Name : Rizka Nur Fadhila

NIM : 22020118120021

Class : A18.2

Effect of Deep Back Massage Against Pain Reduction in First Stage Maternity Mothers
Active Phase

In the process of childbirth, a mother will surely feel extraordinary difficulties. This will
certainly be felt by all people specifically for women who need labor or in the labor process.
Associated with pain, pain is an unpleasant sensory and emotional because of tissue damage.
While labor is the start and thinning of the cervix and fetus, then take to the streets and then
begin with the end of the baby who has finished at the age of 9 months and is followed by
opening the placenta and fetal membranes of women born on the road.1 Labor is considered
normal if the process occurs at term of gestational age (after 37 weeks) without any problem.

Pain in childbirth can cause anxiety and fear in patients so that oxygen demand increases,
muscles become tense and blood pressure increases, this condition will stimulate catecholamines
which can cause the occurrence of contraction forces resulting in prolonged labor. Handling and
supervision of labor pain, especially in the first phase of the active phase is very important,
because this is the deciding limit whether a maternity mother can undergo a normal delivery or
be done by using other measures (cesarean) due to an obstacle caused by extreme pain. Given
that the impact of pain is very influential on the mother and baby, then there must be efforts to
reduce the pain.2

Various attempts have been made to overcome labor pain. The way to deal with labor
pain is divided into two ways, namely by means of pharmacology and non pharmacology. The
pain experienced by each individual will certainly be different and come slowly and will peak at
the end of labor. Some are strong enough to deal with it and some are not strong enough to deal
with it. For patients who can not bear the pain, it will interfere with the delivery process. One
effective method in reducing labor pain non-pharmacologically is the massage method. Massage
is doing hand pressure on soft tissue, usually a muscle, or ligament, without causing movement
or changes in joint position to relieve pain, produce relaxation and improve circulation.3

Massage consists of several methods and here is more emphasis on the method of deep
back massage. Deep back message is an emphasis on the sacrum which reduces the tension of
the sacroiliacus joint from the fetal posterior occiput position.2 This method is done by means of
the patient lying on his side, then the nurse or midwife presses the sacrum area firmly using the
palm of the hand, then release and press again, so so on. With the emphasis on stimulating
cutaneous so that it can inhibit the impulse of pain so that it does not reach kethalamus. Deep
back massage is really needed during delivery on a scale of 1, because at the time of spread of
pain on a scale of 1 where the pain does not spread as a whole but only at a point. Based on the
results of the study, the intervention group that received Deep Back Massage mostly experienced
a decrease in pain to mild pain. Whereas the group that received only posttest care in labor
experienced severe pain. This shows the suitability of giving massage and pain reduction
response.2

Deep back massage during labor can function as an epidural analgesic that can reduce
pain and stress, and can provide comfort to the mother. Therefore essential care is needed for the
mother during childbirth to reduce pain and stress due to childbirth that can increase nursing care
for the mother.1 Deep back massage provides stimulation to the sacrum by way of gentle rubbing
with both hands on the maternal sacrum for 20 minutes with a frequency of 30-40x rubbing per
minute with movements such as stroking the mother at the active stage 1 mother.2 This is done to
provide comfort for the mother to relax the muscles after a contraction. Massage and touch have
proven that it can help mothers to be more relaxed and comfortable during labor. This is evident
from the results of research that mothers who are massaged 20 minutes each hour during the
labor stage will be more free from pain, because massage stimulates the body to release
endorphins which are natural pain relievers and create a feeling of equality and comfort.3
 Deep back massage provides a great influence on the reduction of pain in the first stage
of labor during active mothers. Where in the first phase of the active level the level of pain of the
mother experiencing childbirth is higher than the others, so with this we need a non-
physiological method in support of pharmacological methods. One method of non-pharmacology
in relieving maternal pain during labor is Deep Back Massage. What is done by giving
stimulation to the sacrum by gentle rubbing with both hands on the sacrum of the mother during
delivery for 20 minutes with a frequency of 30-40x rubbing per minute with movements such as
stroking the mother during the active phase 1. Where to use the deep method This back massage,
pain on a scale 1 maternal patient has decreased. And provide comfort to her mother during
labor.
 DAFTAR PUSTAKA

Wahyuni, Wahyuningsih, 2015, Pengaruh Massage Effleurage Terhadap Tingkat Nyeri

Persalinan Kala 1 Fase Aktif Pada Ibu Bersalin Di RSU PKU Muhammadiyah Delanggu Klaten
2015.

Maryunani, 2010. Nyeri Dalam Persalinan. Trans Info Media, Jakarta.

Janssen. P, Shroff. F, & Jaspar. P. 2012. Massage Theraphy and labour outcome : a randomized
controlled trial, international journal of therapeutic massage ang body work 5(4) : 15-20.