The Effect of Reflexology on Labor
The Effect of Reflexology on Labor
Aims and Objectives: The purpose of this study was to determine the effect of reflexology,
 one of the non-pharmacological methods used in the management of labor pain, on anxiety,
 labor duration, labor pain, and labor satisfaction in primiparous pregnant women.

 Background: Labor pain is one of the most severe types of pain experienced by a woman
 throughout her life. As a result of the labor pain and birth-related stress, maternal and
 fetus health is negatively affected. Controlling of labor pain will decrease the anxiety and
 tension experienced by pregnant woman.

 Design: A randomized controlled experimental was used. Method: A total of 60 women
 participated in the study in 2 groups of 30 for reflexology and control groups. By giving
 appropriate position in the first stage of delivery to the pregnant women in the experimental
 group, 10-minute massage was applied to both feet including 5-minute massage for each foot
 starting first from the right foot by using vaseline under the supervision of a doctor to
 facilitate the hand movements, then the reflexology technique was applied by stimulating the
 nerve points by applying pressure to reflex regions of each foot for 20 minutes as totally 40
 minutes for both feet. The control group was composed of pregnant women who received routine
 treatment, care and applications of the hospital.
Aims:This study was conducted as a randomized controlled experimental study in order to
 determine the effect of reflexology application in primiparous pregnant women on labor pain,
 anxiety, labor duration, and birth satisfaction.

 METHOD Participants The study was conducted with voluntary pregnant women applying to the
 delivery room unit of Gaziantep Cengiz Gökçek Maternity and Children Hospital to perform
 their first birth between 01 July 2017 and 07 July 2018. When the sample volume that would
 represent the population with the conditions of α= 0.05 risk, 1-α =0.95 accuracy rate, B=
 0.20, 1-B= 0.80 power ratio was considered with the comparison results of VAS mean scores in
 the study by Dolation et al., it was determined to be minimum 27 people for each group.

 The study was conducted with two groups including Reflexology Group (experimental) and
 Control Group. By including 30 women into each group, the study was conducted with a total of
 60 women. The drawing method was used to decide to which group the women would be assigned.
 In order to draw lots, 60 small paper pieces were prepared, control was written on 30 of
 these paper pieces, reflexology was written on the other 30 pieces of paper, and they were
 then folded and placed into a bag. Inclusion of women into groups was determined according to
 the papers women drew from the bag.

 Data Collection Tools The data of the study were collected using "Descriptive Information
 Form", "Visual Analog Scale (VAS)", "State-Trait Anxiety Scale (STAI FORM TX-I )", and "Birth
 Satisfaction Scale".

 Descriptive Information Form: The form prepared by the researcher by examining the related
 literature consists of two sections. In the first section, age, height, weight, educational
 level, and working status of the woman along with the number of birth, parity, number of
 abortus, number of living children, and modes of previous births were asked. The second
 section of the form includes questions related to the period of birth stages (Stages I, II,
 and III), interventions made in the first stage of birth and during the labor (Oxytocin
 administration, amniotomy, Fundal pressure, Vacuum etc.), perineal tear, Apgar score and the
 newborn's status of being accepted to the intensive care unit.

 Visual Analog Scale (VAS): Visual Analogue Scale (VAS) is used to describe the severity of
 pain in patients with pain. The diagnosis will be established based on subjective data
 including the patient's verbal expression. There are numbers horizontally placed varying from
 0 to 10. The pain severity is expressed in numbers ranging from 0 to 10 and no pain is
 determined with "0" and the most severe pain is determined with "10". In this method, it is
 explained that there are two endpoints and she is free to mark any point between these two
 points.

 State-Trait Anxiety Inventory: To determine state and trait anxiety levels of the
 participants, the state-trait anxiety inventory (STAI FORM TX -I) was used. The individual is
 required to indicate the feelings or behaviours that he/she has experienced in a specific
 situation according to the degree of severity by marking one of the options such as (1)
 Never, (2) Little, (3) Very and (4) Completely. The state-trait anxiety inventory requires
 the individual to describe how he/she feels at a certain moment and under certain conditions
 by considering his/ her feelings about a specific situation. While high scores indicate high
 anxiety levels, low scores indicate low anxiety levels. The state-trait anxiety inventory
 consists of 20 statements. The score obtained from the scale may vary between 20 and 80.
 While a high score represents a high anxiety level, a low score represents a low anxiety
 level.

 Birth Satisfaction Scale: Birth Satisfaction Scale was developed by Martin and Fleming in
 2009. The original language of the scale is English. The translation of the scale was
 performed by Coşar et al.,. The scale is a Likert-type scale that is scored according to the
 responses. The scale form consists of 30 items and total score obtained from the scale varies
 between 30 and 150. As the scores obtained from the scale increase, birth satisfaction level
 increases.
Inclusion Criteria:

 -  Pregnant women who were 19 years old and older,

 -  Pregnant women who had singleton pregnancy, were between 38-42nd weeks of gestation,

 -  Pregnant women who can perform spontaneous vaginal delivery,

 -  Pregnant women who were at the beginning of the active phase in the first phase of
 action (4 cm dilatation),

 -  Pregnant women who were primiparous, can establish verbal communication,

 -  Pregnant women who agreed to participate in the study.

 Exclusion Criteria:

 -  Pregnant women who had risky pregnancy,

 -  Pregnant women who had a systemic disease that would interfere with normal birth,

 -  Pregnant women who were in the second stage of labor