Journal of Midwifery and Reproductive Health

Journal of Midwifery and Reproductive Health

The Effect of Ice Massage on LI4 Acupressure Point for Labor Pain: A Systematic Review and Meta‑analysis

Document Type : Systematic Review

Authors
Sedigheh Abdollahpour
Mona Larki
Zahra Hadizadeh-Talasaz
a) Assistant Professor in Reproductive Health, Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran b) Department of Midwifery, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
10.22038/jmrh.2025.89060.2700
Abstract
Background & aim: Pain management during childbirth is a key component of midwifery care. Acupressure with ice may provide pain relief, but findings are inconsistent. Therefore, this systematic review and meta-analysis evaluated the effects of LI4 massage with ice on labor pain.
Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses2020 on articles published. PubMed-Medline, Web of Science, ScienceDirect, and Cochrane Library databases were searched up to April 07, 2025. The potential for bias in both randomized and non-randomized trials was assessed utilizing the Cochrane Risk of Bias Tool for Randomized Trials (RoB-1) and Non-Randomized Studies (ROBINS-I). Data were analyzed using CMA software version 2. Continuous outcomes were analyzed using MD or SMD, as appropriate, with 95% CIs, and pooled estimates were calculated using a random-effects model.
Results: Of 224 articles, 12 studies were included in the systematic review, and 9 were included in the meta-analysis. The results demonstrated that LI4 massage with ice can reduce labor pain compared with control group 30 minutes (MD = −1.25, 95% CI: −1.96 to −0.54, P-value<0/001), and 60 minutes after intervention (SMD = −1.85, 95% CI: −2.61 to −1.10, P-value<0/001). However, no significant reduction was observed immediately after the intervention (MD = −1.89, 95% CI: −4.65 to 0.87, P-value = 0.179).
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 and simplicity.
Keywords
Acupressure
Ice Massage
Hegu (LI4) Point
Labor Pain
Complementary Therapy
Subjects
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Journal of Midwifery and Reproductive Health
Volume 14, Issue 4
Autumn 2026
Pages 5614-16