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Enhancing labor outcomes through non-pharmacologic interventions: a study on birthing ball and deep breathing relaxation in Indonesia

Abstract

The typical procedure of a vaginal delivery can be painful, concerning, and frightening throughout the active phase of the first stage of labor. These emotional and physiological responses can prolong labor and negatively impact the delivering process.  Non pharmacological approaches, such as positional therapy and relaxation techniques, have been developed to assist women who are in labor.  The BB (BB) and DBR (DBR) are two examples of these. Few studies have directly compared the efficiency of the two approaches, despite the fact that each has demonstrated advantages of its own.  A growing collection of anecdotal and clinical evidence suggests that BB may give superior benefits in improving labor outcomes. Objective: This study compares the effects of DBR and BB exercise es on mothers' anxiety, pain threshold, and progress during the active phase of labor. Method: This quasi-experimental study comprised 46 participants who were consecutive sampling to one of two groups using sequential sampling: DBR (n = 23) or BB (n = 23). The study had a pretest-posttest two-group comparison design.  Interventions were carried out by midwifery led care in Pringsewu, Indonesia, from November 2024 to April 2025, during the active phase of labor.  Data were collected using the State-Trait Anxiety Inventory (S-TAI) scale, partograph, Visual Analog Scale (VAS), and Labor and Delivery Satisfaction Questionnaire (LDSQ) mother satisfaction survey.  The statistical analysis employed paired t-tests and Mann Whitney. Results: Labor pain was considerably decreased by both therapies (DBR: mean reduction from 4.3 to 3.6; BB: mean reduction 4.5 to 3.8; p < 0.01).  Following the therapies, anxiety levels also dropped, though not statistically significantly in DBR group 52.2 to 49.4; p < 0.05 and BB group 50.4 to 48.3; p< 0.00.  In comparison to the DBR group (mean = 274.3 ± 29.3 minutes; p = 0.003), the BB group's active phase duration was significantly shorter (mean = 243.5 ± 31.1 minutes).  In comparison to the DBR group (mean = 31.3 ± 3.1; p < 0.001), maternal satisfaction was significantly higher in the BB group (mean = 34.2 ± 3.7). Conclusion: Both DBR techniques and BB activities can help reduce pain and accelerate the labor process.  However, BB exercises were more effective in shortening the duration of labor and increasing mother satisfaction.  These findings support the use of non-pharmacological treatments in routine intrapartum care, especially in under resourced areas. These findings suggest that midwives and healthcare providers should consider incorporating BB exercises into standard intrapartum care protocols, especially in resource-limited settings.

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How to Cite This

Fitriana, F. (2025). Enhancing labor outcomes through non-pharmacologic interventions: a study on birthing ball and deep breathing relaxation in Indonesia. Jurnal Kesehatan Ibu Dan Anak, 18(2). https://doi.org/10.29238/kia.v18i2.2880

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