The Effect of Endorphin Massage on Reducing Anxiety Levels During the First Stage of Labor
DOI:
https://doi.org/10.53713/htechj.v4i1.571Keywords:
anxiety, labor, obstetric, massage, endorphinsAbstract
Anxiety in mothers entering the latent phase of the first stage of labor can arise due to various factors, including psychological conditions, lack of family support, fear of the birthing process, limited information, and physical complaints experienced during labor. One non-pharmacological approach that has the potential to help reduce anxiety is endorphin massage, a massage technique believed to stimulate the release of endorphins, which are natural stress reducers. This study aims to assess the effectiveness of endorphin massage in reducing anxiety levels in pregnant women. The research design used a quantitative descriptive method with a one-group pretest–posttest approach. A total of 25 mothers in the first stage of labor at TPMB Diah Ulul in Probolinggo City were included in the sample. Anxiety levels were measured using the Hamilton Anxiety Rating Scale (HARS) before and after the intervention. Univariate analysis was used to describe the distribution of results, while differences in anxiety scores were tested using the t-test. The results showed a statistically significant decrease in anxiety after endorphin massage (t = 19.5; p < 0.001), with the average HARS score decreasing from 29.9 to 13.9. These findings indicate that endorphin massage is an effective non-pharmacological intervention and can be recommended as a supportive measure to help reduce anxiety in laboring mothers, thereby potentially improving comfort and the quality of the birthing experience.
References
Abidin, Yunita, R., & Aini Tika Rachmad, S. (2022). The Relationship between Anxiety Levels and Pain Degrees in Postoperative Caesarean Patients at Pasirian Hospital. Nursing and Health Sciences Journal (NHSJ), 2(2), 159–166. https://doi.org/10.53713/nhs.v2i2.125
Agrawal, S., Rajbhar, S., & Kashibhatla, J. (2023). First Stage of Labor. In Labour and Delivery: An Updated Guide (pp. 161-177). Springer Nature Singapore. https://doi.org/10.1007/978-981-19-6145-8_11
Alviatussyamsiah, N., Fadilah, L. N., & Yanti, Y. (2024). Effectiveness Of Endorphin Massage On Labor Pain In The Active Phase: Evidence Based Case Report (Ebcr). International Conference On Interprofessional Health Collaboration And Community Empowerment (Vol. 6, No. 1, pp. 107-112). https://doi.org/10.34011/icihcce.v6i1.309
Azissah RS, D., Rustandi, H., Nuh, Y. H., & Suyanto, J. (2024). Enhancing Maternal Comfort: The Impact of Endorphin Massage Therapy on Reducing Preoperative Pain and Anxiety in Primigravida Mothers Undergoing Cesarean Section. Journal of Current Health Sciences, 4(2), 79–86. https://doi.org/10.47679/jchs.202484
Dahlan, F. M., Yanti, R., Suralaga, C., & Aulia, Y. (2023). Endorphin Massage on Intensity of Pain in the First Stage of Active Labour. Health and Technology Journal (HTechJ), 1(4), 420–426. https://doi.org/10.53713/htechj.v1i4.40
Dewanti, A. C., Rohmayanti, R., & Rahayu, H. S. E. (2024). Exploring the soothing power of endorphin massage as a natural pain reliever for pregnant women. Innovation in Health for Society, 4(2), 126-132. https://doi.org/10.31603/ihs.12124
Elgzar, W. T., Alshahrani, M. S., & Ibrahim, H. A. (2024). Non-pharmacological labor pain relive methods: utilization and associated factors among midwives and maternity nurses in Najran, Saudi Arabia. Reproductive Health, 21(1), 11. https://doi.org/10.1186/s12978-023-01737-2
Hu, Q. T., Li, Y., Zhu, Y., Wang, J., & Li, Q. (2025). Effects of Multi-Mechanism Complementary Therapy on Pain and Anxiety During Labor Latency in Primiparous Women. Journal of Holistic Nursing. https://doi.org/10.1177/08980101241232443
Ismarina, Prihayati, Ikhlasiah, M., & Arta, K. (2023). The Effect of Back Massage on Labor Pain in Phase I Active in Maternity Mothers at PMB Intan In Tangerang District 2022. Nursing and Health Sciences Journal (NHSJ), 3(3), 345–348. https://doi.org/10.53713/nhsj.v3i3.278
Kartika, M. A., Maulina, R., & Keswara, N. W. (2025). The Effectiveness Of The Endorphin, Oxytocin, And Suggestive Massage Stimulation Method On Breast Milk Production In Postpartum Mothers: Implications for Midwifery Education. Education, 111-122. https://doi.org/10.59397/edu.v3i2.76
Leinweber, J., & Stramrood, C. (2024). Improving birth experiences and provider interactions: Expert opinion on critical links in Maternity care. European Journal of Midwifery, 8, 10.18332/ejm/191742. https://doi.org/10.18332/ejm/191742
Melaku, L. (2022). Physiological changes in pregnancy and anesthetic implications during labor, delivery, and postpartum. The Open Anesthesia Journal, 16(1). http://dx.doi.org/10.2174/25896458-v16-e2207130
Mrayan, L., Abujilban, S., AbuKaraki, A., & Nashwan, A. J. (2024). Evaluate the effectiveness of using non-pharmacological intervention during childbirth: an improvement project in Jordanian maternity hospitals. BMC Women's Health, 24(1), 605. https://doi.org/10.1186/s12905-024-03414-3
Navarro-Prado, S., Sánchez-Ojeda, M. A., Marmolejo-Martín, J., Kapravelou, G., Fernández-Gómez, E., & Martín-Salvador, A. (2022). Cultural influence on the expression of labour-associated pain. BMC pregnancy and childbirth, 22(1), 836. https://doi.org/10.1186/s12884-022-05173-1
Nori, W., Kassim, M. A., Helmi, Z. R., Pantazi, A. C., Brezeanu, D., Brezeanu, A. M., Penciu, R. C., & Serbanescu, L. (2022). Non-Pharmacological Pain Management in Labor: A Systematic Review. Journal of Clinical Medicine, 12(23), 7203. https://doi.org/10.3390/jcm12237203
Poehlmann, J. R., Stowe, Z. N., Godecker, A., Xiong, P. T., Broman, A. T., & Antony, K. M. (2022). The impact of preexisting maternal anxiety on pain and opioid use following cesarean delivery: A retrospective cohort study. American Journal of Obstetrics & Gynecology MFM, 4(3), 100576. https://doi.org/10.1016/j.ajogmf.2022.100576
Sari, L. P., Susilowati, D., & Sagita, S. (2022). The Phenomenon Of Pregnant Women's Anxiety In Facing Labor. Jurnal Kebidanan dan Kesehatan Tradisional, 85-94. https://doi.org/10.37341/jkkt.v0i0.356
Sartika, Y., Hevrialni, R., Daiyah, I., & Kundarti, F. I. (2024). Healing Touch Intervention in Obstetrics: Influence on Endorphin Levels and Active Labor Phase Duration. Jurnal Bidan Cerdas, 6(3), 143–150. https://doi.org/10.33860/jbc.v6i3.3040
Sartika, S., & Noorlinda, N. (2025). Reducing Labor Pain through Endorphin Massage: Clinical Evidence from Indonesia. Journal of Current Health Sciences, 5(3), 169–176. https://doi.org/10.47679/jchs.2025126
Sutcliffe, K. L., Levett, K., Dahlen, H. G., Newnham, E., & MacKay, L. M. (2023). How Do Anxiety and Relationship Factors Influence the Application of Childbirth Education Strategies During Labor and Birth: A Bowen Family Systems Perspective. International Journal of Women’s Health, 15, 455–465. https://doi.org/10.2147/IJWH.S399588
Swengel, J., & McConville, P. (2025). Mechanisms of labor pain and anesthesia in healthy parturients. In Pharmacology, Physiology, and Practice in Obstetric Anesthesia (pp. 121-125). Academic Press. https://doi.org/10.1016/B978-0-443-21707-4.00011-2
Tandon, A., Gujral, K., & Gupta, V. (2025). Labour Pain: A Comprehensive Review of Perceptions, Experiences, and Sociocultural Influences on Pain and Its Management Practices. Cureus, 17(6), e86540. https://doi.org/10.7759/cureus.86540
Titisari, I., & Putri, N. P. E. (2025). The Effect of Rose Aromatherapy on Anxiety Levels During the First Stage of Labor. Health and Technology Journal (HTechJ), 3(6), 763–770. https://doi.org/10.53713/htechj.v3i6.563
Young, E., Clarke, K., Reed, R., & Hastie, C. (2025). Women’s experiences of the transition phase of physiological labour during freebirth: A qualitative study. Sexual & Reproductive Healthcare, 45, 101115. https://doi.org/10.1016/j.srhc.2025.101115












