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

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.