Midwifery Care For Active Phase First-Stage Labor With Massage Counter Pressure To Reduce Contraction Pain

Abstract

Background: Pain during the active phase of the first stage of labor is a physiological response to increasingly strong and regular uterine contractions. Inadequately managed pain may reduce maternal comfort and interfere with adaptation during labor. Objective: This case study aimed to describe intrapartum midwifery care for a woman experiencing contraction pain through the application of massage counter pressure.  Subject: Mrs. “N”, 35 years old, G7P1A5, at 42 weeks and 1 day of gestation, in the active phase of the first stage of labor at PMB Fatmawaty. Methods: A qualitative case study was conducted using interviews, observation, physical examination, and documentation. Midwifery care followed the seven-step Varney approach and was documented using SOAP. Pain intensity was assessed using the Numeric Rating Scale (NRS) before and after the intervention. Results: The initial assessment showed 6 cm cervical dilatation, four contractions per 10 minutes lasting 40–50 seconds, and a pain score of 8. Massage counter pressure was administered five times during contractions from 22:30 to 00:30 Central Indonesian Time. Following the intervention, the pain score decreased to 6. The mother appeared more relaxed, was able to regulate her breathing, and reported greater comfort. Cervical dilatation reached 10 cm at 01:00, and spontaneous vaginal birth occurred at 01:29. Conclusion: n this case, massage counter pressure was accompanied by a two-point reduction in pain intensity and improved maternal comfort. This technique may be considered as a non-pharmacological intervention while maternal and fetal conditions continue to be monitored.