Article Sidebar

Submitted
19 June 2023
Accepted
6 November 2023
Published
10 September 2023
Download
PDF
Statistic
Read Counter : 215 Download : 112

Main Article Content

Abstract

Highlights:


1. Auricular acupressure at the Shenmen point is effective in reducing anxiety.
2. Auricular acupressure is more practical than body acupressure since it does not interfere with expectant mothers' mobilization.
3. As a non-pharmacological method, auricular acupressure is cost-effective, efficient, and effective in overcoming maternal anxiety during labor


 


Abstract


Anxiety is a common psychological symptom in expectant mothers, particularly among primigravidae during labor. There is a link between excessive anxiety and prolonged labor. One of the options to manage anxiety is the use of non-pharmacological methods. Numerous studies have investigated the effectiveness of auricular acupressure to treat anxiety, but few have examined its effect on anxiety biomarkers. Thus, the objective of this study was to analyze the effect of auricular acupressure targeting the Shenmen point on the levels of β-endorphins and anxiety among primigravidae during the first stage of labor. This experimental study used a pretest-posttest control group design. The research subjects were primigravidae in the first stage of labor at the independent midwife practice of Yefi Marliandiani in Surabaya, Indonesia. Among 40 primigravidae, 34 individuals met the inclusion criteria and were then equally divided into treatment and control groups using a simple randomization. The treatment group received auricular acupressure at the Shenmen point every 30 minutes for a duration of 5 minutes, while the control group practiced deep breathing relaxation. The anxiety levels were assessed using the Hamilton Anxiety Rating Scale. The β-endorphin levels were measured by drawing 3 cc of venous blood before (4 cm cervix dilation) and after (9–10 cm cervix dilation) treatment. The obtained data were analyzed using paired- and independent-samples t-tests. A decrease in the mean anxiety level was observed in the treatment group (18.59±7.52) relative to the control group (19.76±7.11), albeit not significant (p=0.64). Simultaneously, the average β-endorphin levels of the treatment group (355.4±224.7) increased compared to the control group (225.1±127.5), with a significant difference observed between the two groups (p=0.04). In conclusion, while both auricular acupressure at the Shenmen point and deep breathing relaxation are effective in reducing anxiety, the former is more prominent in its ability to increase β-endorphin levels.

Keywords

Childbirth complications auricular acupressure primigravidae anxiety β-endorphins

Article Details

License

Copyright (c) 2023 Folia Medica Indonesiana

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

  • Folia Medica Indonesiana is a scientific peer-reviewed article which freely available to be accessed, downloaded, and used for research purposes. Folia Medica Indonesiana (p-ISSN: 2541-1012; e-ISSN: 2528-2018) is licensed under a Creative Commons Attribution 4.0 International License. Manuscripts submitted to Folia Medica Indonesiana are published under the terms of the Creative Commons License. The terms of the license are:

    Attribution ” You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.

    NonCommercial ” You may not use the material for commercial purposes.

    ShareAlike ” If you remix, transform, or build upon the material, you must distribute your contributions under the same license as the original.

    No additional restrictions ” You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.

    You  are free to :

    Share ” copy and redistribute the material in any medium or format.

    Adapt ” remix, transform, and build upon the material.

How to Cite
Setiawandari, S., Koosnadi Saputra, Yuni Khoirul Waroh, & Setiana Andarwulan. (2023). Auricular Acupressure Effectively Reduces Labor Anxiety in Primigravidae by Increasing β-Endorphin Levels. Folia Medica Indonesiana, 59(3), 246–255. https://doi.org/10.20473/fmi.v59i3.46738
Download Citation
Endnote/Zotero/Mendeley (RIS)
BibTeX

References

  1. Annisya W (2020). Determinan kejadian persalinan lama di Indonesia (Analisis data sekunder survei demografi kesehatan Indonesia 2017) (thesis). Universitas Sriwijaya. Available at: https://repository.unsri.ac.id/35175/3/RAMA_13201_10011181621004_0209088803_01_front_ref.pdf.
  2. Aral Ä°, Köken GK, Bozkurt M, et al (2014). Evaluation of the effects of maternal anxiety on the duration of vaginal labour delivery. Clinical and Experimental Obstetrics & Gynecology 41, 32–36. doi: 10.12891/ceog16052014.
  3. Ayu IP, Rachmawati IN, Ungsianik T (2019). Maternal age as a main factor influencing prenatal distress in Indonesian Primigravida. Enfermerí­a Clí­nica 29, 310–314. doi: 10.1016/j.enfcli.2019.04.039.
  4. Bauer C (2019). Management of prolonged latent phaseed. Ferries-Rowe E. SASGOG.
  5. Bonapace J, Gagné G-P, Chaillet N, et al (2018). No. 355-physiologic basis of pain in labour and delivery: An evidence-based approach to its management. Journal of Obstetrics and Gynaecology Canada 40, 227–245. doi: 10.1016/j. jogc.2017.08.003.
  6. Buckley SJ (2015). Executive summary of hormonal physiology of childbearing: Evidence and implications for women, babies, and maternity care. The Journal of Perinatal Education 24, 145–153. doi: 10.1891/1058-1243.24.3.145.
  7. Çankaya S, Åžimşek B (2021). Effects of antenatal education on fear of birth, depression, anxiety, childbirth self-efficacy, and mode of delivery in primiparous pregnant women: A prospective randomized controlled study. Clinical Nursing Research 30, 818–829. doi: 10.1177/1054773820 916984.
  8. Caughey AB, Cahill AG, Guise JM, et al (2014). Safe prevention of the primary cesarean delivery. Obstetrical & Gynecological Survey 69, 381–383. doi: 10.1097/OGX.0000000000000083.
  9. Clark BR, Engvall E (2018). Enzyme-linked immunosorbent assay (Elisa): Theoretical and practical aspects*. In Enzyme-Immunoassay. 167–180. CRC Press. Available at: https://www.taylorfrancis.com/books/9781351080293/chapters/10.1201/9781351071840-8.
  10. Dixon L, Skinner J, Foureur M (2013). The emotional and hormonal pathways of labour and birth: Integrating mind, body and behaviour. New Zealand College of Midwives Journal 48, 15–23. doi: 10.12784/nzcomjnl48.2013.3.15-23.
  11. Egbewale BE (2014). Random allocation in controlled clinical trials: a review. Journal of pharmacy & pharmaceutical sciences : a publication of the Canadian Society for Pharmaceutical Sciences, Societe canadienne des sciences pharmaceutiques 17, 248–253. doi: 10.18433/j3sw36.
  12. Feng C, Popovic J, Kline R, et al (2017). Auricular acupressure in the prevention of postoperative nausea and emesis a randomized controlled trial. Bulletin of the Hospital for Joint Disease (2013) 75, 114–118. Available at: http://www.ncbi.nlm. nih.gov/pubmed/28583057.
  13. Firouzbakht M, Nikpour M, Khefri S, et al (2015). The effectiveness of prenatal intervention on pain and anxiety during the process of Childbirth-Northern Iran: Clinical trial study. Annals of Medical and Health Sciences Research 5, 348. doi: 10.4103/2141-9248.165260.
  14. Hofmeyr G, Bernitz S, Bonet M, et al. (2021). WHO next"generation partograph: revolutionary steps towards individualised labour care. BJOG: An International Journal of Obstetrics & Gynaecology 128, 1658–1662. doi: 10.1111/1471-0528.16694.
  15. Kaniusas E, Kampusch S, Tittgemeyer M, et al (2019). Current directions in the auricular vagus nerve stimulation I – A physiological perspective. Frontiers in Neuroscience. doi: 10.3389/fnins.2019.00854.
  16. Kuo S-Y, Tsai S-H, Chen S-L, et al (2016). Auricular acupressure relieves anxiety and fatigue, and reduces cortisol levels in post-caesarean section women: A single-blind, randomised controlled study. International Journal of Nursing Studies 53, 17–26. doi: 10.1016/j.ijnurstu.2015.10.006.
  17. Mafetoni RR, Rodrigues MH, Jacob LM da S, et al (2018). Effectiveness of auriculotherapy on anxiety during labor: a randomized clinical trial. Revista Latino-Americana de Enfermagem. doi: 10.1590/1518-8345.2471.3030.
  18. Novianti I, Safitri Muchtar A (2021). Pengaruh terapi akupresur terhadap tingkat kecemasan pada ibu hamil trimester III. Jurnal Bidan Cerdas 3, 110–118. doi: 10.33860/jbc.v3i3.467.
  19. Nursalam (2020). Metodologi penelitian ilmu keperawatan: Pendekatan praktis, 5th edn. Salemba Medika, Jakarta. Available at: https://api.penerbitsalemba.com/book/books/08-0 284/contents/fc506312-5e09-4027-a661 9ba646d ced46.pdf.
  20. Prakasiwi SI, Khasanah U, Rejeki S (2023). The knowledge of midwives about Poedji Rochjati's scorecard. In 377–81. Available at: https://www. atlantis-press.com/doi/10.2991/978-94-6463-132-6_42.
  21. Putri FO (2019). Faktor-faktor yang berhubungan dengan kejadian partus lama pada ibu bersalin (thesis). Poltekkes Kemenkes Semarang. Available at: https://repository.poltekkes-smg.ac. id/index.php?p=show_detail&id=19995&keywords=.
  22. Ritonga JS, Hidayat A (2023). The effect of childbirth education in reducing anxiety in facing childbirth in the third trimester pregnant women: Scoping review. Poltekita : Jurnal Ilmu Kesehatan 17, 227–238. doi: 10.33860/jik.v17i1.2145.
  23. Romoli M (2009). Auricular acupuncture diagnosis, 1st edn. Elsevier.
  24. Sagita YD (2018). Hubungan tingkat kecemasan dengan lama persalinan kala II pada ibu bersalin di Rsia Anugerah Medical Center Kota Metro. Midwifery Journal 3, 31. Available at: https://www.neliti.com/publications/278695/hubungan-tingkat-kecemasan-dengan-lama-persalinan-kala-ii-pada-ibu-bersalin-di-r#cite.
  25. Saputra K, Sudirman S (2009). Akupuntur untuk nyeri dengan pendekatan neurosain. Sagung Seto, Jakarta.
  26. Saraswati W, Wardani R, Suhatno S, et al. (2021). The effect of electroacupuncture therapy on pain, plasma β-endorphin, and quality of life of stage III cervical cancer patients: A randomized control trial. Journal of Acupuncture and Meridian Studies 14, 4–12. doi: 10.51507/j.jams.2021.14.1.4.
  27. Senudin PK (2019). Pengaruh terapi akupresur terhadap tingkat kecemasan dan kadar hormon endorpin pada ibu hamil (thesis). Universitas Hasanuddin. Available at: http://repository.unhas. ac.id/id/eprint/4957/.
  28. Setiawandari S, Noor Pramono, Koosnadi Saputra (2022). Auricular acupuncture on uterine point on PGF2α levels and first-stage of labor duration among primigravida women. Embrio 14, 159–167. doi: 10.36456/embrio.v14i2.6003.
  29. Shodiqoh ER, Syahrul F (2014). Anxiety level differences between the face of labour and multigravida primigravida. Jurnal Berkala Epidemiologi 2, 141. doi: 10.20473/jbe.V2I12014.141-150.
  30. Silva HL da, Almeida MV de S, Diniz J da SP, et al (2020). Efeitos da auriculoterapia na ansiedade de gestantes no pré-natal de baixo risco. Acta Paulista de Enfermagem. doi: 10.37689/acta-ape/2020AO0016.
  31. Tseng C-C, Tseng A, Lin J-G, et al (2015). The effect of acupuncture at ear shenmen on heart rate variability : A subject-assessor-blinded , randomized , sham-controlled crossover study. Journal of Chinese Medicine 26, 1–8. doi: 10.3966/241139642015122602003.
  32. Vakilian K, Ghaemmaghami M, Sheikhganbari N, et al (2022). Reducing labor anxiety with auriculotherapy: A randomized clinical trial study. Chinese Journal of Integrative Medicine 28, 440–444. doi: 10.1007/s11655-021-3452-0.
  33. Walter MH, Abele H, Plappert CF (2021). The role of oxytocin and the effect of stress during childbirth: Neurobiological basics and implications for mother and child. Frontiers in Endocrinology. doi: 10.3389/fendo.2021.742236.