The Effectiveness of Acupressure Versus Birth Ball on Reducing Labor Pain and Shortening the First Stage of Labor: A Comparative Study

https://doi.org/10.56303/jhnresearch.v5i2.1009

Authors

  • Herlina Simanjuntak Midwife Professional Education, Universitas Medika Suherman, Indonesia
  • Hajar Nur Fathur Rohmah Midwife Professional Education, Universitas Medika Suherman, Indonesia
  • Ika Kania Fatdo Wardani Midwife Professional Education, Universitas Medika Suherman, Indonesia

Keywords:

Acupressure, Birth Ball, First Stage of Labor, Labor Pain, Non-pharmacological Interventions

Abstract

Childbirth is a physiological process involving significant physical, emotional, and hormonal changes. Severe, uncontrolled labor pain can lead to an unpleasant experience and complications, including prolonged labor fetal distress and postpartum hemorrhage. A holistic approach incorporating non-pharmacological methods, such as birth ball exercises and acupressure at LI4 (Large Intestine 4) and SP6 (Spleen 6) points, may alleviate pain by modulating endorphin and cortisol levels, thereby optimizing labor. This quasi-experimental study with a pretest-posttest control group design aimed to compare the effectiveness of acupressure and birth ball exercises on pain intensity and the duration of the first stage of labor. Conducted at the independent midwifery practice Iin Sepnita between March and August 2025, it recruited 48 participants via purposive sampling (24 per group) based on inclusion criteria. Data were collected using a Visual Analogue Scale (VAS), an active phase observation sheet, and a partograph. Analysis employed descriptive statistics and the Mann-Whitney U test. Results demonstrated that birth ball exercise was more effective than acupressure in reducing pain intensity and shortening the first stage of labor. This finding is supported by significantly lower mean ranks in the birth ball group for both posttes pain (17.96 vs. 31.04; p = 0.001) and labor duration (18.50 vs. 30.50; p = 0.003). Notably, the mean duration of labor in the birth ball group was 1.10 hours shorter than in the acupressure group.

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References

Hutchison J, Mahdy H. In: StatPearls [Internet]. 2025 [cited 2025 Feb 8]. Stages of Labor. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544290/

Dartiwen D. Analisis Komparasi Tingkat Nyeri Persalinan Antara Primipara Dan Multipara. Vol. 14, Jurnal Ilmu Keperawatan dan Kebidanan. 2023.

Raana HN, Fan XN. The effect of acupressure on pain reduction during first stage of labour: A systematic review and meta-analysis. Complement Ther Clin Pract. 2020 May 1;39:101126.

Whitburn LY, Jones LE, Davey MA, McDonald S. The nature of labour pain: An updated review of the literature. Women and Birth. 2019 Feb 1;32(1):28–38.

Zhang EW, Jones LE, Whitburn LY. Tools for assessing labour pain: a comprehensive review of research literature. Pain. 2023 Dec;164(12):2642–52.

Hashemi Asl BM, Vatanchi A, Golmakani N, Najafi A. Relationship between behavioral indices of pain during labor pain with pain intensity and duration of delivery. Electron Physician. 2018 Jan 25;10(1):6240–8.

Pergialiotis V, Bellos I, Antsaklis A, Papapanagiotou A, Loutradis D, Daskalakis G. Maternal and neonatal outcomes following a prolonged second stage of labor: A meta-analysis of observational studies. Eur J Obstet Gynecol Reprod Biol. 2020 Sep;252:62–9.

Nori W, Kassim MAK, Helmi ZR, Pantazi AC, Brezeanu D, Brezeanu AM, et al. Non-Pharmacological Pain Management in Labor: A Systematic Review. J Clin Med. 2023 Nov 21;12(23):7203.

Simanjuntak H. Latihan Birth Ball Untuk Mengurangi Nyeri Punggung Bawah Pada Ibu Hamil Trimester III. PROFICIO. 2023 Oct 30;5(1):162–7.

Rantala A, Hakala M, Pölkki T. Women’s perceptions of the pain assessment and non-pharmacological pain relief methods used during labor: A cross-sectional survey. Eur J Midwifery. 2022 Apr 13;6(April):1–10.

Ozgoli G, Sedigh Mobarakabadi S, Heshmat R, Alavi Majd H, Sheikhan Z. Effect of LI4 and BL32 acupressure on labor pain and delivery outcome in the first stage of labor in primiparous women: A randomized controlled trial. Complement Ther Med. 2016 Dec 1;29:175–80.

Hamidzadeh A, Shahpourian F, Orak RJ, Montazeri AS, Khosravi A. Effects of LI4 Acupressure on Labor Pain in the First Stage of Labor. J Midwifery Womens Health. 2012 Mar 2;57(2):133–8.

Schlaeger JM, Gabzdyl EM, Bussell JL, Takakura N, Yajima H, Takayama M, et al. Acupuncture and Acupressure in Labor. J Midwifery Womens Health. 2017 Jan 21;62(1):12–28.

Türkmen H, Çeber Turfan E. The effect of acupressure on labor pain and the duration of labor when applied to the SP6 point: Randomized clinical trial. Japan J Nurs Sci. 2020 Jan 15;17(1).

Marsilia ID, Kubilawati S. Pengaruh Akupresur Titik SP6 dan LI4 terhadap Pengurangan Intensitas Nyeri Kala I Persalinan di PMB NY. T.O Desa Klapanunggal Kabupaten Bogor. J Akad Baiturrahim Jambi. 2022 Sep 15;11(2):279.

Suryani H, Lushinta L, Putri RA, Kebidanan J, Kemenkes P, Timur K. Efektifitas Pemberian Akupresur Dan Pijat Es Terhadap Kemajuan Persalinan Kala I Fase Aktif. J Kebidanan Indones. 2023;14(2):55.

Ulfa RM. Science Midwifery 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. Sci Midwifery [Internet]. 2021;9(2). Available from: www.midwifery.iocspublisher.org

Jha S, Vyas H, Nebhinani M, Singh P, T D. The Effect of Birthing Ball Exercises on Labor Pain and Labor Outcome Among Primigraviade Parturient Mothers at a Tertiary Care Hospital. Cureus. 2023 Mar;15(3):e36088.

Karimi L, Mahdavian M, Makvandi S. A Systematic Review and Meta-Analysis of the Effect of Acupressure on Relieving the Labor Pain. Iran J Nurs Midwifery Res. 2020;25(6):455–62.

Astuti SY, Budihastuti UR, Prasetya H. Meta-Analysis: Are Acupressure and Birthing Ball Exercise Associated with Labor Pain? J Matern Child Heal. 2022 Jan 16;7(1):9–21.

Afdila R, Mutiah C, Deviani P. Pengaruh terapi akupresur terhadap intensitas nyeri persalinan pada ibu bersalin kala I fase aktif. Fem J Ilm Kebidanan. 2023 Dec 13;3(2):204–9.

Devi B, Nazunf L. Acupressure As A Potentially Effective Strategy For Reducing The Intensity And Length Of Labour Pain . Int J Dev Res. 2021;11(11).

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 Complement Med Ther. 2025 May 10;25(1):170.

Yeung MPS, Tsang KWK, Yip BHK, Tam WH, Ip WY, Hau FWL, et al. Birth ball for pregnant women in labour research protocol: A multi-centre randomised controlled trial. BMC Pregnancy Childbirth. 2019;19(1):1–6.

Siregar WW, Sihotang SH, Maharani S, Rohana J. Pengaruh Pelaksanaan Teknik Birth Ball Terhadap Kemajuan Persalinan. J Penelit Kebidanan Kespro. 2020 Oct 31;3(1):76–83.

Karningsih K, Purwanti D, Yulfitria F, Sari GN, Nuraenah E. The Effect of Pelvic Rocking Exercise with a Birth Ball and SP6 Acupressure on Duration of the First and Second Stage of Labor. Nurse Media J Nurs. 2022 Dec 28;12(3):380–9.

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 Jan 28;11.

JHNR

Published

01-08-2026

How to Cite

1.
Simanjuntak H, Rohmah HNF, Wardani IKF. The Effectiveness of Acupressure Versus Birth Ball on Reducing Labor Pain and Shortening the First Stage of Labor: A Comparative Study. J. Health Nutr. Res [Internet]. 2026 Aug. 1 [cited 2026 Aug. 6];5(2):941-8. Available from: https://journalmpci.com/index.php/jhnr/article/view/1009

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