Effectiveness of acupressure on Sanyinjiao point in relation to labor pain intensity & duration in the first stage of labor among primigravida mothers admitted in labor rooms in selected hospitals in metropolitan city

Effectiveness of acupressure on Sanyinjiao point in relation to labor pain intensity & duration in the first stage of labor among primigravida mothers admitted in labor rooms in selected hospitals in metropolitan city | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effectiveness of acupressure on Sanyinjiao point in relation to labor pain intensity & duration in the first stage of labor among primigravida mothers admitted in labor rooms in selected hospitals in metropolitan city Deepa Ganesh Reddy, Dhanashree Parulekar, Ann Maria Thomas This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8160070/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Labor and childbirth, through natural processes, are often accompanied by severe pain and discomfort, impacting maternal satisfaction and outcomes. Effective pain management is essential to enhance the childbirth experience. Acupressure, a traditional Chinese medicine technique, applies pressure to specific points to balance energy flow (qi) and address various health concerns. The Sanyinjiao (SP6) point is commonly used to manage gynecological, emotional, and digestive issues, and it is hypothesized to reduce labor pain and duration. This study evaluates the effectiveness of SP6 acupressure in managing labor pain and duration among primigravida mothers in metropolitan city. Methodology: A quasi-experimental post-test-only design was employed in a selected hospital. Non-probability purposive sampling included 64 participants, equally divided into experimental and control groups. Data collection tools included demographic interviews, observational techniques, and the ESWADOPA pain scale. Descriptive and inferential statistics, including the Mann-Whitney U test, were used for analysis. Results: Acupressure significantly reduced labor pain intensity during early and mid-cervical dilation (3–6 cm) and shortened labor duration compared to routine care. Pain escalation was less frequent in the acupressure group, although differences at advanced dilation stages (9–10 cm) were not statistically significant. Conclusion: Acupressure is a promising non-pharmacological intervention for managing labor pain and duration, particularly during the early and middle stages of labor. Nursing Sanyinjiao point childbirth Primi mothers Acupressure labour pain Figures Figure 1 Figure 2 Introduction Childbirth is a significant experience in a woman’s life, involving uterine contractions that facilitate cervical dilation and effacement for delivery. Annually, approximately 140 million births occur worldwide (Smith et al., 2017 ). Labor is a natural process, but it is often accompanied by severe pain and discomfort, which can impact maternal satisfaction and outcomes. Effective pain management is essential to enhance the childbirth experience. According to contemporary obstetric literature, labor pain results from complex physiological mechanisms involving both visceral and somatic components, contributing to the intensity experienced during the first and second stages of labor (Cunningham et al., 2018 ). Despite advances in obstetric care, many women still experience prolonged labor and severe pain, leading to an increased use of pharmacological interventions such as epidurals and analgesics (Koskinen et al., 2016 ). While these methods can be effective, they may have side effects and may not be accessible in all settings, particularly in low-resource areas (Hofmeyr & Kulier, 2014 ). Acupressure, a non-pharmacological intervention rooted in traditional Chinese medicine, has gained attention for its potential benefits in managing labor pain. It is cost-effective, easy to administer, and free from adverse pharmacological effects, making it an appealing option for labor management (Badria, 2004 ). The Sanyinjiao (SP6) point, located on the medial aspect of the leg, is widely recognized for its role in gynecological and obstetric care, including alleviating dysmenorrhea and promoting labor progression (Sayed et al., 2018 ). This study aims to evaluate the relevance of acupressure in the current context, where non-invasive and holistic approaches to labor pain management are increasingly sought. By focusing on the SP6 point, the study explores its effectiveness in reducing labor pain intensity and duration, thereby contributing to the broader discourse on improving maternal health and childbirth experiences. Materials and Methods A quantitative evaluative approach was adopted for this study to assess the effectiveness of acupressure at the Sanyinjiao (SP6) point in reducing labor pain intensity and duration. This approach systematically evaluates interventions, policies, and practices to derive evidence-based conclusions. A quasi-experimental post-test-only design was used, incorporating an experimental group that received acupressure and a control group that received routine care. This design enabled the researcher to explore cause-and-effect relationships between the intervention and the outcomes. The study was conducted in the labor room of Shastri Hospital, located in the Metropolitan City of Mumbai, India. The facility has a 30-bed labor ward, with 4 beds dedicated to active labor management. Approximately 4–6 natural births occur daily, with round-the-clock staff support in rotating shifts. The target population consisted of primigravida mothers in the first stage of labor who met the inclusion criteria. A total sample size of 64 participants was calculated using an effect size of 0.7, power of 0.80, and a significance level of 0.05. The participants were equally divided into an experimental group (32) and a control group (32), selected using a non-probability purposive sampling technique. Data collection involved an interview schedule to gather demographic details, including age, education, marital status, and income, as well as an observational tool to assess pain intensity and labor duration using the ESWADOPA standardized pain scale. Inclusion criteria required mothers to be in the first stage of labor, without pharmacological pain management, and willing to participate. Exclusion criteria included high-risk pregnancies, injuries or abnormalities at the SP6 point, and unwillingness to participate. The tools were validated by experts in nursing, medicine, and statistics, with revisions made based on their feedback. The ESWADOPA pain scale demonstrated acceptable internal consistency (Cronbach’s alpha = 0.784), ensuring its reliability. Ethical clearance was obtained from the Institutional Ethical Committee (File No: IEC/1547/PG/2023-22/03). The study was conducted in accordance with the Indian Council of Medical Research (ICMR) National Ethical Guidelines for Biomedical and Health Research Involving Human Participants, 2019, and the principles outlined in the Declaration of Helsinki (2017). Written informed consent was obtained from all participants, and confidentiality and anonymity were strictly maintained throughout the study. A pilot study was conducted at D. Y. Patil Hospital, Navi Mumbai, to test the feasibility of the methodology and tools. The results indicated that acupressure effectively reduced pain intensity and labor duration, confirming the suitability of the research design for the main study. Data analysis involved editing, classifying, tabulating, and systematically interpreting the collected data to meet the study objectives. The data were compiled into a master sheet and analyzed using IBM SPSS Version 22. Descriptive statistics, including frequency and percentage, were used to summarize baseline demographic and clinical variables of primigravida mothers during the first stage of labor. Inferential statistics, including the Mann-Whitney U test, were applied to compare pain scores between the experimental group (acupressure at the Sanyinjiao point) and the control group (routine care). The correlation coefficient test assessed the relationship between pain scores and labor duration under both conditions. Results were presented through tables and graphs, with statistical significance determined at the 0.05 level. Results The study included 32 participants each in the routine care and acupressure groups. Participants in both groups were primarily aged 18–29 years, with the acupressure group having a slightly higher percentage (93.8%) in this age range compared to the routine care group (75%). Hindu participants predominated in the acupressure group (65.6%), whereas the routine care group had a more even distribution among Hindu (34.4%) and Muslim (37.5%) participants. Educational levels varied, with higher secondary education being more common in the acupressure group (34.4%) than in the routine care group (21.9%). All participants were married, but the duration of marriage varied, with most in the acupressure group (56.3%) reporting 2–3 years compared to 43.8% in the routine care group. Nuclear families were more common in the acupressure group (65.6%) than in the routine care group (43.8%). Employment was higher in the routine care group (68.8%) compared to 56.3% in the acupressure group. Income levels varied, with "no income" being reported more frequently in the acupressure group (43.8%) compared to the routine care group (28.1%). Overall, demographic distributions reflected diverse participant backgrounds across both groups (Table 1 , Figs. 1 & 2 ). Table 1 Frequency percentages distribution demographic variables of the participants both routine care and Acupressure Demographic Variables Routine Care (32) Acupressure (32) Frequency (n) Percentage (%) Frequency (n) Percentage (%) Education Primary Secondary Higher Secondary Graduate and above 3 15 7 7 9.4 46.9 21.9 21.9 6 11 11 4 18.8 34.4 34.4 12.5 Marital Status Married 32 100.0 32 100 Duration of Marriage 1 Years 2–3 Years 4–5 years 13 14 5 40.6 43.8 15.6 14 18 0 43.8 56.3 0 Type of Family Nuclear Joint Extended 14 9 9 43.8 28.1 28.1 21 11 0 65.6 34.4 0 Occupation Employed Unemployed 22 10 68.8 31.2 18 14 56.3 43.8 Income No income 0–15,000 16,000–30,000 31,000 and above 9 10 7 6 28.1 31.3 21.9 18.8 14 7 8 3 43.8 21.9 25.0 9.4 The distribution of pain levels is categorized based on specific pain rating scores. Participants who do not express pain have scores below 1, indicating no pain experience. Mild pain is reflected by scores ranging from 1 to 6, while moderate pain is indicated by scores between 7 and 12. Intense pain is represented by scores from 13 to 18, signifying the highest level of discomfort. This classification serves as a structured framework for assessing and interpreting the intensity of labor pain among participants in the study. Table 2 Frequency percentages distribution clinical variables of pain levels of the participants in both routine care and Acupressure Acupressure Routine Care Level of pain Frequency (n) Percentage (%) Frequency (n) Percentage (%) Cervical Dilatation: 3–4 cm Not express pain 7 23% 2 7% Express mild pain 24 73% 18 53% Express moderate pain 1 4% 12 40% Express intense pain 0 0% 0 0% Cervical Dilatation: 5–6 cm Not express pain 0 0% 0 0% Express mild pain 22 67% 5 17% Express moderate pain 10 33% 20 70% Express intense pain 0 0% 4 13% Cervical Dilatation: 9–10 cm Not express pain 0 0% 1 4% Express mild pain 1 4% 4 11% Express moderate pain 24 73% 19 67% Express intense pain 7 23% 5 18% Table 2 describes the distribution of pain levels among participants across different cervical dilation stages demonstrating distinct variations between the acupressure and routine care groups. At 3–4 cm dilation, 23% of participants in the acupressure group reported no pain compared to 7% in the routine care group, while 73% experienced mild pain in the acupressure group versus 53% in routine care. Moderate pain was significantly lower in the acupressure group (4%) compared to 40% in routine care, with no intense pain reported in either group. At 5–6 cm dilation, the acupressure group saw 67% of participants experiencing mild pain and 33% reporting moderate pain, with no cases of intense pain. In contrast, the routine care group had only 17% reporting mild pain, 70% experiencing moderate pain, and 13% enduring intense pain. At 9–10 cm dilation, the acupressure group showed a higher proportion of participants experiencing moderate pain (73%) compared to 67% in routine care. However, intense pain was reported by 23% in the acupressure group versus 18% in routine care. These findings suggest that acupressure may reduce the intensity of labor pain, particularly during the earlier stages of cervical dilation. Table 3 Comparison of Pain score in two groups (routine and acupressure) using Mann Whitney U test at 3–4cm dilatation, 5–6 cm dilatation, and 9–10cm dilatation. (Mean Pain score ± standard deviation) Stages of Dilatation Type of Care Mann- Whitney U test statistic (standardized) p-value Routine care Acupressure 3-4cm Dilatation 5.69 ± 2.620 3.34 ± 2.295 -3.485 0.000* 5–6 cm Dilatation 8.97 ± 2.890 6.19 ± 1.424 − 4.514 0.000* 9–10 cm Dilatation 10.69 ± 2.764 10.28 ± 3.531 − 0.602 0.547 *P value ≤ 0.05 considered as significant at α = 0.05 Table 3 shows the comparison of pain scores between the routine care and acupressure groups at different stages of cervical dilation revealing significant differences at earlier stages but no significant difference at the final stage. At 3–4 cm dilation, the mean pain score in the routine care group (5.69 ± 2.620) was significantly higher than in the acupressure group (3.34 ± 2.295), with a Mann-Whitney U test statistic of -3.485 and a p-value of 0.000. Similarly, at 5–6 cm dilation, the routine care group reported a higher mean pain score (8.97 ± 2.890) compared to the acupressure group (6.19 ± 1.424), with a test statistic of -4.514 and a p-value of 0.000. However, at 9–10 cm dilation, the mean pain scores between the routine care group (10.69 ± 2.764) and the acupressure group (10.28 ± 3.531) showed no significant difference, with a test statistic of -0.602 and a p-value of 0.547. This suggests that acupressure is effective in reducing pain during early and mid-labor stages but shows comparable outcomes to routine care in the final stages of dilation. Table 4 Comparison of Mean Labor duration in seconds between Routine and Acupressure groups. Duration of labor Type of care Mann- Whitney U test statistic (standardized) p-value Routine care Acupressure Duration of mild: <20 sec 15 ± 5.536 6.78 ± 4.499 − 5.968 0.000* Duration of moderate: 21 to 40 sec 51.25 ± 15.811 23.28 ± 16.685 − 6.461 0.000* Duration of severe: ≥41 sec 128.44 ± 57.142 110 ± 54.299 − 5.422 0.000* *P value ≤ 0.05 considered as significant at α = 0.05; Mann- Whitney U test The comparison of mean labor duration between routine care and acupressure groups shows significant differences across all pain intensities. For mild pain (< 20 seconds), the routine care group reported a longer mean duration (15 ± 5.536 seconds) compared to the acupressure group (6.78 ± 4.499 seconds), with a Mann-Whitney U test statistic of -5.968 and a p-value of 0.000. Similarly, for moderate pain (21–40 seconds), the mean duration was significantly higher in the routine care group (51.25 ± 15.811 seconds) than in the acupressure group (23.28 ± 16.685 seconds), with a test statistic of -6.461 and a p-value of 0.000. For severe pain (≥ 41 seconds), the routine care group again exhibited a longer mean duration (128.44 ± 57.142 seconds) compared to the acupressure group (110 ± 54.299 seconds), with a test statistic of -5.422 and a p-value of 0.000. These findings highlight that acupressure significantly reduces labor duration at all pain intensity levels compared to routine care (Table 4 ). Table 5 Association of labor pain intensity and duration in the first stage of labor score in Routine care and Acupressure groups Level of Pain Duration in the first stage of labor score Mild Moderate Severe Correlation coefficient p-value Correlation coefficient p-value Correlation coefficient p-value Routine care (n = 32) In 3–4 cm dilatation -0.277 0.125 -0.228 0.209 0.473 0.006* In 5–6 cm dilatation 0.261 0.149 -0.025 0.893 -0.100 0.585 In 9–10 cm dilatation 0.307 0.087 -0.146 0.424 -0.271 0.134 Acupressure groups (n = 32) In 3–4 cm dilatation -0.221 0.225 -0.216 0.235 0.100 0.585 In 5–6 cm dilatation 0.165 0.367 0.255 0.160 0.093 0.612 In 9–10 cm dilatation -0.229 0.206 -0.332 0.064 -0.217 0.232 * P value ≤ 0.05 considered as significant at α = 0.05; Spearman rank correlation test Table 5 describes the association between labor pain intensity and duration in the first stage of labor was analyzed for both routine care and acupressure groups across three stages of cervical dilation (3–4 cm, 5–6 cm, and 9–10 cm) using Spearman's rank correlation test. In the routine care group, a significant positive correlation was observed between severe pain intensity and duration at 3–4 cm dilation (correlation coefficient: 0.473, p = 0.006). No significant correlations were found for mild or moderate pain at this stage, or for any pain levels at the subsequent dilation stages (5–6 cm and 9–10 cm). In the acupressure group, no significant correlations were observed between pain intensity and duration across any dilation stages or pain levels. These findings suggest that acupressure may attenuate the relationship between pain intensity and labor duration compared to routine care, with routine care showing a significant link between severe pain and prolonged duration during the early stage of dilation. Discussion The study aimed to evaluate the impact of acupressure at the Sanyinjiao (SP6) point on labor pain intensity and duration among primigravida mothers during the first stage of labor. Both the acupressure and routine care groups frequently reported labor pain during cervical dilation stages from 3 cm to 10 cm. It is hypothesized that the use of acupressure could enhance maternal acceptance of the procedure, ultimately improving their overall quality of life during childbirth. The findings of this study are consistent with those of Asmaa Morgan Farahat Khatap et al. ( 2015 ), who investigated the effect of acupressure at the SP6 point on reducing labor pain. In their study, statistical significance was observed in the reduction of labor pain in the intervention group compared to the control group, as measured by the Wong-Baker Faces Pain Scale. Furthermore, the mean plasma cortisol levels showed a significant difference between the groups, further supporting the effectiveness of SP6 acupressure in reducing pain during the first stage of labor. The authors recommended the incorporation of SP6 acupressure into routine nursing care for women in labor. Similarly, Hulya Turkmen et al. (2020) conducted a randomized controlled trial examining the impact of acupressure on labor pain and duration. Their study demonstrated that the experimental group, which received acupressure at the SP6 point during the active and transition stages of labor, experienced significantly lower pain levels and shorter labor durations compared to the control group. Women in the experimental group also reported greater satisfaction with their birthing experience and were more likely to recommend acupressure to others. These results highlight the potential of SP6 acupressure to improve maternal outcomes by reducing pain and shortening labor. In a similar vein, Halime Oncu H (2019) studied the effects of acupressure at the SP6 point on labor pain and duration among Turkish nulliparous women. The results indicated that acupressure significantly reduced pain intensity and shortened the active phase of labor. However, no significant differences were observed between the acupressure and placebo groups regarding the second stage of labor or cesarean section rates. These findings reinforce the role of acupressure in facilitating a more manageable and satisfying childbirth experience for women. Overall, the findings of these studies align with those of the current research, suggesting that acupressure at the Sanyinjiao point offers a promising intervention for alleviating labor pain and reducing the duration of labor, particularly in the first stage. The use of acupressure as part of routine care may provide valuable benefits to women in labor, contributing to improved birth experiences. However, further research is needed to confirm these results and explore the long-term effects of acupressure on maternal and neonatal outcomes. Limitation This study has several limitations that do not undermine its purpose. First, the study was conducted at only one selected hospital in a metropolitan city. As a result, the findings can only be generalized to the population under study and may not be applicable to all settings or populations. Summary This study aimed to assess the impact of acupressure at the Sanyinjiao point on labor pain intensity and labor duration in primigravida mothers. The findings demonstrated a significant reduction in labor pain intensity and a shorter duration of the first stage of labor in the acupressure group compared to the routine care group. The analysis also revealed that demographic and clinical variables were associated with both labor pain intensity and duration across both groups. These results align with previous research, suggesting that acupressure at the Sanyinjiao point can effectively alleviate pain and shorten labor. This chapter discusses these findings in the context of existing literature, highlighting the potential of acupressure as a non-pharmacological intervention for labor pain management. Recommendations for future research are provided to expand on these findings and further explore the benefits and mechanisms of acupressure during labor. Declarations Conflict of interest: The authors declare no conflict of interest on this study. Ethics Approval: The study was approved by the independent ethics committee of the D. Y. Patil School of Nursing Ethical Committee (File No: IEC/1547/PG/2023-22/03). The study was conducted in accordance with the Indian Council of Medical Research (ICMR) National Ethical Guidelines for Biomedical and Health Research Involving Human Participants, 2019 , and the principles outlined in the Declaration of Helsinki (2017) . Funding Declaration This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Authors’ Contributions: Dhanashree Parulekar, Deepa Ganesh Reddy & Ann Maria Thomas are responsible for research concepts and design, data collection and analysis, manuscript writing, and critical review of important knowledge content. Acknowledgements: The author wishes to thank D. Y. Patil School of Nursing & D. Y. Patil Hospital Navi Mumbai, India, for providing equipment/articles for data collection & labor room of Shastri Hospital, located in the Metropolitan City of Mumbai, India for granting permission for the data collection. They thanked the participants who participated in the study and for their cooperation for the researcher throughout the study period. References Lowdermilk DL, Perry SE, Cashion K, Alden KR. Maternity & Women’s Health Care. 12th ed. St. Louis (MO): Elsevier; 2020. p. 351. Cunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. 25th ed. New York (NY): McGraw-Hill Education; 2018. p. 444–446. Fraser DM, Cooper MA, editors. Myles Textbook for Midwives. 16th ed. London (UK): Elsevier; 2020. p. 476–478. Morgan Farahat Khatap A, Abd El-Hamid A, Mohamed Abd Allah I, Mahmoud Ali El-kosery S. Effect of the Sanyinjiao Point (SP6) Acupressure on Reducing Labor Pain at Ismailia Governmental Hospitals. Egypt J Health Care. 2015 Sep 1;6(3):56-69. Turkmen H, Çeber Turfan E. The effect of acupressure on labor pain and the duration of labor when applied to the SP6 point: Randomized clinical trial. J Nurs Sci. 2020 Jan;17(1): 12256. Oncü H, Okumus F. The effect of acupressure at the Sanyinjiao point on labor pain relief and duration of labor in Turkish nulliparous women. J Exp Clin Med. 2019;36(3):73-80. Smith CA, Hay PJ, Cummings TM, et al. Acupuncture and acupressure for pain management during labor: a systematic review. BMC Complement Altern Med. 2017;17:219. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322618 Koskinen S, Kivimäki M, Leino-Arjas P, et al. Pelvic pain after childbirth: A longitudinal population study. BMC Pregnancy Childbirth. 2016;16: 229. Available from: https://www.researchgate.net/publication/284278778_Pelvic_pain_after_childbirth_A_longitudinal_population_study Hofmeyr GJ, Kulier R. Episiotomy for vaginal birth. Cochrane Database Syst Rev. 2014;2014(9). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161094 Badria H. Labor pain experience and intensity: A Jordanian perspective. J Adv Nurs. 2004;46(4):446-454. Available from: https://www.researchgate.net/publication/8120501_Labor_pain_experience_and_intensity_A_Jordanian_perspective El Sayed H, El Gammal M, El Kholy A, et al. Effect of acupressure on labor pain and duration of delivery among laboring women attending Cairo University Hospital. J Nurs Educ Pract. 2018; 8(10):65-73. Available from: https://www.researchgate.net/publication/327720092_Effect_of_Acupressure_on_Labor_pain_and_Duration_of_Delivery_among_laboring_Women_Attending_Cairo_University_Hospital Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8160070","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":547855154,"identity":"5324e0c8-f35b-4cfc-9476-70bccef7894a","order_by":0,"name":"Deepa Ganesh Reddy","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA30lEQVRIiWNgGAWjYDCCA1Can+EwiCkhQ7wWycZjCSAtPMRrMTh8xgBEE9bCd7z52IOfe7blMRw78/nVjRoLHgb2w0c34NMieeZYumHPs9vFjD1nt1nnHAM6jCct7QY+LQY3cswkeA7cTmyWOLvNOIcNqEWCxwy/lvvvv0n+AWppk3/zzDjnHzFabvCwSYNs6WE4w/w4t40ILZJn0syNZYBaZjAcM2PO7ZPgYSPkF77jh589fAPUsv/A4cefc77VyfGzHz6GVwsQsMEZEihcYrQwfyBC9SgYBaNgFIxAAAAK+FKdtkjL1wAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-3337-8232","institution":"D. 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Patil University School of Nursing","correspondingAuthor":false,"prefix":"","firstName":"Ann","middleName":"Maria","lastName":"Thomas","suffix":""}],"badges":[],"createdAt":"2025-11-20 03:56:51","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":true,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8160070/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8160070/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":96604931,"identity":"678616ba-cfdc-4119-b101-931880280f7c","added_by":"auto","created_at":"2025-11-24 09:16:15","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":49176,"visible":true,"origin":"","legend":"","description":"","filename":"articledhanu1.docx","url":"https://assets-eu.researchsquare.com/files/rs-8160070/v1/e50b370cd39e8dd591042733.docx"},{"id":96566030,"identity":"2318da95-2c0c-41dc-aded-fe6d76004e49","added_by":"auto","created_at":"2025-11-23 15:50:34","extension":"json","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":342,"visible":true,"origin":"","legend":"","description":"","filename":"rs8160070.json","url":"https://assets-eu.researchsquare.com/files/rs-8160070/v1/acfdfc704010b07414e9c521.json"},{"id":96566026,"identity":"2b5ff9e5-3752-419f-869d-b244ca75e081","added_by":"auto","created_at":"2025-11-23 15:50:34","extension":"xml","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":67226,"visible":true,"origin":"","legend":"","description":"","filename":"rs81600700enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-8160070/v1/878cfd0a3b6da3a12aaab0f7.xml"},{"id":96566025,"identity":"4031a40d-e49a-42d6-a263-ab10bc6e0670","added_by":"auto","created_at":"2025-11-23 15:50:34","extension":"xml","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":64693,"visible":true,"origin":"","legend":"","description":"","filename":"rs81600700structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-8160070/v1/8290d220032bd856a1738505.xml"},{"id":96566029,"identity":"bbc8b007-2343-4216-b45c-7910c7e616c6","added_by":"auto","created_at":"2025-11-23 15:50:34","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":72694,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-8160070/v1/0d46ef3660093c5eb35b1649.html"},{"id":96605910,"identity":"cff0e6df-c6b5-4e5d-9304-97f78ce70bfe","added_by":"auto","created_at":"2025-11-24 09:24:21","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":15247,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAge distribution of routine care and acupressure participants\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8160070/v1/97b17e0e5fba2e310025f178.png"},{"id":96566023,"identity":"d1755bfc-b56b-4130-9500-c43e7af7d4ff","added_by":"auto","created_at":"2025-11-23 15:50:34","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":16101,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eComparison of the religious participants\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8160070/v1/9c822c7abb49d15ce4762f95.png"},{"id":96608311,"identity":"7466cf38-26ff-4b00-96ca-86bbfd2cf378","added_by":"auto","created_at":"2025-11-24 09:28:22","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1115294,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8160070/v1/87dcb7da-8400-4585-a2a5-52155bdad615.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eEffectiveness of acupressure on Sanyinjiao point in relation to labor pain intensity \u0026amp; duration in the first stage of labor among primigravida mothers admitted in labor rooms in selected hospitals in metropolitan city\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003eChildbirth is a significant experience in a woman\u0026rsquo;s life, involving uterine contractions that facilitate cervical dilation and effacement for delivery. Annually, approximately 140\u0026nbsp;million births occur worldwide (Smith et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Labor is a natural process, but it is often accompanied by severe pain and discomfort, which can impact maternal satisfaction and outcomes. Effective pain management is essential to enhance the childbirth experience. According to contemporary obstetric literature, labor pain results from complex physiological mechanisms involving both visceral and somatic components, contributing to the intensity experienced during the first and second stages of labor (Cunningham et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eDespite advances in obstetric care, many women still experience prolonged labor and severe pain, leading to an increased use of pharmacological interventions such as epidurals and analgesics (Koskinen et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). While these methods can be effective, they may have side effects and may not be accessible in all settings, particularly in low-resource areas (Hofmeyr \u0026amp; Kulier, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAcupressure, a non-pharmacological intervention rooted in traditional Chinese medicine, has gained attention for its potential benefits in managing labor pain. It is cost-effective, easy to administer, and free from adverse pharmacological effects, making it an appealing option for labor management (Badria, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). The Sanyinjiao (SP6) point, located on the medial aspect of the leg, is widely recognized for its role in gynecological and obstetric care, including alleviating dysmenorrhea and promoting labor progression (Sayed et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThis study aims to evaluate the relevance of acupressure in the current context, where non-invasive and holistic approaches to labor pain management are increasingly sought. By focusing on the SP6 point, the study explores its effectiveness in reducing labor pain intensity and duration, thereby contributing to the broader discourse on improving maternal health and childbirth experiences.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eA quantitative evaluative approach was adopted for this study to assess the effectiveness of acupressure at the Sanyinjiao (SP6) point in reducing labor pain intensity and duration. This approach systematically evaluates interventions, policies, and practices to derive evidence-based conclusions. A quasi-experimental post-test-only design was used, incorporating an experimental group that received acupressure and a control group that received routine care. This design enabled the researcher to explore cause-and-effect relationships between the intervention and the outcomes.\u003c/p\u003e\u003cp\u003eThe study was conducted in the labor room of Shastri Hospital, located in the Metropolitan City of Mumbai, India. The facility has a 30-bed labor ward, with 4 beds dedicated to active labor management. Approximately 4\u0026ndash;6 natural births occur daily, with round-the-clock staff support in rotating shifts. The target population consisted of primigravida mothers in the first stage of labor who met the inclusion criteria. A total sample size of 64 participants was calculated using an effect size of 0.7, power of 0.80, and a significance level of 0.05. The participants were equally divided into an experimental group (32) and a control group (32), selected using a non-probability purposive sampling technique.\u003c/p\u003e\u003cp\u003eData collection involved an interview schedule to gather demographic details, including age, education, marital status, and income, as well as an observational tool to assess pain intensity and labor duration using the ESWADOPA standardized pain scale. Inclusion criteria required mothers to be in the first stage of labor, without pharmacological pain management, and willing to participate. Exclusion criteria included high-risk pregnancies, injuries or abnormalities at the SP6 point, and unwillingness to participate.\u003c/p\u003e\u003cp\u003eThe tools were validated by experts in nursing, medicine, and statistics, with revisions made based on their feedback. The ESWADOPA pain scale demonstrated acceptable internal consistency (Cronbach\u0026rsquo;s alpha\u0026thinsp;=\u0026thinsp;0.784), ensuring its reliability. Ethical clearance was obtained from the Institutional Ethical Committee (File No: IEC/1547/PG/2023-22/03). The study was conducted in accordance with the Indian Council of Medical Research (ICMR) National Ethical Guidelines for Biomedical and Health Research Involving Human Participants, 2019, and the principles outlined in the Declaration of Helsinki (2017). Written informed consent was obtained from all participants, and confidentiality and anonymity were strictly maintained throughout the study.\u003c/p\u003e\u003cp\u003eA pilot study was conducted at D. Y. Patil Hospital, Navi Mumbai, to test the feasibility of the methodology and tools. The results indicated that acupressure effectively reduced pain intensity and labor duration, confirming the suitability of the research design for the main study.\u003c/p\u003e\u003cp\u003eData analysis involved editing, classifying, tabulating, and systematically interpreting the collected data to meet the study objectives. The data were compiled into a master sheet and analyzed using IBM SPSS Version 22. Descriptive statistics, including frequency and percentage, were used to summarize baseline demographic and clinical variables of primigravida mothers during the first stage of labor. Inferential statistics, including the Mann-Whitney U test, were applied to compare pain scores between the experimental group (acupressure at the Sanyinjiao point) and the control group (routine care). The correlation coefficient test assessed the relationship between pain scores and labor duration under both conditions. Results were presented through tables and graphs, with statistical significance determined at the 0.05 level.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe study included 32 participants each in the routine care and acupressure groups. Participants in both groups were primarily aged 18\u0026ndash;29 years, with the acupressure group having a slightly higher percentage (93.8%) in this age range compared to the routine care group (75%). Hindu participants predominated in the acupressure group (65.6%), whereas the routine care group had a more even distribution among Hindu (34.4%) and Muslim (37.5%) participants. Educational levels varied, with higher secondary education being more common in the acupressure group (34.4%) than in the routine care group (21.9%).\u003c/p\u003e\u003cp\u003eAll participants were married, but the duration of marriage varied, with most in the acupressure group (56.3%) reporting 2\u0026ndash;3 years compared to 43.8% in the routine care group. Nuclear families were more common in the acupressure group (65.6%) than in the routine care group (43.8%). Employment was higher in the routine care group (68.8%) compared to 56.3% in the acupressure group. Income levels varied, with \"no income\" being reported more frequently in the acupressure group (43.8%) compared to the routine care group (28.1%). Overall, demographic distributions reflected diverse participant backgrounds across both groups (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, Figs.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e \u0026amp; \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFrequency percentages distribution demographic variables of the participants both routine care and Acupressure\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e\u003cp\u003eDemographic Variables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003eRoutine Care (32)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eAcupressure (32)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eFrequency (n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEducation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrimary\u003c/p\u003e\u003cp\u003eSecondary\u003c/p\u003e\u003cp\u003eHigher Secondary\u003c/p\u003e\u003cp\u003eGraduate and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e3\u003c/p\u003e\u003cp\u003e15\u003c/p\u003e\u003cp\u003e7\u003c/p\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" 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colname=\"c6\"\u003e\u003cp\u003e65.6\u003c/p\u003e\u003cp\u003e34.4\u003c/p\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOccupation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003cp\u003eUnemployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e22\u003c/p\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e68.8\u003c/p\u003e\u003cp\u003e31.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e18\u003c/p\u003e\u003cp\u003e14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e56.3\u003c/p\u003e\u003cp\u003e43.8\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eIncome\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo income\u003c/p\u003e\u003cp\u003e0\u0026ndash;15,000\u003c/p\u003e\u003cp\u003e16,000\u0026ndash;30,000\u003c/p\u003e\u003cp\u003e31,000 and above\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e9\u003c/p\u003e\u003cp\u003e10\u003c/p\u003e\u003cp\u003e7\u003c/p\u003e\u003cp\u003e6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.1\u003c/p\u003e\u003cp\u003e31.3\u003c/p\u003e\u003cp\u003e21.9\u003c/p\u003e\u003cp\u003e18.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e14\u003c/p\u003e\u003cp\u003e7\u003c/p\u003e\u003cp\u003e8\u003c/p\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e43.8\u003c/p\u003e\u003cp\u003e21.9\u003c/p\u003e\u003cp\u003e25.0\u003c/p\u003e\u003cp\u003e9.4\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe distribution of pain levels is categorized based on specific pain rating scores. Participants who do not express pain have scores below 1, indicating no pain experience. Mild pain is reflected by scores ranging from 1 to 6, while moderate pain is indicated by scores between 7 and 12. Intense pain is represented by scores from 13 to 18, signifying the highest level of discomfort. This classification serves as a structured framework for assessing and interpreting the intensity of labor pain among participants in the study.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eFrequency percentages distribution clinical variables of pain levels of the participants in both routine care and Acupressure\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eAcupressure\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eRoutine Care\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLevel of pain\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003cp\u003e(n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eFrequency\u003c/p\u003e\u003cp\u003e(n)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ePercentage (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003eCervical Dilatation: 3\u0026ndash;4 cm\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot express pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e7%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpress mild pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e73%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e18\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e53%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpress moderate pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e40%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpress intense pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCervical Dilatation: 5\u0026ndash;6 cm\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot express pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpress mild pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e67%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e17%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpress moderate pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e33%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e70%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpress intense pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e13%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"5\" nameend=\"c5\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCervical Dilatation: 9\u0026ndash;10 cm\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNot express pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e4%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpress mild pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e4%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e11%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpress moderate pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e24\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e73%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e67%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eExpress intense pain\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e23%\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e18%\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e describes the distribution of pain levels among participants across different cervical dilation stages demonstrating distinct variations between the acupressure and routine care groups. At 3\u0026ndash;4 cm dilation, 23% of participants in the acupressure group reported no pain compared to 7% in the routine care group, while 73% experienced mild pain in the acupressure group versus 53% in routine care. Moderate pain was significantly lower in the acupressure group (4%) compared to 40% in routine care, with no intense pain reported in either group.\u003c/p\u003e\u003cp\u003eAt 5\u0026ndash;6 cm dilation, the acupressure group saw 67% of participants experiencing mild pain and 33% reporting moderate pain, with no cases of intense pain. In contrast, the routine care group had only 17% reporting mild pain, 70% experiencing moderate pain, and 13% enduring intense pain.\u003c/p\u003e\u003cp\u003eAt 9\u0026ndash;10 cm dilation, the acupressure group showed a higher proportion of participants experiencing moderate pain (73%) compared to 67% in routine care. However, intense pain was reported by 23% in the acupressure group versus 18% in routine care. These findings suggest that acupressure may reduce the intensity of labor pain, particularly during the earlier stages of cervical dilation.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Pain score in two groups (routine and acupressure) using Mann Whitney U test at 3\u0026ndash;4cm dilatation, 5\u0026ndash;6 cm dilatation, and 9\u0026ndash;10cm dilatation. (Mean Pain score\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eStages of Dilatation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eType of Care\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMann- Whitney U test statistic (standardized)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRoutine care\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAcupressure\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e3-4cm Dilatation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e5.69\u0026thinsp;\u0026plusmn;\u0026thinsp;2.620\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;2.295\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e-3.485\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.000*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e5\u0026ndash;6 cm Dilatation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e8.97\u0026thinsp;\u0026plusmn;\u0026thinsp;2.890\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e6.19\u0026thinsp;\u0026plusmn;\u0026thinsp;1.424\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;4.514\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.000*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e9\u0026ndash;10 cm Dilatation\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e10.69\u0026thinsp;\u0026plusmn;\u0026thinsp;2.764\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e10.28\u0026thinsp;\u0026plusmn;\u0026thinsp;3.531\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u0026minus;\u0026thinsp;0.602\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.547\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003e*P value ≤ 0.05 considered as significant at α = 0.05\u003c/h3\u003e\n\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the comparison of pain scores between the routine care and acupressure groups at different stages of cervical dilation revealing significant differences at earlier stages but no significant difference at the final stage. At 3\u0026ndash;4 cm dilation, the mean pain score in the routine care group (5.69\u0026thinsp;\u0026plusmn;\u0026thinsp;2.620) was significantly higher than in the acupressure group (3.34\u0026thinsp;\u0026plusmn;\u0026thinsp;2.295), with a Mann-Whitney U test statistic of -3.485 and a p-value of 0.000. Similarly, at 5\u0026ndash;6 cm dilation, the routine care group reported a higher mean pain score (8.97\u0026thinsp;\u0026plusmn;\u0026thinsp;2.890) compared to the acupressure group (6.19\u0026thinsp;\u0026plusmn;\u0026thinsp;1.424), with a test statistic of -4.514 and a p-value of 0.000. However, at 9\u0026ndash;10 cm dilation, the mean pain scores between the routine care group (10.69\u0026thinsp;\u0026plusmn;\u0026thinsp;2.764) and the acupressure group (10.28\u0026thinsp;\u0026plusmn;\u0026thinsp;3.531) showed no significant difference, with a test statistic of -0.602 and a p-value of 0.547. This suggests that acupressure is effective in reducing pain during early and mid-labor stages but shows comparable outcomes to routine care in the final stages of dilation.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Mean Labor duration in seconds between Routine and Acupressure groups.\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\"\u0026plusmn;\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eDuration of labor\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eType of care\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eMann- Whitney U test statistic (standardized)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRoutine care\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAcupressure\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDuration of mild: \u0026lt;20 sec\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e15\u0026thinsp;\u0026plusmn;\u0026thinsp;5.536\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e6.78\u0026thinsp;\u0026plusmn;\u0026thinsp;4.499\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;5.968\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.000*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDuration of moderate: 21 to 40 sec\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e51.25\u0026thinsp;\u0026plusmn;\u0026thinsp;15.811\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e23.28\u0026thinsp;\u0026plusmn;\u0026thinsp;16.685\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;6.461\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.000*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDuration of severe: \u0026ge;41 sec\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c2\"\u003e\u003cp\u003e128.44\u0026thinsp;\u0026plusmn;\u0026thinsp;57.142\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\"\u0026plusmn;\" colname=\"c3\"\u003e\u003cp\u003e110\u0026thinsp;\u0026plusmn;\u0026thinsp;54.299\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e\u003cb\u003e\u0026minus;\u0026thinsp;5.422\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e0.000*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\n\u003ch3\u003e*P value ≤ 0.05 considered as significant at α = 0.05; Mann- Whitney U test\u003c/h3\u003e\n\u003cp\u003eThe comparison of mean labor duration between routine care and acupressure groups shows significant differences across all pain intensities. For mild pain (\u0026lt;\u0026thinsp;20 seconds), the routine care group reported a longer mean duration (15\u0026thinsp;\u0026plusmn;\u0026thinsp;5.536 seconds) compared to the acupressure group (6.78\u0026thinsp;\u0026plusmn;\u0026thinsp;4.499 seconds), with a Mann-Whitney U test statistic of -5.968 and a p-value of 0.000. Similarly, for moderate pain (21\u0026ndash;40 seconds), the mean duration was significantly higher in the routine care group (51.25\u0026thinsp;\u0026plusmn;\u0026thinsp;15.811 seconds) than in the acupressure group (23.28\u0026thinsp;\u0026plusmn;\u0026thinsp;16.685 seconds), with a test statistic of -6.461 and a p-value of 0.000. For severe pain (\u0026ge;\u0026thinsp;41 seconds), the routine care group again exhibited a longer mean duration (128.44\u0026thinsp;\u0026plusmn;\u0026thinsp;57.142 seconds) compared to the acupressure group (110\u0026thinsp;\u0026plusmn;\u0026thinsp;54.299 seconds), with a test statistic of -5.422 and a p-value of 0.000. These findings highlight that acupressure significantly reduces labor duration at all pain intensity levels compared to routine care (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eAssociation of labor pain intensity and duration in the first stage of labor score in Routine care and Acupressure groups\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003eLevel of Pain\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e\u003cp\u003eDuration in the first stage of labor score\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e\u003cp\u003eMild\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e\u003cp\u003eSevere\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCorrelation coefficient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eCorrelation coefficient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eCorrelation coefficient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRoutine care (n\u0026thinsp;=\u0026thinsp;32)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIn 3\u0026ndash;4 cm dilatation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.277\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.228\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.209\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.473\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003e0.006*\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIn 5\u0026ndash;6 cm dilatation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.261\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.149\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.025\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.893\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.585\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIn 9\u0026ndash;10 cm dilatation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.307\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.087\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.146\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.424\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.271\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.134\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"7\" nameend=\"c7\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAcupressure groups (n\u0026thinsp;=\u0026thinsp;32)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIn 3\u0026ndash;4 cm dilatation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.221\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.225\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.216\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.235\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.100\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.585\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIn 5\u0026ndash;6 cm dilatation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.165\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.367\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.255\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.093\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.612\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIn 9\u0026ndash;10 cm dilatation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e-0.229\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.206\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-0.332\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.064\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e-0.217\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.232\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003e*\u003cb\u003eP value\u0026thinsp;\u0026le;\u0026thinsp;0.05 considered as significant at α\u0026thinsp;=\u0026thinsp;0.05; Spearman rank correlation test\u003c/b\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e describes the association between labor pain intensity and duration in the first stage of labor was analyzed for both routine care and acupressure groups across three stages of cervical dilation (3\u0026ndash;4 cm, 5\u0026ndash;6 cm, and 9\u0026ndash;10 cm) using Spearman's rank correlation test.\u003c/p\u003e\u003cp\u003eIn the routine care group, a significant positive correlation was observed between severe pain intensity and duration at 3\u0026ndash;4 cm dilation (correlation coefficient: 0.473, p\u0026thinsp;=\u0026thinsp;0.006). No significant correlations were found for mild or moderate pain at this stage, or for any pain levels at the subsequent dilation stages (5\u0026ndash;6 cm and 9\u0026ndash;10 cm).\u003c/p\u003e\u003cp\u003eIn the acupressure group, no significant correlations were observed between pain intensity and duration across any dilation stages or pain levels.\u003c/p\u003e\u003cp\u003eThese findings suggest that acupressure may attenuate the relationship between pain intensity and labor duration compared to routine care, with routine care showing a significant link between severe pain and prolonged duration during the early stage of dilation.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study aimed to evaluate the impact of acupressure at the Sanyinjiao (SP6) point on labor pain intensity and duration among primigravida mothers during the first stage of labor. Both the acupressure and routine care groups frequently reported labor pain during cervical dilation stages from 3 cm to 10 cm. It is hypothesized that the use of acupressure could enhance maternal acceptance of the procedure, ultimately improving their overall quality of life during childbirth.\u003c/p\u003e\u003cp\u003eThe findings of this study are consistent with those of Asmaa Morgan Farahat Khatap et al. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2015\u003c/span\u003e), who investigated the effect of acupressure at the SP6 point on reducing labor pain. In their study, statistical significance was observed in the reduction of labor pain in the intervention group compared to the control group, as measured by the Wong-Baker Faces Pain Scale. Furthermore, the mean plasma cortisol levels showed a significant difference between the groups, further supporting the effectiveness of SP6 acupressure in reducing pain during the first stage of labor. The authors recommended the incorporation of SP6 acupressure into routine nursing care for women in labor.\u003c/p\u003e\u003cp\u003eSimilarly, Hulya Turkmen et al. (2020) conducted a randomized controlled trial examining the impact of acupressure on labor pain and duration. Their study demonstrated that the experimental group, which received acupressure at the SP6 point during the active and transition stages of labor, experienced significantly lower pain levels and shorter labor durations compared to the control group. Women in the experimental group also reported greater satisfaction with their birthing experience and were more likely to recommend acupressure to others. These results highlight the potential of SP6 acupressure to improve maternal outcomes by reducing pain and shortening labor.\u003c/p\u003e\u003cp\u003eIn a similar vein, Halime Oncu H (2019) studied the effects of acupressure at the SP6 point on labor pain and duration among Turkish nulliparous women. The results indicated that acupressure significantly reduced pain intensity and shortened the active phase of labor. However, no significant differences were observed between the acupressure and placebo groups regarding the second stage of labor or cesarean section rates. These findings reinforce the role of acupressure in facilitating a more manageable and satisfying childbirth experience for women.\u003c/p\u003e\u003cp\u003eOverall, the findings of these studies align with those of the current research, suggesting that acupressure at the Sanyinjiao point offers a promising intervention for alleviating labor pain and reducing the duration of labor, particularly in the first stage. The use of acupressure as part of routine care may provide valuable benefits to women in labor, contributing to improved birth experiences. However, further research is needed to confirm these results and explore the long-term effects of acupressure on maternal and neonatal outcomes.\u003c/p\u003e\n\u003ch3\u003eLimitation\u003c/h3\u003e\n\u003cp\u003eThis study has several limitations that do not undermine its purpose. First, the study was conducted at only one selected hospital in a metropolitan city. As a result, the findings can only be generalized to the population under study and may not be applicable to all settings or populations.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eSummary\u003c/h2\u003e\u003cp\u003eThis study aimed to assess the impact of acupressure at the Sanyinjiao point on labor pain intensity and labor duration in primigravida mothers. The findings demonstrated a significant reduction in labor pain intensity and a shorter duration of the first stage of labor in the acupressure group compared to the routine care group. The analysis also revealed that demographic and clinical variables were associated with both labor pain intensity and duration across both groups. These results align with previous research, suggesting that acupressure at the Sanyinjiao point can effectively alleviate pain and shorten labor. This chapter discusses these findings in the context of existing literature, highlighting the potential of acupressure as a non-pharmacological intervention for labor pain management. Recommendations for future research are provided to expand on these findings and further explore the benefits and mechanisms of acupressure during labor.\u003c/p\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eConflict of interest:\u0026nbsp;\u003c/strong\u003eThe authors declare no conflict of interest on this study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics Approval:\u003c/strong\u003e The study was approved by the independent ethics committee of the D. Y. Patil School of Nursing Ethical Committee (File No: IEC/1547/PG/2023-22/03). The study was conducted in accordance with the\u003cem\u003e\u0026nbsp;\u003cem\u003eIndian Council of Medical Research (ICMR) National Ethical Guidelines for Biomedical and Health Research Involving Human Participants, 2019\u003c/em\u003e,\u0026nbsp;\u003c/em\u003eand the principles outlined in the\u003cem\u003e\u0026nbsp;\u003cem\u003eDeclaration of Helsinki (2017)\u003c/em\u003e.\u003c/em\u003e\u003c/p\u003e\n\u003ch3\u003e\u003cstrong\u003eFunding Declaration\u003c/strong\u003e\u003c/h3\u003e\n\u003cp\u003e\u003cstrong\u003eThis research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors’ Contributions:\u0026nbsp;\u003c/strong\u003eDhanashree Parulekar, Deepa Ganesh Reddy \u0026amp; Ann Maria Thomas are responsible for research concepts and design, data collection and analysis, manuscript writing, and critical review of important knowledge content.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author wishes to thank D. Y. Patil School of Nursing \u0026amp; D. Y. Patil Hospital Navi Mumbai, India, for providing equipment/articles for data collection \u0026amp; labor room of Shastri Hospital, located in the Metropolitan City of Mumbai, India for granting permission for the data collection. They thanked the participants who participated in the study and for their cooperation for the researcher throughout the study period.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eLowdermilk DL, Perry SE, Cashion K, Alden KR. Maternity \u0026amp; Women\u0026rsquo;s Health Care. 12th ed. St. Louis (MO): Elsevier; 2020. p. 351.\u003c/li\u003e\n \u003cli\u003eCunningham FG, Leveno KJ, Bloom SL, Spong CY, Dashe JS, Hoffman BL, et al. Williams Obstetrics. 25th ed. New York (NY): McGraw-Hill Education; 2018. p. 444\u0026ndash;446.\u003c/li\u003e\n \u003cli\u003eFraser DM, Cooper MA, editors. Myles Textbook for Midwives. 16th ed. London (UK): Elsevier; 2020. p. 476\u0026ndash;478.\u003c/li\u003e\n \u003cli\u003eMorgan Farahat Khatap A, Abd El-Hamid A, Mohamed Abd Allah I, Mahmoud Ali El-kosery S. Effect of the Sanyinjiao Point (SP6) Acupressure on Reducing Labor Pain at Ismailia Governmental Hospitals. Egypt J Health Care. 2015 Sep 1;6(3):56-69.\u003c/li\u003e\n \u003cli\u003eTurkmen H, \u0026Ccedil;eber Turfan E. The effect of acupressure on labor pain and the duration of labor when applied to the SP6 point: Randomized clinical trial. J Nurs Sci. 2020 Jan;17(1): 12256.\u003c/li\u003e\n \u003cli\u003eOnc\u0026uuml; H, Okumus F. The effect of acupressure at the Sanyinjiao point on labor pain relief and duration of labor in Turkish nulliparous women. J Exp Clin Med. 2019;36(3):73-80.\u003c/li\u003e\n \u003cli\u003eSmith CA, Hay PJ, Cummings TM, et al. Acupuncture and acupressure for pain management during labor: a systematic review. BMC Complement Altern Med. 2017;17:219. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5322618\u003c/li\u003e\n \u003cli\u003eKoskinen S, Kivim\u0026auml;ki M, Leino-Arjas P, et al. Pelvic pain after childbirth: A longitudinal population study. BMC Pregnancy Childbirth. 2016;16: 229. Available from: https://www.researchgate.net/publication/284278778_Pelvic_pain_after_childbirth_A_longitudinal_population_study\u003c/li\u003e\n \u003cli\u003eHofmeyr GJ, Kulier R. Episiotomy for vaginal birth. Cochrane Database Syst Rev. 2014;2014(9). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4161094\u003c/li\u003e\n \u003cli\u003eBadria H. Labor pain experience and intensity: A Jordanian perspective. J Adv Nurs. 2004;46(4):446-454. Available from: https://www.researchgate.net/publication/8120501_Labor_pain_experience_and_intensity_A_Jordanian_perspective\u003c/li\u003e\n \u003cli\u003eEl Sayed H, El Gammal M, El Kholy A, et al. Effect of acupressure on labor pain and duration of delivery among laboring women attending Cairo University Hospital. J Nurs Educ Pract. 2018; 8(10):65-73. Available from: https://www.researchgate.net/publication/327720092_Effect_of_Acupressure_on_Labor_pain_and_Duration_of_Delivery_among_laboring_Women_Attending_Cairo_University_Hospital\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"D. Y. Patil University School of Nursing, Hospital \u0026 Research Centre","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Sanyinjiao point, childbirth, Primi mothers, Acupressure, labour pain","lastPublishedDoi":"10.21203/rs.3.rs-8160070/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8160070/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eLabor and childbirth, through natural processes, are often accompanied by severe pain and discomfort, impacting maternal satisfaction and outcomes. Effective pain management is essential to enhance the childbirth experience. Acupressure, a traditional Chinese medicine technique, applies pressure to specific points to balance energy flow (qi) and address various health concerns. The Sanyinjiao (SP6) point is commonly used to manage gynecological, emotional, and digestive issues, and it is hypothesized to reduce labor pain and duration. This study evaluates the effectiveness of SP6 acupressure in managing labor pain and duration among primigravida mothers in metropolitan city.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethodology: \u003c/strong\u003eA quasi-experimental post-test-only design was employed in a selected hospital. Non-probability purposive sampling included 64 participants, equally divided into experimental and control groups. Data collection tools included demographic interviews, observational techniques, and the ESWADOPA pain scale. Descriptive and inferential statistics, including the Mann-Whitney U test, were used for analysis.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eAcupressure significantly reduced labor pain intensity during early and mid-cervical dilation (3–6 cm) and shortened labor duration compared to routine care. Pain escalation was less frequent in the acupressure group, although differences at advanced dilation stages (9–10 cm) were not statistically significant.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eAcupressure is a promising non-pharmacological intervention for managing labor pain and duration, particularly during the early and middle stages of labor.\u003c/p\u003e","manuscriptTitle":"Effectiveness of acupressure on Sanyinjiao point in relation to labor pain intensity \u0026amp; duration in the first stage of labor among primigravida mothers admitted in labor rooms in selected hospitals in metropolitan city","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-23 15:50:29","doi":"10.21203/rs.3.rs-8160070/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a17b56fa-df91-4fa7-86f3-f5e3fc777dc0","owner":[],"postedDate":"November 23rd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":58291675,"name":"Nursing"}],"tags":[],"updatedAt":"2025-11-23T15:50:29+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-23 15:50:29","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8160070","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8160070","identity":"rs-8160070","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}