Effects of Hot Sacral Massage and Shower Application With Partner Support on Labor

This study aims to determine the effect of warm sacral massage with cherry pits and shower application with partner support on perceived labor pain, birth experience, and birth comfort. The study includes three groups: massage group, shower group, and control group. A total of 150 pregnant women, 50 in each group, were included in the study.

Steps for the Partner-Assisted Shower Application: Participants in this group will receive a shower administered by their partner in the delivery room (when dilation is 4-5 cm) for at least 20 minutes. The water temperature will be between 32-37 °C (the woman's preferred temperature will be used), and the shower will be administered to the lower back, abdomen, or entire body, depending on the woman's preference, while she is standing or sitting, under the observation of the researcher midwife. The application will be repeated when dilation reaches 7-8 cm. To ensure the safety of pregnant women before showering, non-slip sandals or slippers will be provided, and a non-slip bath mat will be placed under the stool. Blood pressure will be checked before and after showering.

Cherry Pit Hot Sacral Massage Group: The sacral massage will be performed using 20x20 cm pouches filled with cherry pits. The pouches will be cover-shaped, and 100% cotton fabric will be preferred. Each pregnant woman will receive a massage with a washed, clean pouch. Like the shower application, the massage will be performed upon admission to the delivery room (when dilation is 4-5 cm) and repeated when dilation is 7-8 cm. It will begin when contractions start and will last approximately 20 minutes.

Control group application steps: Participants in this group will not receive any application other than the routine hospital protocol (midwifery care).

The vital signs (blood pressure, pulse) of all pregnant women in the groups will be measured hourly by the midwife and recorded in each participant's file.

The VAS will be administered to women in the shower group, massage group, and control groups by a midwife working in the delivery room who is not involved in the study. The VAS will be measured four times during the first stage of labor for pregnant women in the shower and massage groups.

After delivery, before transfer to the ward, the "Birth Experience Scale (BES) and Birth Comfort Scale (BCS)" will be administered to all participants in the groups by a midwife who is not involved in the study and who is working in the delivery room that day.

Inclusion criteria

• Volunteering to participate in the study
• Expectation of spontaneous vaginal delivery
• Estimated fetal weight between 2500-4000 grams by ultrasound
• Single fetus and cephalic presentation,
• Term pregnancy (between 37-42 weeks of gestation)
• Being in the active phase of labor (cervical dilation of 4 cm)
• No analgesia or anesthesia used during the first stage of labor,
• No skin disease or open wound preventing massage or showering

Exclusion criteria

• Having undergone infertility treatment,
• Delivery by cesarean section for any reason during labor,
• Being multiparous
• Having any systemic, chronic, or neurological disease (Diabetes Mellitus, Hypertension, Thyroid disorders, Multiple Sclerosis, Epilepsy, etc.)
• Regular medication use due to any illness,
• Active psychiatric treatment (pharmacotherapy/psychotherapy),
• Any induction that may affect uterine contractions and dilation,
• Any pregnancy complications (such as placenta previa, preeclampsia, premature rupture of membranes, oligohydramnios, and polyhydramnios)
• Interventional delivery (forceps, vacuum)
• Any problem that hinders communication (such as not knowing Turkish, hearing, speech, and comprehension disorders)