Effects of Connective Tissue Massage on Pain in Primiparous Women After Cesarean Birth

Abstract

Objective: To evaluate the efficacy of connective tissue massage to reduce postoperative pain in primiparous women on Postoperative Day 1 after unplanned cesarean birth.

Design: A randomized controlled trial with three groups: intervention (Group 1), control or standard care (Group 2), and individualized attention (Group 3).

Setting: Family/newborn units of a large teaching hospital in the Northeastern United States.

Participants: A total of 165 women who experienced unplanned cesarean births of singleton newborns at term gestation.

Methods: Participants were randomized to three groups: those in Group 1 received a 20-minute massage, those in Group 2 received the usual standard of care, and those in Group 3 received 20 minutes of individualized attention. On Postoperative Day 1, participants completed questionnaires to measure overall pain, stress, and relaxation at Time 1 and again 60 minutes later. Daily numeric pain ratings and medication consumption data were retrieved from the electronic health care records. Latent growth modeling and analysis of variance were used to analyze data, as appropriate.

Results: Participants in Group 1 had increased relaxation (p < .001), decreased pain (p < .001), decreased stress (p < .001), and decreased opioid use on Day 1 (p = .031) and Day 2 (p = .006) of the hospital stay after the intervention compared with the other groups. Additionally, opioid use in Group 1 decreased linearly, whereas the control groups had a nonlinear pattern of change.

Conclusion: Using massage therapy during postoperative hospitalization improved relaxation and decreased pain, stress, and opioid use in this sample of women after unplanned cesarean births.

Keywords: complementary therapies; massage; opioids; pain; relaxation; stress; unplanned cesarean birth.