The role of intrapartum shiatsu massage during labour in Samarinda, Indonesia: a mixed-methods study

Labour pain persists as a challenge, and exploring alternative pain relief methods is crucial. Shiatsu massage shows potential based on available evidence. However, conclusive support for its efficacy and safety in alleviating pain and anxiety during labour is lacking. This study aimed to determine the efficacy and safety of intrapartum Shiatsu massage in reducing pain and anxiety during labour (quantitative phase), and to explore women‘s experiences and perceptions of Shiatsu massage during childbirth (qualitative phase). A concurrent mixed-methods design was employed in four randomly selected low-risk maternity clinics in Samarinda, East Kalimantan, Indonesia, from February to May 2022. In the quantitative phase, 80 participants were selected through systematic sampling. A quasi-experimental design was used, with two clinics assigned to the intervention group (routine care plus Shiatsu massage) and two to the control group (routine care only). Certified practitioners administered Shiatsu massage using a standardised protocol. Pain was measured using the Numeric Rating Scale (NRS), anxiety using the Hamilton Anxiety Rating Scale (HAM-A), and safety outcomes through clinical observation. Data were analysed using SPSS version 26. In the qualitative phase, ten participants from the intervention group were recruited through purposive sampling. Semi-structured interviews were conducted prior to discharge to explore their labour experiences and perceptions of Shiatsu massage. Thematic analysis was applied to the qualitative data. Quantitative findings indicated a significant reduction in pain (p<0.001) and anxiety (p<0.001) in the intervention group during the latent, active, and advanced active phases. Effect sizes were large for pain (η²=0.801) and anxiety (η² = 0.193). There was no significant maternal or neonatal complications were associated with the intervention. Qualitative analysis revealed that participants perceived Shiatsu massage as calming and supportive, contributing to a more positive birth experience. Several expressed a willingness to use Shiatsu massage in future labours. Intrapartum Shiatsu massage appears to be an effective, safe, and well-accepted complementary therapy for reducing labour pain and anxiety. Its application could be especially valuable in settings with limited to pharmacological analgesics.