The Effect of Pelvic Rocking Exercise with a Birth Ball and SP6 Acupressure on Duration of the First and Second Stage of Labor

Karningsih Karningsih; Dwi Purwanti; Fauziah Yulfitria; Gita Nirmala Sari; Een Nuraenah

doi:10.14710/nmjn.v12i3.45589

DOI: https://doi.org/10.14710/nmjn.v12i3.45589

The Effect of Pelvic Rocking Exercise with a Birth Ball and SP6 Acupressure on Duration of the First and Second Stage of Labor

*Karningsih Karningsih

- Department of Midwifery, Polytechnic of Health of Jakarta III, Ministry of Health, Indonesia

Dwi Purwanti

- Department of Midwifery, Polytechnic of Health, Ministry of Health Surabaya, Indonesia

Fauziah Yulfitria

- Department of Midwifery, Polytechnic of Health of Jakarta III, Ministry of Health, Indonesia

Gita Nirmala Sari

- Department of Midwifery, Polytechnic of Health of Jakarta III, Ministry of Health, Indonesia

Een Nuraenah

- Department of Midwifery, Polytechnic of Health of Jakarta III, Ministry of Health, Indonesia

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

BibTex Citation Data :

@article{NMJN45589,
    author = {Karningsih Karningsih and Dwi Purwanti and Fauziah Yulfitria and Gita Sari and Een Nuraenah},
    title = {The Effect of Pelvic Rocking Exercise with a Birth Ball and SP6 Acupressure on Duration of the First and Second Stage of Labor},
    journal = {Nurse Media Journal of Nursing},
  volume = {12},
    number = {3},
    year = {2022},
    keywords = {Acupressure; birth balls; first stage of active labor; pelvic rocking exercise; second stage of labor},
    abstract = {  Background:  Long duration of labor increases the pain that a mother experiences. Several non-pharmacological methods, such as pelvic rocking exercises and SP6 acupressure, have been discovered to reduce pain and accelerate labor duration. It needs to be clarified which of the two methods is more effective.   Purpose:  This study aimed to assess the effectiveness of pelvic rocking exercise with a birth ball and SP6 acupressure in shortening the duration of the active phase in the first and the second stage of labor.   Methods:  This study used a quasi-experimental design involving 64 mothers in the first stage of normal delivery who were recruited using propensity score matching sampling. The participants were divided into two intervention groups (the pelvic rocking exercise with a birth ball and SP6 acupressure). Each respondent in the two intervention groups was monitored for progress of labor during the active phase in the first stage using a partograph starting from cervical dilatation of 4 cm to 10 cm. The duration of the second stage was assessed by calculating the length of time from cervical dilatation of 10 cm to the delivery of the entire baby. The Mann-Whitney U test was performed to assess the difference between the two interventions in the two stages of labor assessed.   Results:  There was a difference in the duration of labor in the first stage ( p =0.00) and the second stage ( p =0.001) between the groups given the pelvic rocking exercise with a birth ball and the SP6 acupressure. The pelvic rocking exercise with a birth ball was found to be more effective in shortening the duration of the active phase in the first stage (Mean rank=19.83) and the second stage of labor (Mean rank=24.56) compared to SP6 acupressure (Mean rank of the first stage=45.17 and Mean rank of the second stage=40.44).  Conclusion:  The pelvic rocking exercise was found to be more effective compared to SP6 acupressure in shortening the duration of the active phase in the first and the second stage of labor. Pelvic rocking exercise can be implemented to help accelerate labor duration so that mothers can feel more comfortable during the labor.},
   issn = {2406-8799},   pages = {380--389}  doi = {10.14710/nmjn.v12i3.45589},
    url = {https://ejournal.undip.ac.id/index.php/medianers/article/view/45589}
}

Citation Format:

Abstract

Background: Long duration of labor increases the pain that a mother experiences. Several non-pharmacological methods, such as pelvic rocking exercises and SP6 acupressure, have been discovered to reduce pain and accelerate labor duration. It needs to be clarified which of the two methods is more effective.

Purpose: This study aimed to assess the effectiveness of pelvic rocking exercise with a birth ball and SP6 acupressure in shortening the duration of the active phase in the first and the second stage of labor.

Methods: This study used a quasi-experimental design involving 64 mothers in the first stage of normal delivery who were recruited using propensity score matching sampling. The participants were divided into two intervention groups (the pelvic rocking exercise with a birth ball and SP6 acupressure). Each respondent in the two intervention groups was monitored for progress of labor during the active phase in the first stage using a partograph starting from cervical dilatation of 4 cm to 10 cm. The duration of the second stage was assessed by calculating the length of time from cervical dilatation of 10 cm to the delivery of the entire baby. The Mann-Whitney U test was performed to assess the difference between the two interventions in the two stages of labor assessed.

Results: There was a difference in the duration of labor in the first stage (p=0.00) and the second stage (p=0.001) between the groups given the pelvic rocking exercise with a birth ball and the SP6 acupressure. The pelvic rocking exercise with a birth ball was found to be more effective in shortening the duration of the active phase in the first stage (Mean rank=19.83) and the second stage of labor (Mean rank=24.56) compared to SP6 acupressure (Mean rank of the first stage=45.17 and Mean rank of the second stage=40.44).

Conclusion: The pelvic rocking exercise was found to be more effective compared to SP6 acupressure in shortening the duration of the active phase in the first and the second stage of labor. Pelvic rocking exercise can be implemented to help accelerate labor duration so that mothers can feel more comfortable during the labor.

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Keywords: Acupressure; birth balls; first stage of active labor; pelvic rocking exercise; second stage of labor

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In Vol 12, No 3 (2022): (December 2022)

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Abdollahpour, S., & Motaghi, Z. (2019). Lived traumatic childbirth experiences of newly delivered mothers admitted to the postpartum ward: A phenomenological study. Journal of Caring Sciences, 8(1), 23–31. https://doi.org/10.15171/jcs.2019.004
Akbarzadeh, M., Moradi, Z., Hadianfard, M. J., Zare, N., & Jowkar, A. (2013). Comparison of the effect of mono-stage and bi-stage acupressure at Sp6 point on the severity of labor pain and the delivery outcome. International Journal of Community Based Nursing and Midwifery, 1(3), 165–172. https://www.sid.ir/en/Journal/ViewPaper.aspx?ID=326536
Aswitami, N. G. A. P., & Septiani, N. G. A. P. (2020). Antenatal clinical hypnosis and birth ball exercise as adjunct therapy for management of labor and delivery pain: A summary of its empirical findings. Jurnal Midpro, 12(2), 233. https://doi.org/10.30736/md.v12i2.229
Bhandary, S. (2017). Increasing trend of caesarean section in patan hospital. Journal of General Practice and Emergency Medicine of Nepal, 6, 6–8
Borem, P., de Cássia Sanchez, R., Torres, J., Delgado, P., Petenate, A. J., Peres, D., Parry, G., Pilar Betrán, A., & Barker, P. (2020). A quality improvement initiative to increase the frequency of vaginal delivery in Brazilian hospitals. Obstetrics and Gynecology, 135(2), 415–425. https://doi.org/10.1097/AOG.0000000000003619
Bringedal, H., & Aune, I. (2019). Able to choose? Women’s thoughts and experiences regarding informed choices during birth. Midwifery, 77, 123–129. https://doi.org/10.1016/j.midw.2019.07.007
Câmara, R., Burlá, M., Ferrari, J., Lima, L., Amim Junior, J., Braga, A., & Rezende Filhos, J. (2016). Cesarean section by maternal request. Revista Do Colegio Brasileiro de Cirurgioes, 43(4), 301–310. https://doi.org/10.1590/0100-69912016004002
Charan, J., & Biswas, T. (2013). How to calculate sample size for different study designs in medical research? Indian Journal of Psychological Medicine, 35(2), 121–126. https://doi.org/10.4103/0253-7176.116232
Chen, H., Cao, L., Cao, W., Wang, H., Zhu, C., & Zhou, R. (2018). Factors affecting labor duration in Chinese pregnant women. Medicine (United States), 97(52), 1–8. https://doi.org/10.1097/MD.0000000000013901
Delgado, A., Maia, T., Melo, R. S., & Lemos, A. (2019). Birth ball use for women in labor: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice, 35, 92–101. https://doi.org/10.1016/j.ctcp.2019.01.015
Farrag, R. E. (2018). Using of birthing ball during the first stage of labor: its effect on the progress of labor and outcome among nulliparous women. International Journal of Nursing Didactics, 8(09), 1–10. https://doi.org/10.15520/ijnd.v8i09.2289
Grenvik, J. M., Rosenthal, E., Wey, S., Saccone, G., De Vivo, V., De Prisco, L. C. P., A., Delgado García, B. E., & Berghella, V. (2021). Birthing ball for reducing labor pain: A systematic review and meta-analysis of randomized controlled trials. Journal of Maternal-Fetal and Neonatal Medicine, 0(0), 1–10. https://doi.org/10.1080/14767058.2021.1875439
Hildingsson, I., Blix, E., Hegaard, H., Huitfeldt, A., Ingversen, K., Ólafsdóttír, Ó. Á., & Lindgren, H. (2015). How long is a normal labor? Contemporary patterns of labor and birth in a low-risk sample of 1,612 women from four nordic countries. Birth, 42(4), 346–353. https://doi.org/10.1111/birt.12191
Hulya, T., & Ceber, T. E. (2020). The effect of acupressure on labor pain and the duration of labor when applied to the SP6 point: Randomized clinical trial. Japan Journal of Nursing Science, 17(1), 1–9. https://doi.org/10.1111/jjns.12256
Kwan, W., Kwan, W. S., & Chan, S.-W. (2011). Evaluation of birth ball the birth ball experience: Outcome evaluation of the intrapartum use of birth ball. Hong Kong Journal of Gynaecology Obstetric and Midwifery, 11(1), 59–64
Lawrence, A., Lewis, L., Hofmeyr, G. J., & Styles, C. (2013). Maternal positions and mobility during first stage labour (review). Cochrane Database of Systematic Reviews, 2013(8), CD003934. https://doi.org/10.1002/14651858.CD003934.pub3
Makvandi, S., Khadigeh, M., Najmeh, T., Masoumeh, M., & Ramin, S. (2019). The impact of birth ball exercises on mode of delivery and length of labor: A systematic review and meta-analysis. Journal of Midwifery & Reproductive Health, 7(3), 1841–1850. https://doi.org/10.22038/jmrh.2019.33781.1367
Makvandi, S., Khadigeh, M., Ramin, S., Mitra, M., & Leila, K. (2016). Meta-analysis of the effect of acupressure on duration of labor and mode of delivery. International Journal of Gynecology and Obstetrics, 135(1), 5–10. https://doi.org/10.1016/j.ijgo.2016.04.017
Mathew, A., Nayak, S., & K., V. (2012). A comparative study on effect of ambulation and birthing ball on maternal and newborn outcome among primigravida mothers in selected hospitals in Mangalore. Journal of Health and Allied Sciences NU, 02(02), 02–05. https://doi.org/10.1055/s-0040-1703561
Mollart, L. J., Adam, J., & Foureur, M. (2015). Impact of acupressure on onset of labour and labour duration: A systematic review. Women and Birth, 28(3), 199–206. https://doi.org/10.1016/j.wombi.2015.03.007
Najafi, F., Jaafarpour, M., Sayehmiri, K., & Khajavikhan, J. (2018). An evaluation of acupressure on the Sanyinjiao (SP6) and Hugo (LI4) points on the pain severity and length of labor: A systematic review and meta-analysis study. Iranian Journal of Nursing and Midwifery Research, 23(1), 1–7. https://doi.org/10.4103/ijnmr.IJNMR_184_15
Neal, J. L., Lowe, N. K., Ahijevych, K. L., Patrick, T. E., Cabbage, L. A., & Corwin, E. J. (2010). “Active labor” duration and dilation rates among low-risk, nulliparous women with spontaneous labor onset: A systematic review. Journal of Midwifery and Women’s Health, 55(4), 308–318. https://doi.org/10.1016/j.jmwh.2009.08.004
Novelia, S., Sitanggang, T. W., & Lutfiyanti, A. (2019). The effect of yoga relaxation on anxiety levels among pregnant women. Nurse Media Journal of Nursing, 8(2), 86. https://doi.org/10.14710/nmjn.v8i2.19111
Osório, S. M. B., Silva Júnior, L. G. da, & Nicolau, A. I. O. (2014). Assessment of the effectiveness of non-pharmacological methods in pain relief during labor. Revista Da Rede de Enfermagem Do Nordeste, 15(1). https://doi.org/10.15253/2175-6783.2014000100022
Raana, H. N., & Fan, X. N. (2020). The effect of acupressure on pain reduction during first stage of labour: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice, 39, 101126. https://doi.org/10.1016/j.ctcp.2020.101126
Sharifipour, P., Kheirkhah, M., Rajati, M., & Haghani, H. (2022). The effect of delivery ball and warm shower on the childbirth experience of nulliparous women: A randomized controlled clinical trial. Trials, 23(1), 1–8. https://doi.org/10.1186/s13063-022-06358-x
Sheishaa, D. M. R., El-Mashad, H. A. M., & Khedr, N. F. H. (2019). Effect of birthing ball exercises during pregnancy on the first stage progress of labor. International Journal of Nursing, 7(2), 47–67. https://doi.org/10.15640/ijn.v6n2a6
Sultan, P., Kormendy, F., Nishimura, S., Carvalho, B., Guo, N., & Papageorgiou, C. (2020). Comparison of spontaneous versus operative vaginal delivery using obstetric quality of recovery-10 (ObsQoR-10): An observational cohort study. Journal of Clinical Anesthesia, 63(January), 109781. https://doi.org/10.1016/j.jclinane.2020.109781
Sungkar, A., & Basrowi, R. W. (2020). Rising trends and indication of caesarean section in Indonesia. World Nutrition Journal, 4(1–2), 1. https://doi.org/10.25220/wnj.v04.s2.0001
Sungkar, A., Santoso, B. I., Surya, R., & Fattah, A. N. (2019). Classifying cesarean section using robson classification: an Indonesian tertiary hospital survey. Majalah Obstetri & Ginekologi, 27(2), 66. https://doi.org/10.20473/mog.v27i22019.66-70
Ulfa, R. M. (2021). Effect of the use of birth balls on the reduction of pain and duration of labor during the first stage of active and second stage of labor in primigravida maternity. Science Midwifery, 9(2), 418–430
Walsh, C. A., Robson, M., & McAuliffe, F. M. (2013). Mode of delivery at term and adverse neonatal outcomes. Obstetrics and Gynecology, 121(1), 122–128. https://doi.org/10.1097/AOG.0b013e3182749ac9
Wang, J., & Lu, X. (2020). The effectiveness of delivery ball use versus conventional nursing care during delivery of primiparae. Pakistan Journal of Medical Sciences, 36(3), 550–554. https://doi.org/10.12669/pjms.36.3.1440
White, H., & Sabarwal, S. (2014). Methodological brief, Impact evaluation No.8 Quasi-Experimental Design and Methods (Issue 8). www.unicef-irc.org/publications/753-quasi-experimental-design-and-methods-methodological-briefs-impact-evaluation-no.html
Wong, C. L., Lai, K. Y., & Tse, H. M. (2010). Effects of SP6 acupressure on pain and menstrual distress in young women with dysmenorrhea. Complementary Therapies in Clinical Practice, 16(2), 64–69. https://doi.org/10.1016/j.ctcp.2009.10.002
Wyatt, S., Silitonga, P. I. I., Febriani, E., & Long, Q. (2021). Socioeconomic, geographic and health system factors associated with rising c-section rate in Indonesia: A cross-sectional study using the Indonesian demographic and health surveys from 1998 to 2017. BMJ Open, 11(5). https://doi.org/10.1136/bmjopen-2020-045592
Yesilcicek Calik, K., & Komurcu, N. (2014). Effects of SP6 acupuncture point stimulation on labor pain and duration of labor. Iranian Red Crescent Medical Journal, 16(10). https://doi.org/10.5812/ircmj.16461
Yeung, M. P. S., Tsang, K. W. K., Yip, B. H. K., Tam, W. H., Ip, W. Y., Hau, F. W. L., Wong, M. K. W., Ng, J. W. Y., Liu, S. H., Chan, S. S. W., Law, C. K., & Wong, S. Y. S. (2019). Birth ball for pregnant women in labour research protocol: A multi-centre randomised controlled trial. BMC Pregnancy and Childbirth, 19(1), 1–6. https://doi.org/10.1186/s12884-019-2305-8
Yousefzadeh, S., Darmiyan, M. E., Younesi, M. A., & Shakeri, M. T. (2016). Effects of training about the benefits of natural childbirth during pregnancy on the attitude and intentions to select the mode of delivery in nulliparous women. Journal of Midwifery and Reproductive Health, 4(3), 704–711
Zakerihamidi, M., Roudsari, R. L., & Merghati, E. (2015). Original article vaginal delivery vs cesarean section: A focused ethnographic study of women’s perceptions in the north of Iran. International Journal of Community Based Nursing and Midwivery, 3(1), 39–50
Zaky, N. H (2016). Effect of pelvic rocking exercise using sitting position on birth ball during the first stage of labor on its progress. IOSR Journal of Nursing and Health Science, 05(04), 19–27. https://doi.org/10.9790/1959-0504031927

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The Effect of Pelvic Rocking Exercise with a Birth Ball and SP6 Acupressure on Duration of the First and Second Stage of Labor

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