Effect of BL23 Acupressure on Pain Among Primiparous Women During the First Stage of Labor: A Randomized, Sham-Controlled Trial

Abstract

Introduction: Labor pain is a well-known physiological phenomenon considered to be the most severe pain experienced by women of childbearing age. One nonpharmacological method used to alleviate labor pain is acupressure. This study aimed to examine the impact of acupressure on the BL23 points on pain intensity during the active phase of the first stage of labor. Method: This randomized, sham-controlled clinical trial took place at Tehran Baharlu Hospital in Iran from August 23 to October 21, 2023. Ninety first-time pregnant women in active labor were randomly assigned to one of three groups: acupressure on BL23 (n = 30), sham acupressure (between the seventh and eighth thoracic vertebra, 2 Cun from the midline) (n = 30), and a control group (n = 30). The sham and acupressure groups received 60 min of acupressure at three different time points during cervical dilatation at 4-5 cm, 6-7 cm, and 8-10 cm. The control group received standard labor care. Pain severity was assessed using a Numerical Rating Scale before, 10 min after, and 20 min after the intervention at each time point. Result: Pain intensity was significantly lower in the BL23 acupressure group compared to the control and sham groups at all three time points (p < 0.0001). Pain intensity decreased in the BL23 acupressure group after 10 min of intervention at all time points (p < 0.001) and continued to decrease throughout the intervention (p < 0.001). The reduction in pain in the BL23 acupressure group was evident before the start of the second and third interventions (p=0.33 and p=0.36, respectively). Twenty minutes of pressure on BL23 points at different dilatation stages were equally effective in reducing pain (p=0.13). No adverse effects on maternal and neonatal outcomes were observed in the BL23 acupressure group compared to the other groups (p > 0.05). Conclusion: This study demonstrates that applying acupressure to the BL23 points during the active phase of the first stage of labor significantly reduces labor pain. However, the pain relief provided by this intervention is temporary, with its effects diminishing over time rather than offering permanent relief. Trial Registration: Iranian Registry of Clinical Trials (IRCT): IRCT20230513058166N1.

Keywords: BL23 point; acupressure; childbirth; labor pain.

Figure 1

Participants' flow diagram.