Abstract
OBJECTIVE: To evaluate the effects of free positioning combined with mindfulness-based relaxation techniques on labor pain, labor progression, and psychological state in primiparous women, providing evidence for promoting natural childbirth. METHODS: A retrospective cohort study was conducted involving 120 primiparous women who met the inclusion criteria and delivered at Wuxi Second People's Hospital between January 2022 and June 2023. Participants were divided into an intervention group (free positioning plus mindfulness relaxation, n=60) and a control group (conventional supine position and routine care, n=60) based on intrapartum management. The two groups were compared in terms of labor duration, pain scores [Visual Analogue Scale (VAS), Pain Rating Index (PRI), Present Pain Intensity (PPI)], emotional status [Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS)], sense of control during labor [Labor Agentry Scale (LAS)], perineal trauma, postpartum blood loss, and neonatal Apgar scores. RESULTS: The intervention group had significantly shorter first, second, and total labor stages (all P < 0.001), with total labor reduced by ~135 minutes (effect size: Cohen's d = 3.86). Pain (VAS, PRI, PPI) and emotional distress (SAS, SDS) scores were significantly lower, and LAS scores higher in the intervention group (all P < 0.001). They also experienced less postpartum bleeding (155.89 ± 22.21 mL vs 204.58 ± 30.88 mL) and fewer second- or third-degree perineal lacerations (23.34% vs 46.67%, P < 0.05). Neonatal Apgar scores were similar between groups. CONCLUSION: Free positioning combined with mindfulness-based relaxation may help shorten labor, relieve pain, improve emotional well-being, reduce trauma and bleeding, and enhance maternal control. However, further multicenter randomized controlled trials are needed to confirm these findings due to the retrospective design and limited sample size.