BACKGROUND:
Midwives can provide more effective support to pregnant women by adding nonpharmacological methods to the care they provide to reduce birth pain in addition to the continuous birth supportive care practices they provide at the time of birth.

OBJECTIVES:
This study aimed to evaluate the effects of pain management methods employed during the active phase of labour on birth outcomes.

METHODS:
Conducted using a randomized controlled experimental design, the research included 120 primiparous women who gave birth at a private hospital between September 2023 and June 2025. Participants were allocated to four groups: Intervention 1 (exercise and massage), Intervention 2 (massage and warm shower), Intervention 3 (exercise, massage, and warm shower), and a Control group (pharmacological interventions only). Data were collected using a demographic information form, a birth monitoring form, the Visual Analogue Scale (VAS), the Birth Experience Scale (BES), and a postpartum evaluation form.

RESULTS:
Analysis of VAS scores revealed statistically significant differences between groups during cervical dilatation phases of 4–5 cm (p=0.001), 6–7 cm (p=0.034), and 8–9 cm (p=0.030). Pain levels were notably lower in the Intervention 2 group. Regarding the duration of labor, significant differences were found in the lengths of the active (p=0.0001) and transition phases (p=0.022), with shorter durations observed in the intervention groups. In terms of mode of delivery, spontaneous vaginal birth rates were higher in the intervention groups (Intervention 1: 76.7%; Intervention 2 and 3: 86.7%), while the cesarean section rate was higher in the control group. No statistically significant differences were found between the groups in neonatal 1st- and 5th-minute APGAR scores. Although the highest BES score (49.00) was observed in the Intervention 3 group, the differences among groups were not statistically significant.

CONCLUSIONS:
In conclusion, non-pharmacological methods such as massage, exercise, and warm showers, when applied during the active phase of labor, appear to facilitate pain management, shorten labor duration, and increase the rate of spontaneous birth.

KEY MESSAGE:
Integrating these practices into midwifery care may enhance both physical and emotional support for women, ultimately improving birth outcomes. Poster session 2 (Group A)