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Medicine Science
ORIGINAL RESEARCH International
Medical Journal
Medicine Science 201..;..(..):…

The effect of effleurage and abdominal lifting massage in the labor pain
Sri Wulan1,2, Ariawan Soejoenoes3, Sri Wahyuni M4, Syarief Thaufik Hidayat5,
Melyana Nurul Widyawati4, Rahmad Gurusinga2
1
Postgraduate Midwifery Program, Semarang Health Polytechnic, Semarang, Central Java, Indonesia
2
High School of Health Science Medistra, Deli Serdang, North Sumatera, Indonesia.
3
Medical Faculty, Diponegoro University. Semarang, Central Java, Indonesia
4
Semarang Health Polytechnic, Semarang, Central Java, Indonesia.
5
General Hospital Center Dr. Karyadi, Semarang, Central Java, Indonesia

Received 07 May 2017; Accepted 09 July 2017

Available online 2with doi: 10.5455/medscience.2017.06.8670

Abstract
This study was aimed to evaluate the effects of effleurage and abdominal lifting massage against a decrease in pain in pregnant women. A total of 36
pregnant women would divided into two groups, i.e. control group (untreated group) and effleurage and abdominal lifting group (group who would
undertake efflurage and abdominal lifting massage exercise). The pain assessment was carried out by using a numerical rating scale. In the intervention
group, a combination of effleurage massage and abdominal massage was applied simultaneously lifting any contraction in the active phase (2-3 minutes)
for 60 minutes. The reduction in the value of pain was found to be significantly greater in the group of pregnant women who undertook effleurage and
abdominal lifting massage workout (p < 0.05). In conclusion, the results of this study showed that effleurage and abdominal lifting massage is an
effective, healthy, and feasible method in reducing pain in the third trimester of pregnancy. Thus, this method is one of the workout alternatives to
suppress the pain in the third trimester of pregnancy.

Keywords: Workout, pregnancy, pain, musculoskeletal dysfunctio

Introduction

A woman's body will change throughout pregnancy. now, many non-pharmacological was performed to
These changes include weight gain, changes in posture, reduce labor pain. Effleurage and abdominal lifting
weakness of joints and ligaments and musculotendinous massage is an alternative method that's easier to
stretch [1]. The incidence of back pain in pregnant implement because it does not require a very strong
women is very high, about 30-70% [2-5]. It is also found force, just use chuck-chuck mild or gentle touch.
that 31.7% of pregnant women have pubic symphysis Mechanical efflaurage can blockade the pain caused no
pain. In addition to back and pubis pains, some skin stimulus. Abdominal lifting techniques can reduce
complaints developed include upper back pain, sacroiliac back pain, giving the advantage of gravity, which can be
joint pain, muscle cramps, lower extremity joint pain, done at any stage of labor so that labor becomes faster
limb discomfort, pedal edema, carpal tunnel syndrome, [10-11]. To date, the application of efflaurage and
imbalance and collapse [6,7]. The pregnancy-related abdominal lifting massage methods to reduce pregnancy
musculoskeletal dysfunction is influenced by the degree pain has never been carried out. Therefore, this study
of physical activity, cultural influence, environment, and aims to evaluate the effects of efflaurage and abdominal
hormonal changes. Hormone relaxin serves to relax the lifting massage against a decrease in pain in pregnant
ligaments in the pelvis for the birthing process [8], this women.
hormone also relaxes the ligaments supporting the spine
thus triggering pregnancy pain. This condition is also Material and Methods
aggravated by the separation of muscles due to the
stretching of the uterus as well as emotional stress [9]. Subject
It is an experimental study. A total of 36 pregnant
Non-pharmacological approach is an action without the women would be randomly divided into two groups, i.e.
administration of drugs that are simple, safe, and Control group (untreated group) and intervention group
relatively inexpensive in order to reduce labor pain. Until (a group who would undertake effleurage and abdominal
lifting massage exercise). The inclusion criteria of this
study include inpartu first stage, maternal age 20-35
*Coresponding Author: Sri Wulan, Postgraduate Midwifery
Program, Semarang Health Polytechnic, Semarang, Central years, primigravida, normal presentation of birth, and
Java, Indonesia. had no daily activities relatively heavy. The exclusion
E-mail: [email protected] criteria of this study include mother having
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doi: 10.5455/medscience.2017.06.8670 Med Science 201..;..(..):…

complications such as kidney disease (low back pain due waist mother without pressing on the abdomen. This
to kidney disorder), pre-eclampsia, bone disorder practice was repeated on every contraction (every 2-3
disease, placenta previa, bleeding, premature rupture of minutes) within 60 minutes.
membrane.
Ethics
Assessment of pain This study has passed an ethical review from the local
The pain assessment was carried out by using a Ethics Commission of Health Polytechnic, Semarang,
numerical rating scale. If the respondent has entered the East Java, Indonesia.
active phase of the first stage (opening 4-8 cm), the
measurement of the first pain scale was performed in the Statistical analysis
intervention group or the control group. In the The age, pain score, education level is shown in mean ±
intervention group, a combination of effleurage massage standard deviation. Differences between treatment
and abdominal massage was applied simultaneously groups will be analyzed using t-student test and bivariate
lifting any contraction in the active phase (2-3 minutes) test with the SPSS 17.0 statistical package. P value <
for 60 minutes. Whereas, for the control group 0.05 was set as statistically significant difference values.
intervention only pain measurement scale with a span of
60 minutes between pretest and posttest. Results

Effleurage massage and abdominal lifting method Table 1 presents subject age, educational level, pain
Massage is done when deep breathing to enhance scores, duration of labor, and body mass index in both
relaxation. Rub both palm and ends of fingers with light treatment groups. There are no significant differences in
pressure from the uterine fundus toward the symphysis, mean age, educational level, pain scores, duration of
then back toward the uterine fundus. Next, wipe the palm labor, and body mass index between the two treatment
and tip of the fingers toward the waist toward the rear groups (p > 0.05).

Table 1. Baseline subjects characteristics

Control Treatment P value

Age 24.50  5.54 24.88  5.34 p > 0.05
Educational degree p > 0.05
Elementary school 3 (16.66 %) 3 (16.66 %)
Junior high school 8 (44.44 %) 6 (33.33 %)
Senior high school 4 (22.22 %) 7 (38.88 %)
Postgraduate 3 (16.66 %) 2 (11.11 %)
Pain score 6.11  2.19 6.44  1.68 p > 0.05
Body mass index 24.90  3.2 25.40  2.98 p > 0.05
Duration of labour 13.60  2.19 13.44  2.38 p > 0.05

Figure 1 shows pain intensity before workout, pain pain in efflurage and abdominal lifting massage groups.
intensity after workout, and differences between the two The reduction in the value of pain are found to be
treatment groups. Values of pain in both groups before significantly greater in the group of pregnant women
undertaking workout are comparable (p < 0.05). After undertaking efflurage and abdominal lifting massage
undertaking workout, there is a reduction in the values of workout compared with the control group (p < 0.05).

Figure 1. The pain score in control and experimental group. The pain score was significantly lower in pregnant women undertaking efflurage and
abdominal lifting massage workout than in the control group.
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pengurangan tingkat nyeri persalinan kala i fase aktif pada
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Declaration of interest
17. Kimber L, McNabb M, Mc Court C, Haines A, Brocklehurst P.
The author(s) declare(s) that there is no conflict of Massage or music for pain relief in labour: a pilot randomised
interests regarding the publication of this article. placebo controlled trial. Eur J Pain. 2008;12(8):961-9.

18. Henderson JM. Peripheral nerve stimuation for chronic pain. Curr.
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