Effects of SP6 Acupressure on Labor Pain During Childbirth Among Nulliparous Women: A Randomized Clinical Trial
Abstract
Background: Acupressure is a nonpharmacological therapeutic technique that involves applying pressure to specific body points to promote energy flow and relieve pain. This study evaluated the effect of Sanyinjiao (SP6) acupressure on labor pain among nulliparous women. Materials and Methods: A randomized clinical trial was conducted between January and March 2023 in the labor and maternity wards of a tertiary care hospital in Sikkim, India. Sixty nulliparous women at 37–42 weeks of gestation with at least three contractions in 10 minutes were randomly assigned to an intervention group (n = 30) or a control group (n = 30). The control group received routine obstetric care, while the intervention group received SP6 acupressure for two minutes during each contraction for 30 minutes, starting at 4 cm and continuing until 8 cm cervical dilatation. Labor pain was assessed seven times using the visual analogue scale (VAS). The collected data were analyzed using one‑way analysis of variance (ANOVA), repeated‑measures ANOVA, and analysis of covariance (ANCOVA). Results: No significant difference was observed in the baseline pain scores between the groups (F1,58 = 0.12, p > 0.05). Repeated‑measures ANOVA showed a significant reduction in pain intensity in the intervention group at 4 cm (F1,58 = 88.67, p < 0.001) and 6 cm dilation (F1,58 = 305.4, p < 0.001). ANCOVA confirmed significant differences between the groups across seven measurements (F1,58 = 117.20, p < 0.05). Conclusions: SP6 acupressure demonstrated a positive effect on pain intensity and was a safe, noninvasive, and cost‑effective method for reducing labor pain among nulliparous women. Therefore, it can be recommended as a supportive midwifery practice alongside routine obstetric care.
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Thomson G, Feeley C, Moran VH, Downe S, Oladapo OT. Women’s experiences of pharmacological and non pharmacological pain relief methods for labour and childbirth: A qualitative systematic review. Reprod Health 2019;16:71.
Azadeh H, Heshmat R, Nasiri M, Azarkish F, Mobarakabadi SS. The Effect of Ex b8 acupressure on labor pain: A randomized, single blind, sham controlled trial. Pain Res Manag 2025;2025:7873155.
Mona JA, Sedigheh AA, Malihe N, Reza H, Nooshin E. Comparison of the effect of acupressure at Sp6 and Sp8 points on pain intensity and duration of the first stage of labor. Evid Based Care J 2021;11:25 34.
Chen Y, Xiang X, Chin KH, Gao J, Wu J, Lao L, et al. Acupressure for labor pain management: A systematic review and meta analysis of randomized controlled trials. Acupunct Med 2021;39:243 52.
Dutta R, Tuli S, Shukla M, Patil P, van Duinen AJ, Thivalapill N, et al. Geographic and socioeconomic inequities in cesarean delivery rates at the district level in Madhya Pradesh, India: A secondary analysis of NFHS 5. Glob Health Action 2023;16:2203544.
Pishva F, Heshmat R, Mobarakabadi SS. Effect of Bl23 acupressure on pain among primiparous women during the first stage of labor: A randomized sham controlled trial. Pain Res Manag 2025;2025:4486038.
Raana HN, Fan X. The effect of acupressure on pain reduction during first stage of labour: A systematic review and meta analysis. Complementary Therapies in Clinical Practice 2020;39:101126.
Mady MM, Aly IK, Abu Elmagd EH, Aly SG. Effect of acupressure on labor pain during the first stage of normal labor. J Med Sci Res 2024;7:8.
Kong X, Fang H, Li X, Zhang Y, Guo Y. Effects of auricular acupressure on dysmenorrhea: A systematic review and meta analysis of randomized controlled trials. Front Endocrinol 2023;13:1016222.
Karacan E, Cevik SA. The effect of breathing exercises using a breathing exercise device and virtual reality applications during pregnancy and labor. Comput Inform Nurs 2024;42:780 7.
Najafi F, Jaafarpour M, Sayehmiri K, Khajavikhan J. An evaluation of acupressure on the sanyinjiao (sp6) and Hegu (li4) points on pain severity and labor length: A systematic review and meta analysis. Iran J Nurs Midwifery Res 2018;23:1 7.
Li L, Xu G, Huang Y, Sun Z, Jia L. Impact of acupressure combined with flexible pressure sensor manometry on anesthesia recovery in patients undergoing Bronchoalveolar lavage: A randomized controlled trial. BMC Anesthesiol 2025;25:529.
Carmona Rodríguez MÁ, Martínez Flores S, Morilla Romero de la Osa R, Luque Oliveros M. Effects of acupressure on maternal and neonatal obstetric outcomes during labor: Study protocol. Healthcare (Basel) 2023;11:2111.
Garcia MK, Meng Z, Rosenthal DI, Shen Y, Chambers M, Yang P, et al. Effect of true and sham acupuncture on radiation induced xerostomia among patients with head and neck cancer: A randomized clinical trial. JAMA Netw Open 2019;2:e1916910.
Mammadov B, Taş Ç. The effect of acupressure and massage on labor pain and birth satisfaction: A randomized controlled trial. EXPLORE 2024;20:103002.
Ashtarkan MJ. Comparison of the effect of acupressure at Sp6 and Sp8 points on pain intensity and duration of the first stage of labor. Evid Based Care J 2021;11:25 34.
Torkiyan H, Sedigh Mobarakabadi S, Heshmat R, Khajavi A, Ozgoli G. The effect of GB21 acupressure on pain intensity in the first stage of labor in primiparous women: A randomized controlled trial. Complement Ther Med 2021;58:102683.
Türkmen H, Turfan EÇ. The effect of acupressure on labor pain and the duration of labor when applied to the Sp6 point: A randomized clinical trial. Jpn J Nurs Sci 2020;17:e12256.
Türkmen H, Çetinkaya S, Kiliç H, Apay E, Karamüftüoğlu D, Yörük S, et al. Effect of focusing on Maryam’s flower during the first stage of labor on pain, labor duration, comfort and satisfaction. Clin Nurs Res 2021;30:780 9.
Liu B, Abdi MA, Ma Y. Trend of cesarean section rates and related factors among first time mothers in Zhejiang Province, China. Int J Womens Health 2025;17:1681 92.
Pietrzak J, Mędrzycka Dąbrowska W, Tomaszek L, Grzybowska ME. A cross sectional survey of labor pain control and women’s satisfaction. Int J Environ Res Public Health 2022;19:1741.
Tandon A, Gujral K, Gupta V. Labour pain: A comprehensive review of perceptions, experiences, and sociocultural influences on pain and its management. Cureus 2025;17:e86540.
Zhang Y, Yang G, Wei J, Chen F, Zhang MZ, Mao S. Prospective comparison of acupuncture with sham acupuncture to determine impact on sedation and analgesia in mechanically ventilated critically Ill patients (Passion study). BMJ Open 2022;12:e059741.
Faul F, Erdfelder E, Lang A, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175 91.
Itani R, Soubra L, Karout S, Rahme D, Karout L, Khojah HM. Primary dysmenorrhea: Pathophysiology, diagnosis, and treatment updates. Korean J Fam Med 2022;43:101 8.
Shirdel E, Taghizadeh Z, Farnam F, Ghorbani M, Haghani S. Effect of acupressure on childbirth outcomes in nulliparous women: A randomized clinical trial. J Educ Health Promot 2024;13:490.
Gönenç IM, Terzioğlu F. Effects of massage and acupressure on relieving labor pain, reducing labor time, and increasing delivery satisfaction. J Nurs Res 2020;28:e68.
Salama SI, Abo Shabana KR, Yousif AM, Said NE. Effect of Spleen 6 point acupressure on severity of labor pain, duration of labor, and women’s satisfaction. SAGE Open Nurs 2025;11:23779608251362171.
Türkmen H, Çetinkaya S, Kiliç H, Tuna SD, Şirvancı M, Mutlu H. The effect of ice massage applied to the Sp6 point on labor pain, comfort, labor duration, and anxiety: A randomized clinical trial. J Midwifery Womens Health 2024;69:491 8.
Karimi L, Mahdavian M, Makvandi S. A systematic review and meta analysis of the effect of acupressure on relieving labor pain. Iran J Nurs Midwifery Res 2020;25:455 62.
Larki M, Karimi L, Jahanfar S, Mohammadi S, Makvandi S. Unveiling the latest evidence: An updated systematic review and meta analysis and GRADE assessment on the effectiveness of acupressure in managing labor pain. BMC Complementary Medicine and Therapies 2025;25:170.
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