Maddady et al., 20183535 Maddady S, Mohammad-Alizadeh S, Shafaei S, Mirghafourvand M. Comparing the effects of hot shower and intravenous injection of hyoscine on the pain intensity and duration of active phase of labour in nulliparous women. Iranian J Obstetr Gynecol Infertility 2018; 12(8):QC07-QC11. |
Hot / warm shower |
50 |
49 |
Reduction |
Active stage: 221.2 |
Active stage: 312.6 |
Mean Difference -110.7; 95%CI: 169.5; -51.8 |
Low risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Immersion bath |
Silva and Oliveira, 20062020 Silva FMB, Oliveira SMJV. O efeito do banho de imersão na duração do trabalho de parto. Rev Esc Enferm USP 2006; 40(1):57-63. |
Immersion bath for 40 to 60 minutes |
54 |
54 |
No effect |
6-10 cm dilation: 250.9 |
6-10 cm dilation: 260.4 |
p=0.89 |
Low risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Neiman et al., 20203838 Neiman E, Austin E, Tan A, Anderson CM, Chipps E. Outcomes of waterbirth in a US Hospital-Based Midwifery practice: a retrospective cohort study of water immersion during labor and birth. J Midwifery Womens Health 2020; 65(2):216-223. |
Immersion bath |
61 |
111 |
Nulliparous No effect Increase Multiparous No effect No effect |
Nulliparous Active stage: 764.7 Expulsion stage: 88.4 Multiparous Active stage: 469.3 Expulsion stage: 20.6 |
Nulliparous Active stage: 757.8 Expulsion stage: 79.7 Multiparous Active stage: 401.9 Expulsion stage: 16.8 |
Nulliparous p=0.13 p=0.03 Multiparous p=0.59 p=0.08 |
Good quality1414 Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. The Ottawa Hospital, Our Research; 2021 [cited 2023 jul 8]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. |
Liu et al., 20142727 Liu Y, Liu Y, Huang X, Du C, Peng J, Huang P, Zhang J. A comparison of maternal and neonatal outcomes between water immersion during labor and conventional labor and delivery. BMC Pregnancy Childbirth 2014; 14:160. |
Immersion bath in first stage of labor |
33 |
47 |
No effect No effect |
Active stage: 596.55 Expulsion stage: 58.79 |
Active stage: 552.30 Expulsion stage: 56.04 |
p=0.43 p=0.72 |
Some concerns1313 Palmeri V, Colamesta V, La Torre G. Evaluation of methodological quality of studies. Senses Sci 2016; 3(3):235-224. |
Eckert et al., 20011717 Eckert K, Turnbull D, MacLennan A. Immersion in water in the first stage of labor: a randomized controlled trial. Birth 2001; 28(2):84-93. |
Immersion bath in first stage of labor |
137 |
137 |
No effect No effect |
Active stage: 404.23 Expulsion stage: 64.94 |
Active stage: 407.21 Expulsion stage: 68.80 |
p=0.89 p=0.65 |
High risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Walking |
Mamede et al., 20072323 Mamede FV, Almeida AM, Souza L, Mamede MV. A dor durante o trabalho de parto: o efeito da deambulação. Rev Lat Am Enfermagem 2007; 15(6):1157-1162. |
Walking |
75 |
- |
Reduction |
Active stage: 22; 10 and 6 minutes shorter for every 100 meters walked at 1st, 2nd or 3rd hour, respectively |
Linear regression |
Low risk of bias1313 Palmeri V, Colamesta V, La Torre G. Evaluation of methodological quality of studies. Senses Sci 2016; 3(3):235-224. |
Breathing techniques |
Cicek and Basar, 20173232 Cicek S, Basar F. The effects of breathing techniques training on the duration of labor and anxiety levels of pregnant women. Complement Ther Clin Pract 2017; 29:213-219. |
Lamaze breathing technique |
35 |
35 |
Reduction Reduction No effect No effect |
Latent stage: 403.71 Active stage: 174.00 Transition stage: 110.71 Expulsion stage: 19.11 |
Latent stage: 658.71 Active stage: 264.57 Transition stage: 101.42 Expulsion stage: 24.48 |
p<0.001 p=0.01 p=0.28 p=0.14 |
Some concerns1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Ball exercises |
Gau et al., 20112424 Gau M-L, Chang C-Y, Tian S-H, Lin K-C. Effects of birth ball exercise on pain and self-efficacy during childbirth: a randomised controlled trial in Taiwan. Midwifery 2011; 27(6):e293-300. |
Birth ball exercises |
48 |
39 |
Reduction No effect |
Active stage: 380 Expulsion stage: 38.48 |
Active stage: 485.4 Expulsion stage: 41.3 |
p=0.04 p=0.59 |
Some concerns1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Massage |
Gallo et al., 20132626 Gallo RBS, Santana LS, Ferreira CHJ, Marcolin AC, Polineto OB, Duarte G, Quintana SM. Massage reduced severity of pain during labour: a randomised trial. J Physiother 2013; 59(2):109-116. |
30-min massage |
23 |
23 |
Increase |
Labor: 408 |
Labor: 342 |
Mean difference 1.1 hour; 95%CI: 0.2; 2.0 |
Low risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Positions adopted by mother |
Desseauve et al., 20162929 Desseauve D, Gachon B, Bertherat P, Fradet L, Lacouture P, Pierre F. Dans quelle position les femmes accouchent-elles en 2015? Résultats d'une étude prospective régionale multicentrique. Gynécologie Obstétrique Fertil 2016; 44(10):548-556. |
Dorsal decubitus during labor |
431 |
120 |
Reduction |
Labor classified as ≥120 or <120 minutes |
OR=2.2 95%CI: 1.2; 4.2 |
Good quality1515 Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Rev 2015; 4:1. |
Dorsal decubitus during expulsion |
303 |
144 |
Increase |
Labor classified as ≥120 or <120 minutes |
OR=0.1 95%CI: 0.0; 0.4 |
|
Bomfim-Hyppólito,19981616 Bomfim-Hyppólito S. Influence of the position of the mother at delivery over some maternal and neonatal outcomes. Int J Gynecol Obstetr 1998; 21(63):S67-S73. |
Semi-sitting position (60º) in expulsion stage |
127 |
121 |
No effect |
Expulsion stage: 21.7 |
Expulsion stage: 25.1 |
p=0.06 |
High risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Maternal mobility |
Desseauve et al., 20162929 Desseauve D, Gachon B, Bertherat P, Fradet L, Lacouture P, Pierre F. Dans quelle position les femmes accouchent-elles en 2015? Résultats d'une étude prospective régionale multicentrique. Gynécologie Obstétrique Fertil 2016; 44(10):548-556. |
Switching position during labor |
411 |
140 |
Increase |
Labor classified as ≥120 or <120 minutes |
OR=0.2 95%CI: 0.1; 0.3 |
Good quality1515 Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Shekelle P, Stewart LA. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Rev 2015; 4:1. |
Acupuncture/Acupressure/Auriculotherapy |
Gaudernack et al., 20062121 Gaudernack LC, Forbord S, Hole E. Acupuncture administered after spontaneous rupture of membranes at term significantly reduces the length of birth and use of oxytocin: a randomized controlled trial. Acta Obstet Gynecol Scand 2006; 85(11):1348-1353. |
Acupuncture |
43 |
48 |
Reduction |
Active stage: 264 |
Active stage: 366 |
Mean Difference 1.7 hour; 95%CI: 0.2; 3.1 |
Low risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Mafetoni and Shimo, 20152828 Mafetoni RR, Shimo AKK. Efeitos da acupressão na evolução do parto e taxa de cesárea: ensaio clínico randomizado. Rev Saude Publica 2015; 49:9. |
Acupressure at point BP6 |
38 |
30 |
Reduction |
628.10 |
913.10 |
p=0.004 |
Low risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Mafetoni et al., 20183636 Mafetoni RR, Jacob LMS, Jorge HMF, Shimo AKK. Efeitos da auriculoterapia no tempo de trabalho de parto e taxa de cesárea: ensaio clínico randomizado. REME 2018; 22:e1139. |
Auriculotherapy |
25 |
27 |
No effect |
607.8 |
694.7 |
p=0.08 |
Low risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Water birth |
Schröcksnadel et al., 20031818 Schröcksnadel H, Kunczicky V, Meier J, Brezinka C, Oberaigner W. Water Birth: experience at a university clinic and a district hospital in Austria. Gynakol Geburtshilfliche Rundsch 2003; 43(1):7-11. |
Water birth in District Hospital |
47 |
265 |
Reduction |
Expulsion stage: 15 |
Expulsion stage: 20 |
p=0.02 |
Good quality14 |
Water birth at University Hospital |
218 |
265 |
No effect |
Expulsion stage: 23 |
Expulsion stage: 20 |
Non-significant |
Zanetti-Daellenbach et al., 20072222 Zanetti-Daellenbach RA, Tschudin S, Zhong XY, Holzgreve W, Lapaire O, Hösli I. Maternal and neonatal infections and obstetrical outcome in water birth. Eur J Obstet Gynecol Reprod Biol 2007; 134(1):37-43. |
Water birth after immersion bath |
89 |
146 |
No effect Reduction |
Active stage: 330.5 Expulsion stage: 35.3 |
Active stage: 352.8 Expulsion stage: 49.1 |
Non-significant p<0.001 |
Good quality1414 Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. The Ottawa Hospital, Our Research; 2021 [cited 2023 jul 8]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. |
Cortes et al., 20112525 Cortes E, Basra R, Kelleher CJ. Waterbirth and pelvic floor injury: a retrospective study and postal survey using ICIQ modular long form questionnaires. Eur J Obstet Gynecol Reprod Biol 2011; 155(1):27-30. |
Water birth |
78 |
48 |
Reduction |
Expulsion stage: 43 |
Expulsion stage: 57 |
p=0.01 |
Good quality1414 Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. The Ottawa Hospital, Our Research; 2021 [cited 2023 jul 8]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. |
Ulfsdottir et al., 20183434 Ulfsdottir H, Saltvedt S, Georgsson S. Waterbirth in Sweden: a comparative study. Acta Obstet Gynecol Scand 2018; 97(3):341-348. |
Water birth |
306 |
306 |
Reduction |
Expulsion stage: 21.6 |
Expulsion stage: 26.8 |
p=0.01 |
Good quality1414 Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. The Ottawa Hospital, Our Research; 2021 [cited 2023 jul 8]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. |
Neiman et al., 20203838 Neiman E, Austin E, Tan A, Anderson CM, Chipps E. Outcomes of waterbirth in a US Hospital-Based Midwifery practice: a retrospective cohort study of water immersion during labor and birth. J Midwifery Womens Health 2020; 65(2):216-223. |
Water birth |
58 |
111 |
Nulliparous Reduction Multiparous No effect |
Nulliparous Expulsion stage: 23.2 Multiparous Expulsion stage: 9.5 |
Nulliparous Expulsion stage: 79.7 Multiparous Expulsion stage: 16.8 |
Nulliparous p=0.03 Multiparous p=0.08 |
Good quality1414 Wells GA, Shea B, O'Connell D, Peterson J, Welch V, Losos M, Tugwell P. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses [Internet]. The Ottawa Hospital, Our Research; 2021 [cited 2023 jul 8]. Available from: http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. |
Pushing techniques in expulsion stage |
Koyucu and Demirci, 20173131 Koyucu RG, Demirci N. Effects of pushing techniques during the second stage of labor: A randomized controlled trial. Taiwan J Obstet Gynecol 2017; 56(5):606-612. |
Spontaneous pushing |
40 |
40 |
Increase |
Expulsion stage: 63.2 |
Expulsion stage: 46.6 |
p<0.001 |
Low risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Vaziri et al., 20163030 Vaziri F, Arzhe A, Asadi N, Pourahmad S, Moshfeghy Z. Spontaneous pushing in lateral position versus valsalva maneuver during second stage of labor on maternal and fetal outcomes: a randomized clinical trial. Iran Red Crescent Med J 2016; 18(10):e29279. |
Spontaneous pushing in lateral position |
35 |
34 |
Increase |
Expulsion stage: 76.32 |
Expulsion stage: 64.56 |
p<0.001 |
Some concerns1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Techniques used in association |
Almeida et al., 20051919 Almeida NAM, Sousa JT, Bachion MM, Silveira NA. Utilização de técnicas de respiração e relaxamento para alívio de dor e ansiedade no processo de parturição. Rev Lat Am Enferm 2005; 13(1):52-58. |
Breathing plus relaxation techniques |
19 |
17 |
Increase No effect No effect |
Latent stage: 145.26 Active stage: 173.68 Transition stage: 126.31 |
Latent stage: 84.70 Active stage: 151.76 Transition stage: 103.23 |
p=0.01 p=0.54 p=0.16 |
Some concerns1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Cavalcanti et al., 20193737 Cavalcanti ACV, Henrique AJ, Brasil CM, Gabrielloni MC, Barbieri M. Terapias complementares no trabalho de parto: ensaio clínico randomizado. Rev Gaucha Enferm 2019; 40:e20190026. |
Hot / warm shower plus birth ball exercises |
39 |
44 |
No effect |
From combined intervention to birth: 216.85 |
Hot shower to birth: 255.05 |
p=0.10 |
Low risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
45 |
From birth ball exercises to birth: 288.41 |
p=0.10 |
Gallo et al., 201888 Gallo RBS, Santana LS, Marcolin AC, Duarte G, Quintana SM. Sequential application of non-pharmacological interventions reduces the severity of labour pain, delays use of pharmacological analgesia, and improves some obstetric outcomes: a randomised trial. J Physiother 2018; 64(1):33-40. |
Ball exercises, lumbosacral massage plus warm/hot shower |
40 |
40 |
No effect Reduction |
Active stage: 373 Expulsion stage: 19 |
Active stage: 445 Expulsion stage: 37 |
95%CI: 148; 5 95%CI: 30; -5 |
Low risk of bias1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|
Makvandi et al., 20183333 Makvandi S, Mirzaiinajmabadi K, Mirteimoori M, Esmaily H. Effect of normal physiologic childbirth program in mother-friendly hospitals on duration of labor. Electron J Gen Med 2018; 15(3):em21. |
Immersion bath, birth ball exercise, aromatherapy with lavender and vertical positions during second stage of labor |
77 |
77 |
Reduction No effect |
Active stage: 210.02 Expulsion stage: 36.61 |
Active stage: 269.54 Expulsion stage: 43.08 |
p<0.001 p=0.08 |
Low risk of bias1313 Palmeri V, Colamesta V, La Torre G. Evaluation of methodological quality of studies. Senses Sci 2016; 3(3):235-224. |
Bio et al., 200677 Bio E, Bittar RE, Zugaib M. Influência da mobilidade materna na duração da fase ativa do trabalho de parto. Rev Bras Ginecol Obstetr 2006; 28(11):671-679. |
Mobility and alternating vertical postures |
50 |
50 |
Reduction |
Active stage: 316 |
Active stage: 508 |
p<0.001 |
Some concerns1212 Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. In: Aromataris E, Lockwood C, Porritt K, Pilla B, Jordan Z, editors. JBI Manual for Evidence Synthesis [Internet]. 2020 [cited 2023 jul 8]. Available from; https://synthesismanual.jbi.global. https://synthesismanual.jbi.global...
|