Effectiveness of sacral massage during labor in pregnant women: A systematic review and meta-analysis

Background and aim: Performing sacral massage during the childbirth process can provide numerous benefits due to its potential to alleviate stress and exhaustion. This systematic review and meta-analysis aimed to assess the effectiveness of sacral massage in pregnant women during labor. Method: A comprehensive search was conducted in main databases from inception to 18th May 2024. The quality of included randomized control trials (RCTs) and quasi-experimental studies was assessed using the Jadad Scale and the Risk of Bias Assessment Tool for Nonrandomized Studies (RoBANS), respectively. All analyses were performed using the RevMan version 5.3. The GRADEpro GDT tool was utilized to determine the level of certainty of the evidence. Findings: Nine articles were included in the systematic review and eight studies were included in the metaanalysis. The findings showed that in the sacral massage group, the labor pain intensity was significantly decreased (SMD= -2.40, 95 % CI -3. 5 to -1.29, p < 0.0001, I2 = 97 %). The findings also showed that sacral massage does not significantly alter the length of the first labor stage (MD=-0.04, 95 % CI -0.27 to 0.20, p = 0.77, I2 = 0 %) and the total duration of labor (MD= -0.56, 95 % CI -1.66, 0.55, p = 0.32, I2 = 90 %). The certainty of evidence for labor pain was moderate and for duration of the first stage and total duration of labor were very low. Conclusion: This study demonstrated that sacral massage was an effective, non-pharmacologic method that significantly alleviating pain in women during childbirth. As a result, this intervention can be implemented in clinical settings during labor.