E:/R Mehra/Baba Farid/Nursing/2013/Vol.5 No.2 Dec. 2013/Maninder Kaur.cdr 20.01.

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BFUNJ, Volume 5 Number 2, December, 2013 47

RESEARCH ARTICLE
1
EFFECTIVENESS OF BACK MASSAGE WITH KAUR MANINDERJIT
KAUR BHUPINDER2
MUSTARD OIL ON LEVEL OF PAIN DURING
FIRST STAGE OF LABOUR AMONG
ANTENATAL MOTHERS

ABSTRACT
INTRODUCTION: Nearly every woman in labour experiences some degree of discomfort and it has
been reported that low back pain is one of the main complaints. Women in labour who suffer from low
1
back pain experience an increase in physical and mental discomfort, which delays the progress of their Lecturer, MM College of Nursing,
labour. MMU, Mullana, Ambala, Haryana
2
Professor, University College of
AIM: The study aimed to evaluate the effectiveness of back massage with mustard oil on level of pain
Nursing, Faridkot
during first stage of labour among antenatal mothers to ease the process of grueling labour and improve
nursing care practices.
MATERIALS AND METHODS: The quasi experimental study was conducted in obstetrics department
of Guru Gobind Singh Medical College and Hospital Faridkot on 60 subjects (30 in each experimental
and control group). The experimental group received 20 min massage during active and transition
phase of first stage of labour and the levels of pain in both the groups were assessed by using Numerical
rating scale during the observations.
RESULTS : The results revealed that most of the study subjects experienced mild to moderate level of
back pain during active phase and moderate to severe level during transition phase. Although back
massage with mustard oil in both active and transition phase was effective in reducing the level of back Address for Correspondence :
pain ,however the effectiveness was more marked in active phase. MANINDER KAUR
CONCLUSION: Hence it can be concluded that back massage with mustard oil during first stage of Lecturer, MM College of Nursing,
labour is effective in reducing the level of back pain. MMU, Mullana, Ambala, Haryana
Mobile: 9041666828
KEY WORDS: First stage of labour, level of back pain, back massage. E-mail : meenyellow@yahoo.co.in

INTRODUCTION & BACKGROUND OF with mustard oil on level of pain during first stage of
THE STUDY labour among antenatal mothers.

During labour, the woman experiences some degree
of stress as her system responds to the physical
changes that prepare her to give birth. Nearly every
woman in labour experiences some degree of
discomfort.1
It has been reported that back pain during labour can
range from mild to moderate to severe pain. Although
labour felt as strong cramping in the abdomen, groin,
and back,is often thought of as one of the more
painful events in human experience, it ranges widely
from woman to woman and even from pregnancy to
pregnancy.2
Many mothers avoid pharmacological methods of
pain management in labour, and prefer the
complementary methods and studies indicate that
women who experience less labour pain report
higher levels of childbirth satisfaction. Studies into
the benefits of massage therapy for maternal and
infant care reported a significant reduction in
suffering due to labour pain and back pain.
OBJECTIVES
1. To evaluate the effectiveness of back massage
MATERIAL & METHODS
A quasi experimental study was conducted in
maternity unit of GGSMC&H, Faridkot to evaluate the
effectiveness of back massage with mustard oil on
level of back pain during first stage of labour among
60 antenatal mothers (30 in each experimental and
control group) selected by purposive sampling. The
experimental group received 20 min massage during
active and transition phase of first stage of labour and
the levels of pain were assessed immediately before
and after the intervention using the standardized
numerical rating scale. For this Written informed
consent was taken from each study subject and the
ethical approval and permissions were taken from
concerned authorities.
Final data was collected and analysed by using
descriptive and inferential statistics. Paired t-test was
used to evaluate the effectiveness of massage and
assess the levels of pain during active and transition
phase. Discussion was based on standard analysis,
current trends and previous researches.
BFUNJ, Volume 5 Number 2, December, 2013 48

RESULTS
TABLE 1
Distribution of Sample According To Level of
Backpain During First Stage of Labour (Active & Transition Phase)
N= 30
Pain Score Active phase Transition phase
(NRS) (n) (%) (n) (%)
0 nil 0 0 0 0
1-3 mild 31 51.67 5 8.33
4-6 moderate 22 36.67 13 21.67
7-10 severe 7 11.66 42 70
TOTAL 60 100% 60 100%

Table 1 depicts the distribution of sample according to moderate(36.67%) pain whereas the pain score shifts
level of back pain during first stage of labour(both active towards severity in transition phase with almost 70% of
and transition phase). In active phase most of the study the study subjects reporting severe back pain .
sample were in the category of mild (51.67%) and

TABLE 2
Effect of Massage on Level of Backpain During First Stage
(Active Phase) of Labour
N= 30
Group Variable Mean df t p value
±SD
Exp. Pre int. (Ist obs) 2.83±.747
Group 29
Post int. (IInd obs) 1.70±.877 9.109 .000***

Control Ist obs 2.37±.556

Group IInd obs 2.40±.621 1.000
.326NS
significant at p< .01 NS- non significant
Table 2 shows that mean level of pain during active phase significant at p< .01.
in experimental group before and after massage was 2.83
Thus it clearly indicates the effectiveness of back
and 1.70 respectively which is statistically significant at
massage with mustard oil in reducing the level of back pain
p<.01 whereas in control group the two observations were
during active phase of labour.
2.37 and 2.40 respectively which is statistically non

TABLE 3
Effect of Massage on Level of Backpain During First Stage
(transition Phase) of Labour
N= 30
Group Variable Mean df t p value
±SD
Exp. Pre int. (Ist obs) 3.83±.379
Group 29 7.878 .000***
Post int.(IInd obs) 2.80±.925
Control Ist obs 3.40±.770
NS
Group IInd obs 3.57±.774 2.408 .23
***significant at p< .01 NS- Non Significant

Table 3 shows the mean level of back pain during
transition phase before and after massage being 3.83 and
2.80 respectively, which is statistically significant at
p<.01.However the mean levels of pain during two
observations in control group in transition phase were
3.40 and 3.57 respectively, which is statistically
insignificant at p<.01.
It can be concluded that back massage with mustard oil
during transition phase helps in reduction of back pain.
BFUNJ, Volume 5 Number 2, December, 2013
DISCUSSION
It has been found in the present study that the level of
pain intensified with the progress of labour as they
were mild to moderate in active phase and moderate
to severe in transition phase .Similar results were
reported by (TzengYL, SuTJ 2008)3 where Low back
pain was repeatedly measured during the latent
phase (cervix dilated 2-4 cm), early active phase
(cervix dilated 5-7 cm), and late active phase (cervix
dilated 8-10 cm) of labour concluding that low back
pain intensified with the progression of labour,
suggesting early prevention is necessary. Back
massage was found to be effective in the present
study in reducing the level of back pain during first
stage of labour (both active and transition phase).
(Field T etal 1997)4 in their study where partners were
given instructions on massaging the back and the
legs during the first 15 min of every hour of labour [Ist
(active & transition phase)and II stage] of the
pregnant women from a side-lying position reported
significantly less back pain. (MahinKamalifard, etal,
2012)5 also reported the effectiveness of back
massage employed during the first stage of labour at
4, 6, 8 and 10 cm of dilatation for 30 minutes in
reducing the back pain scores significantly in their
study.
The results of the present study revealed that the
effect of back massage to reduce the level of back
pain was more marked during active phase than
transition phase which is similar to the results of the
study of (Chang MY etal 2006)6 where massage was
noted to lessen the back pain intensity during phase
1(latent phase) and 2(active phase) of cervical
dilation, but there were no significant differences in
phase 3(transition phase) of cervical dilation.
49
CONCLUSIONS
 Most of the study subjects experienced mild to
moderate level of back pain during active phase
and moderate to severe back pain during
transition phase.
 Back massage was effective in reducing the level
of back pain during first stage (active and
transition phase) of labour in experimental group.
 Effect of massage in reducing the level of back
pain was more marked in active phase as
compared to transition phase.
REFERENCES
1. B BJ. Effective Nursing Interventions on Pain During
Labour Among Primigravid Mothers. The Nursing
Journal Of India. June 2010;C1No.6.
2. The Nemours Foundation. Dealing With Pain During
Childbirth: The Nemours Foundation; 1995 [cited
2012 4Nov]. Available from: http://kidshealth.org/
parent/pregnancy_center/childbirth/childbirth_pain.
html.
3. Tzeng Y, Su T. Low back pain during labor and related
factors. The journal of nursing research : JNR. 2008
Sep;16(3):231-4.
4. Field T, Hernandez-Reif M, Taylor S, Quintino O,
Burman I. Labor pain is reduced by massage therapy.
J Psychosom Obstet Gynaecol. 1997 Dec;18(4):286-
91. PubMed PMID: 9443139.
5. Kamalifard M, Shahnazi1 M, Melli MS,
Allahverdizadeh S, Tora-by S, Ghahvechi. A. The
Efficacy of Massage Therapy and Breathing
Techniques on Pain Intensity and Physiological
Responses to Labor Pain. Journal of Caring
Sciences. 2012;1(2):73-8.
6. Chang M, Chen C, Huang K. A comparison of
massage effects on labor pain using the McGill Pain
Questionnaire. J Nurs Res. 2006 Sep;14(3):190-7.
PubMed PMID: 16967401.
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