Effectiveness of Olive Oil Back Massage on Reduction of Labor Pain during First Stage of Labor

Abstract

Introduction: Pregnancy is the sensational journey of women toward motherhood. Pain in labor is nearly universal experience for the child bearing women. Olive oil back massage stimulates the body to release endorphins, which are having natural pain-killing properties.

Full text

Research Article
© ADR Journals 2016. All Rights Reserved.
Kamini Chauhan
1
,
Seema Rani2,
Priyanka Bansal3
1M.Sc. Nursing Student
(Obstetrics and
Gynecology Nursing),
Rufaida College of
Nursing, Jamia Hamdard.
2Assistant Professor,
Rufaida College of
Nursing, Jamia Hamdard.
3Tutor, Rufaida College of
Nursing, Jamia Hamdard.
Correspondence to:
Ms. Kamini Chauhan,
Rufaida College of
Nursing, Jamia Hamdard.
E-mail Id: kaminichauhan
1481991@gmail.com
How to cite this article:
Chauhan K, Rani S, Bansal
P. Effectiveness of Olive
Oil Back Massage on
Reduction of Labor Pain
during First Stage of
Labor. Int J Nurs Midwif
Res 2016; 3(2&3): 32-36.
ISSN: 2455-9318
Effectiveness of Olive Oil Back Massage on
Reduction of Labor Pain during First Stage
of Labor
Abstract
Introduction: Pregnancy is the sensational journey of women toward motherhood. Pain
in labor is nearly universal experience for the child bearing women. Olive oil back
massage stimulates the body to release endorphins, which are having natural pain-
killing properties.
Objectives: (i) To assess the level of labor pain of primigravida mother in experimental
group before and after olive oil back massage during first stage of labor. (ii) To
determine the level of labor pain of primigravida mother in control group. (iii) To
compare the level of labor pain among primigravida mothers in experimental group and
control group.
Methods: A quasi-experimental study with purposive non-probability sampling
technique is used for the sample. Study was conducted on 60 samples (30 in
experimental group and 30 in control group). A structured interview schedule, labor
assessment proforma, numerical pain-rating scale was used for data collection and the
data were analyzed using descriptive and inferential statistics.
Results: Results revealed that there was less pain score in experimental group after the
olive oil back massage as compared to mothers who had not received olive oil back
massage in control group.
Conclusion: Results confirmed that the olive oil back massage is significantly effective in
reducing labor pain during first stage of labor.
Keywords: Labor pain, Back Massage, Olive oil.
Introduction
Labor is usually a painful experience for women who vary in their response to it. Pain is
a subjective experience involving a complex interaction of physiological, psychosocial,
cultural and environmental influences.1 Labor pain is an unpleasant, complex, highly
individualized phenomenon with both sensory and emotional components.2 A woman’s
experience of labor pain is influenced by many factors including her past experiences of
pain, her coping abilities, the birth environment and psychological factors.3
The events of labor are divided into four stages. First stage starts from the onset of true
labor pain and ends with full dilatation of cervix. It is in other words, the “cervical
stage” of labor. Second stage of labor starts with full dilatation of cervix and ends with
the expulsion of fetus. Third stage begins after the expulsion of fetus and ends with the
expulsion of placenta and membranes. Fourth stage is the stage of observation of at
least one hour after the expulsion of placenta and membranes.4
The first symptom to appear in first stage of labor is intermittent painful uterine
contractions followed by expulsion of bloody mucous per vagina. The first stage of labor
is characterized by noticeable cervical changes as a result of uterine contractions.

Int. J. Nurs. Midwif. Res. 2016; 3(2&3) Chauhan K et al.
33 ISSN: 2455-9318
The cervix softens, thins, shortens and opens to a
diameter of 10 cm. These changes are referred to as
effacement and dilatation. The first stage is
characterized by several physical and psychological
changes of which the most important one to be
managed is the pain due to intermittent uterine
contractions. In first stage of labor the mothers are
screaming and become exhausted which leads to
prolonged and complicated labor.4
Pain relief is the way in which women feel that they
have coped with pain during labor. Different alternative
and contemporary modalities used are: continuous
labor support, hydrotherapy, intra-dermal water blocks,
positioning and movement, touch and massage,
acupressure, acupuncture, hypnosis, trans-cutaneous
electric nerve stimulation, aromatherapy, hot and cold
application, breathing and relaxation, music, audio
analgesia, birth balls, etc.5
Massage is an ancient method to reduce labor pain.
Massage stimulates the body to release endorphins,
which are natural pain-killing substances and stimulates
for the production of oxytocin, decreases stress
hormones and neurological excitability.6 Olive oil has
pain-killing properties and acts as an anti-inflammatory
drug. It is known to possess soothing and tranquilizing
properties.7
As highlighted by Chandra,8 a study was conducted to
evaluate the effect of olive oil back massage therapy on
labor pain during first stage of labor among primigravida
women in selected hospital at Selam. Olive oil massage
was given to all the mothers and the pain, was
measured after massage and compared with pre-test
value. The findings of the study show that the mean of
pain severity at the first stage of labor was significantly
different between the experiment group and the control
group The result concluded that there was significant
reduction of labor pain ‘t’=8.886, which was significant
at 0.01 level of significance.
As highlighted by Jayalakhmi,9 a study was conducted in
Chennai on effectiveness of olive oil massage upon low
back pain of parturient mothers in the first stage of
labor. 60 parturient mothers were selected by
systematic random sampling technique. The samples
were divided into both experimental and control
groups. Before and after therapy, back pain and feta-
maternal parameters were assessed for both the
groups. Massage therapy was given to the experimental
group. The results revealed that before therapy,
majority of them experienced severe back pain in both
groups. In experimental group, 100% of them
experienced moderate level of pain after therapy. The
study reported that olive oil massage was helpful,
providing lower back pain relief and psychological
support to parturient mothers.
Materials and Methods
The research approach of this study was quantitative
with time series non-equivalent control group design
with multiple institutions of the treatment design to
determine the effectiveness of olive oil back massage on
reduction of labor pain during first stage of labor among
primigravida mothers. After obtaining ethical
permission, the subjects were selected according to the
inclusion and exclusion criteria as set in the screening
sheet; mothers with labor pain during first stage of labor
were selected purposively for experimental and control
group. In experimental group, there were 30 mothers
and in control group there were 30 mothers and the
selected sample size was 60. Informed consent was
obtained from each participant of the experimental and
control groups. The researcher assessed the pain of the
mothers who were in the first stage of labor (4-10 cm)
dilatation of cervix. The demographic data were
collected using a structured interview schedule, labor
assessment were assessed using labor assessment
proforma and the pain score level were assessed using
numerical pain-rating scale before the administration of
olive oil back massage in experimental and no
intervention was given in control group. The reliability
of olive oil back massage procedure was established by
inter-observer reliability, which was 0.95. Researcher
self-applied the olive oil back massage to the
experimental group.
Olive oil back massage was done in following steps:
 Put the mother in left lateral position.
 Make sure that hands are warm and flexible.
 Take 2 drops of olive oil and mix with 3 drops of
mineral water.
 Place palmer aspect of hand on the mother hip with
finger tips face upward.
 Move both hands (palmer aspect) simultaneously
toward the lateral aspect and move in the upward
direction till T10 level and slowly come down.
 Repeat these strokes 3 to 5 times.
 Work with thumb on the sacral area by using the
ball of thumb and short rapid strokes from sacral
region to T10 level of back.
 Finish the back massage by giving simple lateral
stroke by using fingertips of hands.
Olive oil back massage was performed for experimental
group for 20 min for 3 times at the interval of 30 min.
Before and after every olive oil back massage, the

Chauhan K et al. Int. J. Nurs. Midwif. Res. 2016; 3(2&3)
ISSN: 2455-9318 34
numeric pain-rating scale was administered to record
pain level. In control group, mothers were getting only
routine care. Numeric pain-rating scale was
administered to record pain level before and after every
routine care 3 times at the interval of 30 min. Pre-test
and post-test pain score were entered in the record
sheet. The data taken were subjected to be analyzed
using descriptive and inferential statistics.
Results
Section 1: Findings related to Demographic Characteristics of Primigravida Mothers
Table 1.Frequency and Percentage Distribution of Primigravida Mothers according to Their Age, Educational Status,
Classes Attended and Heard the Importance of Therapies to Reduce Labor Pain in Experimental and Control Group
Sample Characteristics
Experimental Group
Control Group
Test Applied
p
-
Value
n
1
=30
n
2
=30
Frequency Percentage Frequency Percentage
Age of Women (in years)
18
-
21
7
23.3
8
26.6
Fisher Exact Test
0.9
22-26 15 50 14 46.6 (0.02)
27-31 6 20 6 20
32
-
36
2
6.6
2
6.6
Education
Illiterate 4 13.3 3 10 Fisher Exact Test 0.8
Primary Schooling
11
36.6
9
30
-
0.003
Higher secondary 10 33.3 9 30
Graduation 4 13.3 6 20
Post
-
graduation
1
3.3
3
10
Attended antenatal/ Intra-natal/ Post-natal classes
Yes 2 6.6 0 0 Fisher Exact Test 0.4
No
28
93.3
30
100
-
0.49
Heard the importance of Therapies to reduce Labor Pain
Yes 1 3.3 1 3.3 Fisher Exact Test 1
No
29
96.6
29
96.6
-
0.7
Non-significant at 0.05 level, p≥0.05 level, n1+n2=60
Section 2: Findings related to the Labor Assessment of Mothers
Table 2.Frequency and Percentage Distribution of Primigravida Mothers according to Their Presentation, Membrane,
Dilatation, Effacement, Frequency of Contraction, Duration of Contraction and Fetal
Heart Sound in Experimental and Control Group
Sample Characteristics
Experimental Group
Control Group
Test Applied
p
-
Value
n
1
=30 n
2
=30
Frequency Percentage (%) Frequency Percentage (%)
Presentation
Cephalic 28 93.3 30 100 Fisher Exact
Test -0.49
0.4
Breech 2 6.6 0 0
Others
0
0
0
0
Membrane
Intact 11 36.6 8 26.6 Chi-Square
Test 0.69
df=1
0.4
Ruptured
19
63.3
22
73.3
Dilatat
ion of
C
ervix (cm)
5
-
Apr
19
63.3
16
53.4
Fisher Exact
Test -0.07
0.7
7-Jun 10 33.3 13 43.3
10
-
Aug
1
3.3
1
3.3
Effacement of
C
ervix (%)
40-50 12 40 16 3.3 Fisher Exact 0.2

Int. J. Nurs. Midwif. Res. 2016; 3(2&3) Chauhan K et al.
35 ISSN: 2455-9318
60
-
70
16
53.3
14
46.7
Test 2.7
80
-
100
2
6.6
0
0
Frequency of Contraction
2
0
0
0
0
Fisher Exact
Test 1
1
3
25
83.3
26
86.75
4 5 16.7 4 13.3
Duration of
C
ontraction (sec)
Less than 20
0
0
0
0
Fisher Exact
Test -.0.70
0.7
20-40 25 83.3 27 90
More than 40 5 16.7 3 10
Fetal
H
eart
S
ound (beats/min)
120-140 21 70 26 86.6 Fisher Exact
Test -.0.13
0.2
140
-
160
9
30
4
13.3
More than 160
0
0
0
0
Non-significant at 0.05 level, p≥0.05 level, n1+n2=60
Section 3: Comparison between the Pre-test Pain Scores of Mothers during First Stage of Labor in the
Experimental and Control Group
Table 3.Mean, Standard Deviation, SEMD, Mean D and ‘t’ Value of Pre-test Scores of Labor Pain of Mothers during First
Stage of Labor in the Experimental and Control Group
n1+n2=60, t(29)=2.04, p≥0.05 level
The data presented in Table 3 shows that the calculated
‘t’ value (1.28) is less that the table ‘t’ value 2.04 for 29
degree of freedom at 0.05 level of significance, hence
there was no significant difference between the level of
pain in the experimental and control group before
administration of olive oil massage.
Section 4: Evaluation of Effect of Olive Oil Back Massage on Reduction of Labor Pain during First Stage
of Labor among Primigravida Mothers
(a) Findings related to Mean Pre-Test and Post-Test Pain Scores of Mothers during First Stage of Labor in the
Experimental Group
Table 4.Mean, Standard deviation, S.ED Mean and ‘t’ value of Pre-test and Post-test Scores of Labor Pain of Mothers
during First Stage of Labor in the Experimental Group
t(29)=2.04, p< 0.05,***Significant at 0.05 level of significance, n1=30
The data presented in Table 4 shows that the calculated
‘t’ value (9.14) is more that the table ‘t’ value 2.04 for 29
degree of freedom at 0.05 level of significance, hence
there was significant difference in the level of pain in
the experimental group before and after administration
of olive oil massage.
(b) Comparison between the Post-Test Pain Scores of Mothers during First Stage of Labor in the Experimental
and Control Group
Table 5.Mean, Standard Deviation, Mean Difference, Standard Error, and ‘t’ value of Post-test Pain Score of
Primigravida Mothers in both Experimental and Control Group
Groups
Mean
S.D.
Mean Difference
S.E
MD
‘t’ Value
p
-
Value
Experimental group
6.53
1.04
2.67
0.22
12.09
0.001
***
Control group 9.20 1.61
t(58)=2, p<0.05,***Significant at 0.05 level of significance, n1+n2=60
Group
Mean
S.D.
M
D
S.E.
D
‘t’ Value
p
-
Value
Experimental group 7.70 0.88 0.23
0.20
1.28 0.26
Control group 7.93 0.69
Group Intervention Mean S.D. M
D
S.E
D
‘t’ Value p-Value
Experimental group
Pre
-
test
7.70
0.88
1.17
0.13
9.14
0.0001
***
Post-test 6.53 1.04

Chauhan K et al. Int. J. Nurs. Midwif. Res. 2016; 3(2&3)
ISSN: 2455-9318 36
The data presented in Table 5 shows that the calculated
‘t’ value (12.09) is more that the table ‘t’ value 2 for 58
degree of freedom at 0.05 level of significance, hence
there was a significant difference in the level of pain in
the experimental group and control group. It concluded
that there was less pain score in experimental group
after the olive oil back massage and increase pain score
in mothers who had not received olive oil back massage.
Discussion and Conclusion
A study was done by Divya10 to assess the effectiveness
of massage with olive oil on active phase pain intensity
and satisfaction of labor in nulliparous women. 90
pregnant women with 38-42 weeks of gestation,
referred for vaginal delivery and admitted to labor
room, Coimbatore, were taken for the study and divided
into three groups, 1st group took only massage, 2nd
group took massage with almond oil and 3rd group took
massage with olive oil. The results of massage were that
by olive oil the active phase pain intensity significantly
decreased and also increased patient’s satisfaction from
delivery. The results of massage effectiveness,
particularly massage by olive oil, indicated that use of
massage can decrease active phase pain intensity and
increase satisfaction in patients. This study finding is
similar to the findings of the present study which
revealed that olive oil back massage is effective in
reducing labor pain during first stage of labor. It was
observed that there was less pain score in experimental
group after the olive oil back massage compared to
mothers who had not received olive oil back massage in
control group. The study concluded that olive oil back
massage is an effective method of reducing labor pain
during first stage of labor.
Conflict of Interest: None
References
1. Donna JS. Effects of labor support on mothers,
babies and birth outcomes. JOGNN 2002; 31(6):
733.
2. Hodnett E. Pain and women’s satisfaction with the
experience of child birth: A systematic review. Am
Journal of Obstetrics and Gynaecology 2002; 186(4):
160-72.
3. Lowe NK. The nature of labor pain. Journal of
Obstetrics and Gynaecology 2002; 186(5): 16-24.
4. Jayne K, Lossner J. Introductory Maternity and
Paediatric Nursing. 18th Edn. London: Lippincott
Williams and Wilkins, 2006: 1120-43.
5. Gentz BA. Alternative therapies for management of
pain in labor and delivery. Canadian Journal of
Nursing Research 2005; 26(8): 36-39.
6. Birch ER. The experience of touch received during
Labor: Postpartum perceptions of therapeutic
value. Journal of Midwifery Women’s Health1986;
31(6): 97-104.
7. Enkin. Effects of oil massage on labor. International
Journal of Nursing Studies 2000; 37(6): 493-500.
8. Chandra T. Effectiveness of olive oil back massage
on primigravida mothers. Nightingale Nursing Times
2011; 6: 54-58.
9. Jayalakshmi S. Effectiveness of olive oil massage
upon low back pain of parturient mothers in the
first stage of labor. Nightingale Nursing Times 2008;
4(7): 48.
10. Kuriakose D. A study to evaluate the effectiveness
of olive oil back massage on labor pain and progress
in first stage of labor among primipara mothers.
Indian Journal of Nursing and Midwifery Research
2012: 88-90.
Date of Submission: 14th Jun. 2016
Date of Acceptance: 26th Jul. 2016