title: The efficacy of massage therapy and breathing techniques on pain intensity and physiological responses to labor pain.
abstract: BACKGROUND
  There are many non-pharmacological methods for relieving labor pain. The preferable method is certainly the one that is effective and harmless. Therefore, we decided to compare the efficacy of massage therapy and breathing techniques on pain intensity, physiological responses to labor pain, labor type and the outcomes.
  
  
  METHODS
  A quasi-experimental study was conducted in Alzahra Hospital in Tabriz. At first, 4o primigravidas, satisfying the inclusion criteria, were selected and randomly divided into two groups of massage 1 (M1) and breathing 1 (B1). Then, another 42 mothers were selected based on the same criteria and randomly divided into two groups of massage 2 (M2) and breathing 2 (B2). An educated researcher assistant (ERA) provided practical training to (B1 and B2 groups) by holding one educational session. As the labor process started, the ERA, who was present at the labor room, repeated the breathing technique for B1 and B2 groups. The breathing groups employed the techniques during the first or second stage of labor at 4, 6, 8 and 10 centimeter of dilatation for 30 minutes. The intensity of pain was measured by a numerical rating scale (NRS) 30 minutes after determining dilatation. The physiological responses were evaluated at the same time intervals. The ERA performed massaging at the same dilatations for M1 and M2 groups. The data was collected similarly. Labor progression was evaluated by the partograph.
  
  
  RESULTS
  Massage at 4 and 6 cm dilatations and breathing at most dilatations decreased pain scores significantly. The mean difference of pain intensity and physiological responses to pain was not significant between the massaging and breathing groups at most dilatations.
  
  
  CONCLUSIONS
  Based on the findings of this research, providing the possibility of choosing one or both methods for labor pain relief and decreasing cesarean section rate is suggested.
authors.affiliation: MSc, Instructor, Departement of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mahin
authors.initials: M
authors.lastname: Kamalifard
authors.affiliation: MSc, Instructor, Departement of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mahnaz
authors.initials: M
authors.lastname: Shahnazi
authors.affiliation: MD, Professor, Departement of Obstetrics and Gynecology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Manizheh
authors.initials: M
authors.lastname: Sayyah Melli
authors.affiliation: MSc, Instructor, Departement of Midwifery, Tabriz Branch, Islamic Azad University, Tabriz, Iran.
authors.forename: Shirin
authors.initials: S
authors.lastname: Allahverdizadeh
authors.affiliation: BSc in Midwifery, Tabriz, Iran.
authors.forename: Shiva
authors.initials: S
authors.lastname: Toraby
authors.affiliation: BSc in Midwifery, Tabriz, Iran.
authors.forename: Atefeh
authors.initials: A
authors.lastname: Ghahvechi
keywords: Breathing exercises; Delivery; Labor pain; Massage