Journal of Midwifery and Reproductive Health

Journal of Midwifery and Reproductive Health

The Effects of LI4 Massage with Ice on Labor Pain: A Systematic Review and Meta‑Analysis

Articles in Press

Document Type : Systematic Review

Authors
sedigheh abdollahpour
mona larki
Zahra Hadizadeh-Talasaz
Assistant Professor in Reproductive health, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/jmrh.2025.89060.2700
Abstract
Background & aim: Pain management during childbirth is a key part of midwifery care. Non-pharmacological methods for pain relief are recommended. Acupressure with ice is one such method. Given conflicting findings, this study aimed to systematically review and meta-analyze the effects of LI4 massage with ice on labor pain.
Methods: This meta‑analysis study was performed on articles published up to April 07, 2025. PubMed-Medline, Web of Science, Science-Direct, and Cochrane Library databases were searched. Data were analyzed by using CMA software version 2. The risk of bias in the included studies was assessed.
Results: Out of a total of 385 articles, nine articles that met the inclusion criteria were included in the meta-analysis. The result demonstrated that LI4 massage with ice can reduce labor pain compared with the control group 60 minutes after intervention (SMD = −1.85, 95% CI: −2.61 to −1.10, p-value<0/001); heterogeneity (Q = 66.36, P value <0.001, and I2 = 92.46%), and 30 minutes after intervention (MD = −1.25, 95% CI: −1.96 to −0.54, p-value<0/001); heterogeneity (Q = 19.70, P value <0.001, and I2 = 79.69%). However, no significant reduction was found immediately after the intervention (MD = −1.89, 95% CI: −4.65 to 0.87, p-value=0.179); heterogeneity (Q = 88.24, P value <0.001, and I2 = 97.73%).
Conclusion: Based on the results, the acupressure point (LI4) with ice significantly relieved labor pain. Health care providers, especially midwives, can perform this procedure at a hospital or maternity clinic due to its cost-effectiveness, simplicity, and lack of negative health effects.
Keywords
Acupressure
ice massage
Hegu (LI4) point
labor pain
Subjects
Journal of Midwifery and Reproductive Health

Articles in Press, Accepted Manuscript
Available Online from 05 August 2026