The Effect of Using Endorphin Massage for Decreasing Pain at First Stage in Normal Labor


  • Siti Choirul Dwi Astuti Department of Midwifery, Politeknik Kesehatan Kementerian Kesehatan Gorontalo, Gorontalo City, Gorontalo Province, Indonesia
  • Riana Trinovita Sari Department of Midwifery, Politeknik Kesehatan Kementerian Kesehatan Kalimantan Timur, Samarinda City, East Kalimantan, Indonesia



Hypertension, Knowledge Level, Lifestyle


Labor pain is a subjective experience of physical sensations associated with uterine contractions, dilation, thinning cervix and fetal descent during labor. To resolve the pain of labor, it has been implemented in a nonpharmacological method which is endorphin massage, in understanding endorphin massage for pressing pain in the first stage, in an active phase of normal multiparous mothers' deliveries. This research aims to research endorphin massage's influence on suppressing pain during the active phase of normal labor of multiparous mothers. This study is quasi-experimental with a cross-sectional approach. The study population of all women giving birth administered the purposive sampling data capture techniques, and it was obtained 132 multiparous mothers with normal labor in the observation sheet. Data were examined by administering a T-test. The majority of the pain intensity in the first stage of active phase multiparous mothers with normal labor, before the breath relaxation, is severe, with up to 49% experiencing severe pain. The majority of the percentage of moderate pain in the first stage of active phase multiparous mothers with normal labor, after breath relaxation, is as high as 42%. Meanwhile, the pain intensity of the first stage in active phase multiparous mothers with normal labor, prior to endorphin massage, is as high as 73.3%. Pain intensity of the first stage in active phase multiparous mothers normal labor after endorphin massage, the majority of the percentage is moderate pain up to 53.3%. Statistical test results obtained p-value is 0.004 endorphin massage. In conclusion, there is an effect of breath relaxation on the intensity of pain during normal labor in multiparous mothers. Furthermore, researchers can do a combination of endorpine massage with other treatments to treat pain during the I active phase of labor and pain intensity checks can be done by testing cortisol levels.


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Al-qerem, A. (2020). An efficient machine-learning model based on data augmentation for pain intensity recognition. Egyptian Informatics Journal, 21(4), 241–257.

Alhafez, L., & Berghella, V. (2020). Evidence-based labor management: first stage of labor (part 3). American Journal of Obstetrics and Gynecology MFM, 2(4), 100185.

Aminisaman, J., Karimpour, H. A., Hemmatpour, B., Mohammadi, S., Darvishi, S., & Kawyannejad, R. (2020). Effect of Transcutaneous Electrical Nerve Stimulation on the Pain Intensity During Insertion of Needle in Patients Undergoing Spinal Anesthesia : A Randomized Controlled Study. Journal of Acupuncture and Meridian Studies, 13(3), 83–86.

Apryanti, Y. P. & Astuti, S. C. D. (2020). Efektivitas Kombinasi Endorphine Massage Dan Aromaterapi Lemon Terhadap Intensitas Nyeri Pada Ibu Bersalin Kala I. JIDAN (Jurnal Ilmiah Bidan), 8(1), 7-14.

Bintang, A. K., Santosa, I., Goysal, Y., Akbar, M., & Aulina, S. (2021). Relationship between sleep quality and pain intensity in patients with chronic low back pain ଝ. Medicina Clínica Práctica, 4, 100208.

Briozzo, L., Gómez Ponce de León, R., Tomasso, G., & Faúndes, A. (2016). Overall and abortion-related maternal mortality rates in Uruguay over the past 25 years and their association with policies and actions aimed at protecting women’s rights. International Journal of Gynecology and Obstetrics, 134, S20–S23.

Bruton, A. (2008). Breathing and relaxation training improves respiratory symptoms and quality of life in asthmatic adults: Commentary. Australian Journal of Physiotherapy, 54(1), 76.

Bukenya, B., & Golooba-Mutebi, F. (2020). What explains sub-national variation in maternal mortality rates within developing countries? A political economy explanation. Social Science and Medicine, 256, 113066.

Burgess, A., Clark, S., Dongarwar, D., & Salihu, H. (2020). 5: Hospital maternal mortality rates are falling, overall maternal mortality still rises: Implications for forward movement. American Journal of Obstetrics and Gynecology, 222(1), S5.

Cassaglia, P., Penas, F., Betazza, C., Fontana Estevez, F., Miksztowicz, V., Martínez Naya, N., Llamosas, M. C., Noli Truant, S., Wilensky, L., Volberg, V., Cevey, Á. C., Touceda, V., Cicale, E., Berg, G., Fernández, M., Goren, N., Morales, C., & González, G. E. (2020). Genetic Deletion of Galectin-3 Alters the Temporal Evolution of Macrophage Infiltration and Healing Affecting the Cardiac Remodeling and Function after Myocardial Infarction in Mice. American Journal of Pathology, 190(9), 1789–1800.

Chakhtoura, N., Chinn, J. J., Grantz, K. L., Eisenberg, E., Artis Dickerson, S., Lamar, C., & Bianchi, D. W. (2019). Importance of research in reducing maternal morbidity and mortality rates. American Journal of Obstetrics and Gynecology, 221(3), 179–182.

Churakov, M., Silvera, A. M., Gussmann, M., & Nielsen, P. P. (2021). Parity and days in milk affect cubicle occupancy in dairy cows. Applied Animal Behaviour Science, 244, 105494.

Cojocaru, A. L., & Mârza-Dănilă, D. (2014). Study Concerning the Efficiency of the Reflex Massage in the Treatment of Varicose Veins. Procedia-Social and Behavioral Sciences, 117, 559–565.

Fasihi, S. M., Karampourian, A., Khatiban, M., Hashemi, M., & Mohammadi, Y. (2022). The effect of Hugo point acupressure massage on respiratory volume and pain intensity due to deep breathing in patients with chest tube after chest surgeries. Contemporary Clinical Trials Communications, 27, 100914.

Fitri, S. Y. R., Nasution, S. K., Nurhidayah, I., & Maryam, N. N. A. (2021). Massage therapy as a non-pharmacological analgesia for procedural pain in neonates: A scoping review. Complementary Therapies in Medicine, 59, 102735.

Fitri, S. Y. R., Lusmilasari, L., Juffrie, M., & Bellieni, C. V. (2020). Modified sensory stimulation using breastmilk for reducing pain intensity in neonates in Indonesia: A randomized controlled trial. Journal of Pediatric Nursing, 53, e199-e203.

Häggsgård, C., Nilsson, C., Teleman, P., Rubertsson, C., & Edqvist, M. (2021). Women’s experiences of the second stage of labour. Women and Birth, 35(5), e464-e470.

Hong, S., & Shin, D. (2020). Relationship between pain intensity , disability , exercise time and computer usage time and depression in o ffi ce workers with non-speci fi c chronic low back pain. Medical Hypotheses, 137, 109562.

Jarrah, M. I., Hweidi, I. M., Al-dolat, S. A., Alhawatmeh, H. N., Al-obeisat, S. M., Hweidi, L. I., Hweidi, A. I., & Alkouri, O. A. (2022). International Journal of Nursing Sciences The effect of slow deep breathing relaxation exercise on pain levels during and post chest tube removal after coronary artery bypass graft surgery. International Journal of Nursing Sciences, 9(2), 155–161.

Kahrs, B. H., & Eggebø, T. M. (2021). Intrapartum ultrasound in women with prolonged first stage of labor. American Journal of Obstetrics and Gynecology MFM, 3(6), 100427.

Kim, E. T., Lillie, M., Gallis, J., Hembling, J., McEwan, E., Opiyo, T., Acayo, P., & Baumgartner, J. N. (2021). Correlates of early stimulation activities among mothers of children under age two in Siaya County, Kenya: Maternal mental health and other maternal, child, and household factors. Social Science and Medicine, 287, 114369.

Li, M., & Zhao, D. (2021). A simple parity violating model in the symmetric teleparallel gravity and its cosmological perturbations. Physics Letters B, 827, 136968.

Liao, M., Hsu, J., & Fung, H. (2021). The correlation of small fiber neuropathy with pain intensity and age in patients with Fabry ’ s disease : A cross sectional study within a large Taiwanese family. Biomedical Journal, 45(2), 406–413.

Liu, Y., Jiang, T., Shi, T., Liu, Y., & Liu, X. (2021). The effectiveness of diaphragmatic breathing relaxation training for improving sleep quality among nursing staff during the COVID-19 outbreak : a before and after study. Sleep Medicine, 78, 8–14.

López-Fernández, G., Gómez-Benito, J., & Barrios, M. (2022). The psychometric properties of the parenting scale for Spanish mothers with children aged between 2 and 7 years. Journal of Pediatric Nursing, 62, 60–68.

Meer, H. A. Van Der, Calixtre, L. B., Engelbert, R. H. H., Visscher, C. M., Wg, M., Sanden, N. Van Der, & Speksnijder, C. M. (2020). Musculoskeletal Science and Practice Effects of physical therapy for temporomandibular disorders on headache pain intensity : A systematic review. Musculoskeletal Science and Practice, 50, 102277.

Mulhaeriah, M., Afiyanti, Y., Achmad, E. K., & Sangkala, M. S. (2018). Effectiveness of Relaxation Breathing Exercise on fatigue in gynecological cancer patients undergoing chemotherapy. International journal of nursing sciences, 5(4), 331-335.

Murphy, L., Gray, K., Gerkin, R., & Garfield, R. (2021). 1021 Use of electromyography to determine quantitative effects of oxytocin during the 1st stage of labor. American Journal of Obstetrics and Gynecology, 224(2), S632.

Neige, C., Brun, C., Gagné, M., Bouyer, L. J., & Mercier, C. (2020). Do nociceptive stimulation intensity and temporal predictability in fl uence pain-induced corticospinal excitability modulation ?. NeuroImage, 216, 116883.

Nunes, G. S., Bender, P. U., de Menezes, F. S., Yamashitafuji, I., Vargas, V. Z., & Wageck, B. (2016). Massage therapy decreases pain and perceived fatigue after long-distance Ironman triathlon: a randomised trial. Journal of physiotherapy, 62(2), 83-87.

Page, M. G., Gauvin, L., Sylvestre, M., Nitulescu, R., Dyachenko, A., & Choini, M. (2022). Original Reports An Ecological Momentary Assessment Study of Pain Intensity Variability : Ascertaining Extent , Predictors , and Associations With Quality of Life , Interference and Health Care Utilization Among Individuals Living With. 23(7), 1151-1166.

Quinlan-Colwell, A., Rae, D., & Drew, D. (2022). Prescribing and Administering Opioid Doses Based Solely on Pain Intensity: Update of A Position Statement by the American Society for Pain Management Nursing. Pain Management Nursing, 23(1), 68–75.

Raana, H. N., & Fan, X. N. (2020). The effect of acupressure on pain reduction during first stage of labour: A systematic review and meta-analysis. Complementary Therapies in Clinical Practice, 39, 101126.

Saldanha-Gomes, C., Hallimat Cissé, A., Descarpentrie, A., de Lauzon-Guillain, B., Forhan, A., Charles, M. A., Heude, B., Lioret, S., & Dargent-Molina, P. (2022). Prospective associations between dietary patterns, screen and outdoor play times at 2 years and age at adiposity rebound: The EDEN mother-child cohort. Preventive Medicine Reports, 25, 1–7.

Sangeethalaxmi, M. J., & Hankey, A. (2022). Journal of Ayurveda and Integrative Medicine Impact of yoga breathing and relaxation as an add-on therapy on quality of life , anxiety , depression and pulmonary function in young adults with bronchial asthma : A randomized controlled trial. Journal of Ayurveda and Integrative Medicine, 100546.

Scuteri, D., Contrada, M., Loria, T., Sturino, D., Cerasa, A., Tonin, P., Sandrini, G., Tamburin, S., Bruni, A. C., Nicotera, P., Corasaniti, M. T., & Bagetta, G. (2022). Biomedicine & Pharmacotherapy Pain and agitation treatment in severe dementia patients : The need for Italian Mobilization – Observation – Behavior – Intensity – Dementia ( I-MOBID2 ) pain scale translation , adaptation and validation with psychometric te. Biomedicine & Pharmacotherapy, 150, 113013.

Shen, T., Zheng, J., Xu, Z., Zhang, C., Shen, Y., & Xu, T. (2021). The 90% Effective Dose of Sufentanil for Epidural Analgesia in the Early First Stage of Labor: A Double-blind, Sequential Dose-Finding Study. Clinical Therapeutics, 43(7), 1191–1200.

Sorel, J. C., Oosterhoff, J. H. F., Broekman, B. F. P., Jaarsma, R. L., Doornberg, J. N., Ijpma, F. F. A., Jutte, P. C., Spekenbrink-spooren, A., Gademan, M. G. J., & Poolman, R. W. (2022). Do symptoms of anxiety and / or depression and pain intensity before primary Total knee arthroplasty influence reason for revision ? Results of an observational study from the Dutch arthroplasty register in 56 , 233 patients. General Hospital Psychiatry, 78, 42–49.

Talukder, A., Khan, Z. I., Khatun, F., & Tahmida, S. (2021). Factors associated with age of mother at first birth in Albania: application of quantile regression model. Heliyon, 7(3), E06547.

Timmers, I., Ven, V. G. Van De, Vlaeyen, J. W. S., Smeets, R. J. E. M., Verbunt, J. A., Jong, J. R. De, & Kaas, A. L. (2021). Archival Report Corticolimbic Circuitry in Chronic Pain Tracks Pain Intensity Relief Following Exposure In Vivo. Biological Psychiatry: Global Open Science, 1(1), 28–36.

Torkiyan, H., Sedigh Mobarakabadi, S., Heshmat, R., Khajavi, A., & Ozgoli, G. (2021). The effect of GB21 acupressure on pain intensity in the first stage of labor in primiparous women: A randomized controlled trial. Complementary Therapies in Medicine, 58, 102683.

Triansyah, A., Stang, Indar, Indarty, A., Tahir, M., Sabir, M., Nur, R., Basir-Cyio, M., Mahfudz, Anshary, A., & Rusydi, M. (2021). The effect of oxytocin massage and breast care on the increased production of breast milk of breastfeeding mothers in the working area of the public health center of Lawanga of Poso District. Gaceta Sanitaria, 35, S168–S170.

Urio, P., Medeiros, C., Feldkircher, J. M., & Nunes, G. S. (2019). Massage therapy slightly decreased pain intensity after habitual running , but had no effect on fatigue , mood or physical performance : a randomised trial. Journal of Physiotherapy, 65(2), 75–80.

Valente, N. F., Cardoso, E. de. S, Rezende, J. A. da. S., & Santos, J. A. (2020). Impact of Acupuncture Intervention on the Pain Intensity of Patients Treated at a Tertiary Hospital in Brazil. Journal of Acupuncture and Meridian Studies, 13(5), 147-151.

Vilč, B., Vrdoljak, A., Kirac, I., Herman, I., Brnić, S., & Martinović, Z. (2021). The Relaxation and breathing exercises in perinterventional period in hospitalized cancer patients. European Journal of Integrative Medicine, 48, 102045.

Yasar, E., & Uysal, A. I. (2021). Erector spinae plane blockade in the first stage of labour: a case series. Brazilian Journal of Anesthesiology, 72(4), 519-521.

Zhu, Y., Wang, R., Tang, X., Li, Q., Xu, G., & Zhang, A. (2021). The effect of music, massage, yoga and exercise on antenatal depression: A meta-analysis. Journal of Affective Disorders, 292, 592–602.




How to Cite

Astuti, S. C. D. ., & Sari, R. T. . (2022). The Effect of Using Endorphin Massage for Decreasing Pain at First Stage in Normal Labor . JURNAL INFO KESEHATAN, 20(2), 194–205.



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