Effectiveness of Non-pharmacological Interventions for Perineal Pain Management within 0-72 Hours after Vaginal Delivery: A Systematic Review
DOI:
https://doi.org/10.64767/trcn.2026.280393Keywords:
non-pharmacological pain management, cold compression, perineal wound pain, postpartum women, systematic reviewAbstract
Background: Perineal wound pain is a common problem among women after vaginal delivery, affecting both their physiological and psychological well-being. It is typically most severe during the first 24 hours after childbirth and tends to decrease within 72 hours postpartum.
Objective: To synthesize the methods and outcomes of non-pharmacological management of perineal pain during the first 0–72 hours postpartum among women following vaginal delivery.
Methods: A systematic review was conducted in accordance with the JBI Manual for Evidence Synthesis. Two reviewers independently searched five electronic databases, PubMed, Cochrane Library, ScienceDirect, CINAHL, and ThaiJO guided by the PICOT framework. Studies were selected based on the PRISMA 2020 guidelines and reported using a PRISMA flow diagram. Methodological quality was appraised using the JBI Critical Appraisal Checklist for Randomized Controlled Trials, with a minimum quality threshold of 60%. Data were extracted using a researcher-developed form based on the JBI guidelines and descriptive synthesis.
Results: Seven studies met the inclusion criteria, all of which were randomized controlled trials (RCTs), classified as Level 1.c evidence according to the JBI criteria. The studies included a total of 731 participants from five countries. Four studies were rated as high quality, while three were rated as moderate quality.
Conclusions: Cold therapy may help reduce acute perineal pain during the early postpartum period, particularly in the short term. However, evidence regarding the optimal frequency of application remains insufficient. As a simple and practical intervention within the scope of nursing practice, cold therapy may be used as an adjunct to standard care, with its application tailored to each woman’s needs and the local clinical context.
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