608292)

Amiri, P., Mirghafourvand, M., Esmaeilpour, K., Kamalifard, M. & Ivanbagha, R. (2019). The effect of distraction techniques on pain and stress during labor: A randomized controlled clinical trial. BMC Pregnancy Childbirth, 19(1), 534. https.// 10.1186/s12884-019-2683-y.

Anarado, A., Ali, E., Nwonu, E., Chinweuba, A. & Ogbolu, Y. (2015). Knowledge and willingness of prenatal women in Enugu Southeastern Nigeria to use in labour non- pharmacological pain reliefs. African Health Sciences, 15(2), 568- 575. 10.4314/ahs.v15i2.32

Beevi, Z., Low, W.Y. & Hassan, J. (2017). The effectiveness of hypnosis intervention for labor: An experimental study. Am J Clin Hypn, 60(2), 172-191. 10.1080/00029157.2017.1280659

Burns, E., Feeley, C., Hall, P.J. & Vanderlaan, J. (2022). Systematic review and meta analysis to examine intrapartum interventions, and maternal and neonatal outcomes following immersion in water during labour and waterbirth. BMJ Open, 12(7), e056517. 10.1136/bmjopen-2021-056517

Cohen, G. L. & Sherman, D. K. (2014). The psychology of change: Self-affirmation and social psychological intervention. Annual Review of Psychology, 65, 333-371. 10.1146/annurev-psych-010213-115137.

Conner, S.N., Trudell, A.S. & Conner, C.A. (2021). Chiropractic care for the pregnant body. Clin Obstet Gynecol, 64(3), 602-610. https:// 10.1097/GRF.0000000000000621

Corrigan, L., Moran, P., McGrath, N., Eustace-Cook, J.& Daly, D. (2022). The characteristics and effectiveness of pregnancy yoga interventions: A systematic review and meta-analysis. BMC Pregnancy Childbirth, 22(1), 250. https://

Çevı̇k, B. & Taşci, S. (2017). Akupres uygulamasının ağrı yönetimine etkisi. Sağlık Bilimleri Dergisi, 26(3), 257–261.

Declercq, E.R., Sakala, C., Corry, M.P. & S. Applebaum, A.S. (2014). Herrlich major survey findings of listening to mothers(SM) III: Pregnancy and birth: Report of the third national U.S. survey of women’s childbearing experiences. J Perinat Educ, 23(1), 9-16.

Erdoğan, Z.& Çınar, S. (2011). Reiki: Eski bir iyileştirme sanatı – modern hemşirelik uygulaması. Kafkas Journal of Medical Sciences, 2(1), 86-91.

Familiari, A., Neri, C., Passananti, E., Marco, G.D., Felici, F., Ranieri, E., Flacco, M.E….Lanzone, A. (2023). Maternal position during the second stage of labor and maternal-neonatal outcomes in nulliparous women: A retrospective cohort study. AJOG Glob Rep, 3(1), 100160. 10.1016/j.xagr.2023.100160

Fata, S. & Aluş Tokat, M. (2017). Fertilite desteği alan kadınların stresini azaltmada Hipnofertilite’nin kullanımı. DEUHFED, 10, 60-6.

Geçeli, M. (2022). Travayda Uygulanan Nefes Egzersizlerinin Gebenin Memnuniyetine ve Doğum Sürecine Etkisi (Yüksek Lisans Tezi). YÖK Tez. (734261)

Gueguen, J., Huas, C., Orri, M.& Falissard, B. (2021). Hypnosis for labour and childbirth: A meta-integration of qualitative and quantitative studies. Complement Ther Clin Pract, 43, 101380. 10.1016/j.ctcp.2021.101380

Guo, H., Que, M., Shen, J., Nie, Q., Chen, Y., Huang, Q. & Jin, A. (2022). Effect of music therapy combined with free position delivery on labor pain and birth outcomes. Appl Bionics Biomech, 11(2022), 2022. https://

Jahdi, F., Sheikhan, F., Haghani, H., Sharifi, B., Ghaseminejad, A., Khodarahmian, M. & Rouhana, N. (2017). Yoga during pregnancy: The effects on labor pain and delivery outcomes (A randomized controlled trial). Complement Ther Clin Pract, 27,1-4. 10.1016/j.ctcp.2016.12.002.

Kalder, M., Knoblauch, K., Hrgovic, I.& Münstedt, K. (2011). Use of complementary and alternative medicine during pregnancy and delivery. Arch Gynecol Obstet, 283(3), 475-482.

Kaplan, E. & Çevik, S. (2021). The effect of guided imagery and reflexology on pain intensity, duration of labor and birth satisfaction in primiparas: Randomized controlled trial. Health Care Women Int, 42(4-6), 691-709. 10.1080/07399332.2021.1880411

Kamjoo, A., Yabandeh, A. P., Shahi, A., & Dabiri, F. (2018). The effect of reflexology on labor pain and length among primiparous women: A randomized controlled trial. International Electronic Journal of Medicine, 7(1), 30–34.

Karabulutlu, Ö. (2014). Doğum ağrısı kontrolünde kullanılan non-farmakolojik yöntemler. Caucasian Journal of Sciencetley, 1(1),43-50.

Karkada, S.R., Noronha, J.A., Bhat, S.K., Bhat, P.& Nayak, B.S. (2023). Effectiveness of antepartum breathing exercises on the outcome of labour: A randomized controlled trial. F1000Res, 30,(11)159. 10.12688/f1000research.

Kilci, Ş. & Sevil, Ü. (2021). Laktasyonu Arttıran Yöntemler: Hipnoemzirme. Ege Üniversitesi Hemşirelik Fakültesi Dergisi, 37 (3) , 229-234. 10.53490/egehemsire.637342

Kömürcü, N. (2014). Doğum ağrısı ve yönetimi. Nobel Tıp Kitabevi.

Lai, C.Y., Wong, M.K.W., Tong, W.H., Chu, S.Y., Lau, K.Y., Tan, A.M.L., Hui, L.L.,… Leung, T.Y. (2021). Effectiveness of a childbirth massage programme for labour pain relief in nulliparous pregnant women at term: A randomised controlled trial. Hong Kong Med J, 27(6), 405-412.

Lee, N., Gao, Y., Mårtensson, L.B., Callaway, L., Barnett, B. & Kildea, S. (2022). Sterile water injections for relief of labour pain (the SATURN trial): Study protocol for a randomised controlled trial. Trials, 23(1), 155. https:// 10.1186/s13063-022-06093-3.

Leutenegger, V., Grylka-Baeschlin, S., Wieber, F., Daly, D.& Pehlke-Milde, J. (2022). The effectiveness of skilled breathing and relaxation techniques during antenatal education on maternal and neonatal outcomes: A systematic review. BMC Pregnancy Childbirth, 22(1), 856.

Liao, C.C., Lan, S.H., Yen, Y.Y., Hsieh, Y.P.& Lan, S.J. (2021). Aromatherapy intervention on anxiety and pain during first stage labour in nulliparous women: A systematic review and meta-analysis. J Obstet Gynaecol, 41(1), 21-31.

Mahmoudikohani, F., Torkzahrani, S., Saatchi, K.& Nasiri M. (2019). Effects of acupressure on the childbirth satisfaction and experience of birth: A randomized controlled trial. J Bodyw Mov Ther, 23(4), 728-732. 10.1016/j.jbmt.2019.04.002

Mazzarino, M., Morris, M.E.& Kerr, D. (2021). Pilates for low risk pregnant women: Study protocol for a randomized controlled trial. J Body Mov Ther, 25, 240-247. 10.1016/j.jbmt.2020.12.015.

Musie, M.R., Peu, M.D.& Bhana-Pema, V. (2022). Culturally appropriate care to support maternal positions during the second stage of labour: Midwives' perspectives in South Africa. Afr J Prim Health Care Fam Med, 14(1), e1-e9.

Neerland, C.E., Avery, M.D.& Saftner, M.A. (2019). Maternal confidence for physiologic birth: Associated prenatal characteristics and outcomes. Midwifery, 77, 110-116.

Njogu, A., Qin, S., Chen, Y., Hu, L.& Luo, Y. (2021). The effects of transcutaneous electrical nerve stimulation during the first stage of labor: A randomized controlled trial. BMC Pregnancy Childbirth, 21(1), 164. 10.1186/s12884-021-03625-8

Özkan, B. (2006). Türkçede dilbilgisel terim olarak “olumlama” ve “olumsuzlama”. Çukurova Üniversitesi Sosyal Bilimler Enstitüsü Dergisi, 15(1), 269-282.

Öztürk, R., Emi̇nov, A. & Ertem, G. (2022). Use of complementary and alternative medicine in pregnancy and labour pain: A cross-sectional study from Turkey. BMC Complement Med Ther, 22, 332.

Pettigrew, J. (2014). Utilizing chiropractic for optimal pregnancy and birth outcomes. Midwifery Today Int Midwife, 110, 56-7.

Reis, C.C.S.D., Dias, L.D.C., Carvalho, L.B., Junior, L.B.A. & Imoto, A.M. (2022). Transcutaneous nerve electrostimulation (TENS) in pain relief during labor: A Scope Review. Rev Bras Ginecol Obstet, 44(2),187-193. 10.1055/s-0042-1742290.

Rosmiarti, R., Marlin, R. & Murbiah. (2020). Reduction of labour pain with back massage. Enfermería Clinica, 30(5), 209–212.

Sağlık İstatistikleri Yıllığı 2021 Haber Bülteni. (2022). Erişim Adresi: Erişim Tarihi: 26.11.2023)

Schlaeger, J.M., Gabzdyl, E.M., Bussell, J.L., Takakura, N., Yajima, H., Takayama, M.& Wilkie, D.J. (2017). Acupuncture and acupressure in labor. J Midwifery Womens Health, 62(1), 12-28.

Schlesinger, Y., Hamiel, D., Rousseau, S., Perlman, S., Gilboa, Y., Achiron, R.& Frenkel, T.I. (2022). Preventing risk for posttraumatic stress following childbirth: Visual biofeedback during childbirth increases maternal connectedness to her newborn thereby preventing risk for posttraumatic stress following childbirth. Psychol Trauma, 14(6), 1057-65. https:// 10.1037/tra0000558

Serhatlıoğlu Göncü, S., Karahan, N. (2018). Doğum memnuniyeti ve etkileyen faktörler. Uluslararası Hakemli Kadın Hastalıkları ve Anne Çocuk Sağlığı Dergisi, 5 (12), 75-91. 10.17367/JACSD.2018.1.8

Sevil, Ü., Ertem, G. (2016), Perinatoloji ve Bakım. Nobel Tıp Kitabevleri.

Sidebottom, A.C., Vacquier, M., Simon, K., Wunderlich, W., Fontaine, P., Dahlgren-Roemmich, D., Steinbring, S., …Saul, L.(2020). Maternal and neonatal outcomes in hospital-based deliveries with water immersion. Obstet Gynecol, 136(4), 707-715. 10.1097/AOG.0000000000003956

Smith, C.A., Collins, C.T., Levett, K.M., Armour, M., Dahlen, H.G., Tan, A.L.& Mesgarpour B. (2020). Acupuncture or acupressure for pain management during labour. Cochrane Database Syst Rev, 2(2), CD009232. 10.1002/14651858.CD009232.pub2

Srisopa, P., Cong, X., Russell, B.& Lucas, R. (2021). The role of emotion regulation in pain management among women from labor to three months postpartum: An ıntegrative review. Pain Manag Nurs, 22(6),783-790. https://doi: 10.1016/j.pmn.2021.05.011

Steel, A., Adams, J., Sibbritt, D., Broom, A., Frawley, J. & Gallois, C. (2014). The influence of complementary and alternative medicine use in pregnancy on labor pain management choices: Results from a nationally representative sample of 1,835 women. The Journal of Alternative and Complementary Medicine, 20(2),87-97.

Tabatabaeichehr, M.& Mortazavi, H. (2020). The effectiveness of aromatherapy in the management of labor pain and anxiety: A systematic review. Ethiop J Health Sci, 30(3), 449-458. 10.4314/ejhs.v30i3.16

Thomson, G., Feeley, C., Moran, V. H., Downe, S., & Oladapo, O. T. (2019). Women's experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: A qualitative systematic review. Reproductive health, 16(1), 71.

Traylor, C.S., Johnson, J.D., Kimmel, M.C.& Manuck, T.A. (2020). Effects of psychological stress on adverse pregnancy outcomes and nonpharmacologic approaches for reduction: An expert review. Am J Obstet Gynecol MF,. 2(4), 100229. 10.1016/j.ajogmf.2020.100229

Uzunlar, Ö., Özel, Ş., Tokmak, A.& Engin-Üstün, Y. (2017) Alternatif bir doğum yöntemi; faydaları ve riskleri ile suda doğum. Jinekoloji- Obstetrik ve Neonatoloji Tıp Dergisi, 14(4),187-191.

Whitburn, L. Y., Jones, L. E., Davey, M. A. & McDonald, S. (2019). The nature of labour pain: An updated review of the literature. Women and birth: journal of the Australian College of Midwives, 32(1), 28–38.

WHO, World Health Organization. (2021). Caesarean section rates continue to rise, amid growing inequalities in access. ( Erişim Tarihi:01.09.2023).

Yarıcı Atış, F. & Rathfisch, G. (2018). The effect of hypnobirthing training given in the antenatal period on birth pain and fear. Complementary Therapies in Clinical Practice, 33, 77-84.

Yılmaz Esencan, T.& Rathfisch, G. (2023). Effects of yoga and meditation on the birth process. Altern Ther Health Med, 29(1), 6-14.

Yüksel, H., Çayır, Y., Koşan, Z. & Taştan, K. (2017). Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: A randomized controlled trial. Journal of Integrative Medicine, 15(6), 456-461.

Zhu, Y., Wang, R., Tang, X., Li, Q., Xu, G.& Zhang A. (2021). The effect of music, massage, yoga and exercise on antenatal depression: A meta-analysis. J Affect Disord, 292, 592-602. 10.1016/j.jad.2021.05.122

Zuarez-Easton, S., Erez, O., Zafran, N., Carmeli, J., Garmi, G.& Salim R. (2023). Pharmacologic and nonpharmacologic options for pain relief during labor: An expert review. Am J Obstet Gynecol, S0002-9378(23)00145-X. 10.1016/j.ajog.2023.03.003



How to Cite

GÜLTEPE, R. (2024). Nonpharmacological Methods Used in the Management of Labor Pain. GEVHER NESIBE JOURNAL OF MEDICAL AND HEALTH SCIENCES, 9(1), 54–61.