Research Article

Kamini Chauhan1,
Effectiveness of Olive Oil Back Massage on
Seema Rani2, Reduction of Labor Pain during First Stage
Priyanka Bansal3
1
M.Sc. Nursing Student
of Labor
(Obstetrics and
Gynecology Nursing), Abstract
Rufaida College of
Nursing, Jamia Hamdard. Introduction: Pregnancy is the sensational journey of women toward motherhood. Pain
2
Assistant Professor, in labor is nearly universal experience for the child bearing women. Olive oil back
Rufaida College of massage stimulates the body to release endorphins, which are having natural pain-
Nursing, Jamia Hamdard. killing properties.
3
Tutor, Rufaida College of Objectives: (i) To assess the level of labor pain of primigravida mother in experimental
Nursing, Jamia Hamdard. group before and after olive oil back massage during first stage of labor. (ii) To
determine the level of labor pain of primigravida mother in control group. (iii) To
Correspondence to:
Ms. Kamini Chauhan, compare the level of labor pain among primigravida mothers in experimental group and
Rufaida College of control group.
Nursing, Jamia Hamdard.
Methods: A quasi-experimental study with purposive non-probability sampling
E-mail Id: kaminichauhan technique is used for the sample. Study was conducted on 60 samples (30 in
1481991@gmail.com experimental group and 30 in control group). A structured interview schedule,
labor
assessment proforma, numerical pain-rating scale was used for data collection and the
data were analyzed using descriptive and inferential statistics.

Results: Results revealed that there was less pain score in experimental group after the
olive oil back massage as compared to mothers who had not received olive oil back
massage in control group.

Conclusion: Results confirmed that the olive oil back massage is significantly effective in
reducing labor pain during first stage of labor.

Keywords: Labor pain, Back Massage, Olive oil.

Introduction
Labor is usually a painful experience for women who vary in their response to it. Pain is
a subjective experience involving a complex interaction of physiological, psychosocial,
cultural and environmental influences.1 Labor pain is an unpleasant, complex, highly
individualized phenomenon with both sensory and emotional components.2 A woman’s
experience of labor pain is influenced by many factors including her past experiences of
pain, her coping abilities, the birth environment and psychological factors.3

How to cite this article: The events of labor are divided into four stages. First stage starts from the onset of true
Chauhan K, Rani S, Bansal labor pain and ends with full dilatation of cervix. It is in other words, the “cervical
P. Effectiveness of Olive stage” of labor. Second stage of labor starts with full dilatation of cervix and ends with
Oil Back Massage on
the expulsion of fetus. Third stage begins after the expulsion of fetus and ends with the
Reduction of Labor Pain
during First Stage of expulsion of placenta and membranes. Fourth stage is the stage of observation of
Labor. Int J Nurs Midwif at least one hour after the expulsion of placenta and membranes.4
Res 2016; 3(2&3): 32-36.
The first symptom to appear in first stage of labor is intermittent painful uterine
ISSN: 2455-9318 contractions followed by expulsion of bloody mucous per vagina. Thefirst stage of labor
is characterized by noticeable cervical changes as a result of uterine contractions.

© ADR Journals 2016. All Rights Reserved.

Int. J. Nurs. Midwif. Res. 2016; 3(2&3)
The cervix softens, thins, shortens and opens to a
diameter of 10 cm. These changes are referred to as
effacement and dilatation. The first stage is
characterized by several physical and psychological
changes of which the most important one to be
managed is the pain due to intermittent uterine
contractions. In first stage of labor the mothers are
screaming and become exhausted which leads to
prolonged and complicated labor.4
Pain relief is the way in which women feel that they
have coped with pain during labor. Different alternative
and contemporary modalities used are: continuous
labor support, hydrotherapy, intra-dermal water blocks,
positioning and movement, touch and massage,
acupressure, acupuncture, hypnosis, trans-cutaneous
electric nerve stimulation, aromatherapy, hot and cold
application, breathing and relaxation, music, audio
analgesia, birth balls, etc.5
Massage is an ancient method to reduce labor pain.
Massage stimulates the body to release endorphins,
which are natural pain-killing substances and stimulates
for the production of oxytocin, decreases stress
hormones and neurological excitability.6 Olive oil has
pain-killing properties and acts as an anti-inflammatory
drug. It is known to possess soothing and
tranquilizing properties.7
As highlighted by Chandra,8 a study was conducted to
evaluate the effect of olive oil back massage therapy on
labor pain during first stage of labor amongprimigravida
women in selected hospital at Selam. Olive oil massage
was given to all the mothers and the pain, was
measured after massage and compared with pre-test
value. The findings of the study show that the mean
of pain severity at the first stage of labor was
significantly different between the experiment group
and the control group The result concluded that there
was significant reduction of labor pain ‘t’=8.886, which
was significant at 0.01 level of significance.
As highlighted by Jayalakhmi,9 a study was conducted in
Chennai on effectiveness of olive oil massage upon low
back pain of parturient mothers in the first stage of
labor. 60 parturient mothers were selected by
systematic random sampling technique. The samples
were divided into both experimental and control
groups. Before and after therapy, back pain and feta-
maternal parameters were assessed for both the
groups. Massage therapy was given to the experimental
group. The results revealed that before therapy,
majority of them experienced severe back pain in
both groups. In experimental group, 100% of them
experienced moderate level of pain after therapy.
The
3 ISSN: 2455-
Chauhan K et al.
study reported that olive oil massage was helpful,
providing lower back pain relief and psychological
support to parturient mothers.
Materials and Methods
The research approach of this study was quantitative
with time series non-equivalent control group design
with multiple institutions of the treatment design to
determine the effectiveness of olive oil back massage on
reduction of labor pain during first stage of labor among
primigravida mothers. After obtaining ethical
permission, the subjects were selected according to the
inclusion and exclusion criteria as set in the screening
sheet; mothers with labor pain during first stage of labor
were selected purposively for experimental and control
group. In experimental group, there were 30 mothers
and in control group there were 30 mothers and the
selected sample size was 60. Informed consent was
obtained from each participant of the experimental and
control groups. The researcher assessed the pain of the
mothers who were in the first stage of labor (4-10
cm) dilatation of cervix. The demographic data were
collected using a structured interview schedule, labor
assessment were assessed using labor assessment
proforma and the pain score level were assessed
using numerical pain-rating scale before the
administration of olive oil back massage in
experimental and no intervention was given in
control group. The reliability of olive oil back massage
procedure was established by inter-observer reliability,
which was 0.95. Researcher self-applied the olive oil
back massage to the experimental group.
Olive oil back massage was done in following steps:
 Put the mother in left lateral position.
 Make sure that hands are warm and flexible.
 Take 2 drops of olive oil and mix with 3 drops of
mineral water.
 Place palmer aspect of hand on the mother hip with
finger tips face upward.
 Move both hands (palmer aspect) simultaneously
toward the lateral aspect and move in the
upward direction till T10 level and slowly come
down.
 Repeat these strokes 3 to 5 times.
 Work with thumb on the sacral area by using the
ball of thumb and short rapid strokes from sacral
region to T10 level of back.
 Finish the back massage by giving simple lateral
stroke by using fingertips of hands.
Olive oil back massage was performed for experimental
group for 20 min for 3 times at the interval of 30 min.
Before and after every olive oil back massage, the
 Chauhan K et Int. J. Nurs. Midwif. Res. 2016;

numeric pain-rating scale was administered to record routine care 3 times at the interval of 30 min. Pre-
pain level. In control group, mothers were getting test and post-test pain score were entered in the
only routine care. Numeric pain-rating scale was record sheet. The data taken were subjected to be
administered to record pain level before and after every analyzed using descriptive and inferential statistics.
Results
Section 1: Findings related to Demographic Characteristics of Primigravida Mothers
Table 1.Frequency and Percentage Distribution of Primigravida Mothers according to Their Age, Educational
Status, Classes Attended and Heard the Importance of Therapies to Reduce Labor Pain in Experimental and
Control Group
Sample Characteristics Experimental Group Control Group Test Applied p-Value
n1=30 n2=30
Frequency Percentage Frequency Percentage
Age of Women (in years)
18-21 7 23.3 8 26.6 Fisher Exact Test 0.9
22-26 15 50 14 46.6 (0.02)
27-31 6 20 6 20
32-36 2 6.6 2 6.6
Education
Illiterate 4 13.3 3 10 Fisher Exact Test 0.8
Primary Schooling 11 36.6 9 30 -0.003
Higher secondary 10 33.3 9 30
Graduation 4 13.3 6 20
Post-graduation 1 3.3 3 10
Attended antenatal/ Intra-natal/ Post-natal classes
Yes 2 6.6 0 0 Fisher Exact Test 0.4
No 28 93.3 30 100 -0.49
Heard the importance of Therapies to reduce Labor
Pain
Yes 1 3.3 1 3.3 Fisher Exact Test 1
No 29 96.6 29 96.6 -0.7
Non-significant at 0.05 level, p≥0.05 level, n1+n2=60

Section 2: Findings related to the Labor Assessment of Mothers

Table 2.Frequency and Percentage Distribution of Primigravida Mothers according to Their Presentation,
Membrane, Dilatation, Effacement, Frequency of Contraction, Duration of Contraction and Fetal
Heart Sound in Experimental and Control Group
Sample Characteristics Experimental Group Control Group Test Applied p-
n1=30 n2=30 Value
Frequency Percentage (%) Frequency Percentage (%)
Presentation
Cephalic 28 93.3 30 100 Fisher Exact 0.4
Breech 2 6.6 0 0 Test -0.49
Others 0 0 0 0
Membrane
Intact 11 36.6 8 26.6 Chi-Square 0.4
Ruptured 19 63.3 22 73.3 Test 0.69
df=1
Dilatation of Cervix (cm)
5-Apr 19 63.3 16 53.4 Fisher Exact 0.7
7-Jun 10 33.3 13 43.3 Test -0.07
10-Aug 1 3.3 1 3.3
Effacement of Cervix (%)
40-50 12 40 16 3.3 Fisher Exact 0.2

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Int. J. Nurs. Midwif. Res. 2016; 3(2&3) Chauhan K et al.

60-70 16 53.3 14 46.7 Test 2.7

80-100 2 6.6 0 0
Frequency of Contraction
2 0 0 0 0 Fisher Exact 1
3 25 83.3 26 86.75 Test 1
4 5 16.7 4 13.3
Duration of Contraction (sec)
Less than 20 0 0 0 0 Fisher Exact 0.7
20-40 25 83.3 27 90 Test -.0.70
More than 40 5 16.7 3 10
Fetal Heart Sound (beats/min)
120-140 21 70 26 86.6 Fisher Exact 0.2
140-160 9 30 4 13.3 Test -.0.13
More than 160 0 0 0 0
Non-significant at 0.05 level, p≥0.05 level, n1+n2=60

Section 3: Comparison between the Pre-test Pain Scores of Mothers during First Stage of Labor in the
Experimental and Control Group
Table 3.Mean, Standard Deviation, SEMD, Mean D and ‘t’ Value of Pre-test Scores of Labor Pain of Mothers during First
Stage of Labor in the Experimental and Control Group
Group Mean S.D. MD S.E.D ‘t’ Value p-Value
Experimental group 7.70 0.88 0.23 0.20 1.28 0.26
Control group 7.93 0.69
n1+n2=60, t(29)=2.04, p≥0.05 level

The data presented in Table 3 shows that the calculated there was no significant difference between the level of
‘t’ value (1.28) is less that the table ‘t’ value 2.04 for 29 pain in the experimental and control group before
degree of freedom at 0.05 level of significance, hence administration of olive oil massage.
Section 4: Evaluation of Effect of Olive Oil Back Massage on Reduction of Labor Pain during First Stage
of Labor among Primigravida Mothers
(a) Findings related to Mean Pre-Test and Post-Test Pain Scores of Mothers during First Stage of Labor in the
Experimental Group
Table 4.Mean, Standard deviation, S.ED Mean and ‘t’ value of Pre-test and Post-test Scores of Labor Pain of Mothers
during First Stage of Labor in the Experimental Group
Group Intervention Mean S.D. MD S.ED ‘t’ Value p-Value
Experimental group Pre-test 7.70 0.88 1.17 0.13 9.14 0.0001***
Post-test 6.53 1.04
t(29)=2.04, p< 0.05,***Significant at 0.05 level of significance, n1=30

The data presented in Table 4 shows that the calculated there was significant difference in the level of pain in
‘t’ value (9.14) is more that the table ‘t’ value 2.04 for 29 the experimental group before and after administration
degree of freedom at 0.05 level of significance, hence of olive oil massage.
(b) Comparison between the Post-Test Pain Scores of Mothers during First Stage of Labor in the Experimental
and Control Group

Table 5.Mean, Standard Deviation, Mean Difference, Standard Error, and ‘t’ value of Post-test Pain Score of
Primigravida Mothers in both Experimental and Control Group
Groups Mean S.D. Mean Difference S.EMD ‘t’ Value p-Value
Experimental group 6.53 1.04 2.67 0.22 12.09 0.001***
Control group
***
9.20 1.61
t =2, p<0.05, Significant at 0.05 level of significance, n +n =60
(58) 1 2

3 ISSN: 2455-
 Chauhan K et
The data presented in Table 5 shows that the calculated
‘t’ value (12.09) is more that the table ‘t’ value 2 for
58 degree of freedom at 0.05 level of significance,
hence there was a significant difference in the level of
pain in the experimental group and control group. It
concluded that there was less pain score in
experimental group after the olive oil back massage
and increase pain score in mothers who had not
received olive oil back massage.
Discussion and Conclusion
A study was done by Divya10 to assess the effectiveness
of massage with olive oil on active phase pain intensity
and satisfaction of labor in nulliparous women. 90
pregnant women with 38-42 weeks of gestation,
referred for vaginal delivery and admitted to labor
room, Coimbatore, were taken for the study and divided
into three groups, 1st group took only massage, 2 nd
group took massage with almond oil and 3rd group took
massage with olive oil. The results of massage were that
by olive oil the active phase pain intensity
significantly decreased and also increased patient’s
satisfaction from delivery. The results of massage
effectiveness, particularly massage by olive oil,
indicated that use of massage can decrease active
phase pain intensity and increase satisfaction in
patients. This study finding is similar to the findings of
the present study which revealed that olive oil back
massage is effective in reducing labor pain during first
stage of labor. It was observed that there was less pain
score in experimental group after the olive oil back
massage compared to mothers who had not received
olive oil back massage in control group. The study
concluded that olive oil back massage is an effective
method of reducing labor pain during first stage of
labor.
Conflict of Interest: None
ISSN: 2455-
Int. J. Nurs. Midwif. Res. 2016;
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th
Date of Submission: 14 Jun.
th
2016 Date of Acceptance: 26 Jul.
2016
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