Do Breathing Techniques Enhance the Effect of Massage Therapy in Reducing the Length of Labor or not? a Randomized Clinical Trial.

Introduction: Prolonged labor is a common birth complication that is associated with some negative maternal and fetal effects. The aims of this study were 1) to evaluate the effect of effleurage abdominal massage and 2) to assess the effects size of breathing techniques with massage on the length of labor. Methods: This study was a randomized trial with concealed allocation, assessor blinding for some outcomes and intent-to-treat analysis. Primiparous women (n=117) age 18-35 years who were randomly assigned to three groups; abdominal massage (n=37), abdominal massage with breathing technique (n=38) and control (n=42). Although it was randomized block design with the allocation ratio 1:1:1 but soon after the sample was withdrawn in labor, another was replaced. Experimental groups' participants received a 30-min effleurage abdominal massage during the active and transitional phases of labor. Particular breathing techniques in each stage of labor were done. Data were analyzed using SPSS ver.13. Results: Duration of the active phase was 244.89(83.30) min in the massage, 254(68.55) min in massage with breathing and 312.07(67.17) min in control group, which was significantly different between the massage and control groups (P<0.001, Min Diff; -67.18), as well as massage with breathing and control groups (P=0.003, Min Diff; -9.63). The Scheffe test showed no significant difference between the two experimental groups. Conclusion: Effleurage abdominal massages decrease length of active phase on labor, but the learning of breathing techniques in labor couldn't enhance this effect of massage, so it is likely that breathing exercises may be considered during pregnancy.