Researchers recently focused on the use of massage therapy during labor to determine, among other factors, whether massage would have any effect on delaying the use of an epidural. The results of the research showed a delay in epidural use in association with massage therapy.

The study, “Massage therapy and labor outcomes: a randomized controlled trial,” involved 77 healthy women, ranging in age from 18 to 35 and arriving at the hospital in spontaneous labor. Women included in the study were giving birth for the first time to a single infant, with cephalic presentation and 37 to 41 completed weeks of pregnancy.

Once the women consented to participate in the study, they were randomly assigned to receive either massage during labor or standard care followed by massage during the first 24 hours postpartum. For those assigned to receive massage during labor, the intervention began right away.

“The massage technique used was Swedish massage, but the exact location and nature of the massage was negotiated between the woman and the therapist,” state the study’s authors. “The protocol provided massage therapy for up to five hours per participant, but women were permitted to choose to receive it only for part of that time.”

According to the researchers, the limit of five hours was selected as the maximum number of hours one massage therapist could provide the massage without becoming exhausted. The massage came to a stop if and when each subject chose to receive epidural analgesia.

The main outcome measure for the study was the timing of epidural analgesia with respect to cervical dilation. Other measures included intensity of pain as measured on the Short Form McGill Pain Questionnaire, severity of pain from contractions, and length of first and second stage of labor.

Data analysis showed women in the massage group received epidural analgesia at a higher cervical dilation compared to women in the standard care group. The mean cervical dilation at the time of epidural insertion was 5.9 centimeters among women in the massage group and 4.9 centimeters among the women receiving standard care.

There were no statistically significant differences between the two groups for the other outcome measures, but total scores on the Short Form McGill Pain Questionnaire were lower among the women in the massage group during labor.

“We report a delay in epidural insertion of 1 centimeter associated with massage therapy by a registered massage therapist, and a reduction in pain perception of up to 20 points on the McGill Pain Questionnaire out of a total possible difference of 64,” state the study’s authors. “Our inability to demonstrate statistically significant results may have been a consequence of our need to limit the period for massage to five hours due to fatigue on the part of the therapists.”


Authors: Patricia Janssen, Farah Shroff and Paula Jaspar.

Sources: School of Population and Public Health, Departments of Family Practice and Obstetrics, University of British Columbia; Child and Family Research Institute; and Massage Therapists’ Association of BC. Originally published in December 2012 in the International Journal of Therapeutic Massage and Bodywork, 5(4), 15-20.