Effect of plantar reflexology on labor pain and childbirth experience: A randomized controlled clinical trial

Authors: Jameei-Moghaddam Massoumeh, Goljaryan Sakineh, Mohammad Alizadeh Charandabi Sakineh, Taghavi Simin, Mirghafourvand MojganJournal: The journal of obstetrics and gynaecology researchPublished: June 1, 2021DOI: 10.1111/jog.14755

Strong EvidenceRandomized Controlled Trialn=90 participants

Pregnancy Discomfort

In Plain Language: reflexology for pregnancy, explained

This study aimed to determine the effect of plantar reflexology on the severity of labor pain and childbirth experience (primary outcomes) and the duration of labor stages (secondary outcomes). This single-blind randomized controlled trial was performed on 90 women in Al-Zahra and Taleghani hospitals in Tabriz-Iran. Participants were randomly assigned into three groups; Intervention 1 (two 30-min massages at the effective point of pain for each sole), intervention 2 (one 30-min massage at the effective point of pain and one 30-min massage at the heel for each sole), and control (two 30-minute heel massages). Massage was performed once in 4-cm dilatation and the second time in 7-cm dilatation. The severity of pain and childbirth experience were measured by Visual Analogue Scale and Labor Agentry Scale, respectively. Partograph chart was used to measure the length of labor stages. The severity of pain in intervention group 1 was significantly lower than the control group (AMD: -1.7; 9% confidence interval: -2.8 to -0.6; p = 0.001), but there was no significant difference between intervention groups 1 and 2 (p = 0.066) and intervention group 2 and control (p = 0.336). A significant difference was observed between groups in terms of length of the third stage of labor (p = 0.04). There was no significant difference between groups in terms of mean childbirth experience score (p = 0.217), duration of active phase (p = 0.099), and second stage of labor (p = 0.114). The results of the study showed that plantar reflexology can reduce the severity of labor pain and the length of third stage of labor.

Key Findings: what this randomised trial found about pregnancy

✓Plantar reflexology massage at effective pain points significantly reduced labor pain severity compared to control heel massage alone (AMD: -1.7).
✓Two 30-minute reflexology massages targeting pain-effective points on the soles during active labor (at 4-cm and 7-cm dilation) demonstrated greater pain reduction than heel-only massage in the control group.
✓The study evaluated reflexology's effects on both pain severity and overall childbirth experience using validated measurement scales (Visual Analogue Scale and Labor Agentry Scale).

What This Means for You

Plantar reflexology at specific pain-related points may modestly reduce labor pain intensity, though the effect is small and it does not appear to improve overall satisfaction with the childbirth experience.

What This Means for Practitioners

Target specific plantar reflex points rather than general heel massage if aiming to support labor pain management, as this approach showed statistically significant pain reduction in this clinical trial.

Study Design: how this randomised trial was run

Sample Size

90 participants

Read Full Paper↗

Reflexology for pregnancy: common questions

Does reflexology help with pregnancy?

What did this study find?

Plantar reflexology massage at effective pain points significantly reduced labor pain severity compared to control heel massage alone (AMD: -1.7). Two 30-minute reflexology massages targeting pain-effective points on the soles during active labor (at 4-cm and 7-cm dilation) demonstrated greater pain reduction than heel-only massage in the control group. The study evaluated reflexology's effects on both pain severity and overall childbirth experience using validated measurement scales (Visual Analogue Scale and Labor Agentry Scale).

How strong is this evidence?

This is a randomised trial and we rate its evidence strong. It covers 90 participants. It was published in The journal of obstetrics and gynaecology research. Reflexology is a complementary therapy, not a replacement for medical treatment.