Aromatherapy intervention on anxiety and pain during first stage labour in nulliparous women: a systematic review and meta-analysis

J Obstet Gynaecol. 2021 Jan;41(1):21-31. doi: 10.1080/01443615.2019.1673707. Epub 2020 Jul 15.


This systematic review and meta-analysis aimed to critically evaluate and summarise all available evidence derived from randomised clinical trials (RCTs) regarding aromatherapy's effects on labour pain and anxiety relief. Literature search was performed in MEDLINE/PubMed, Cochrane library, Cochrane Central Register of Controlled Trials (CENTRAL) and Scopus since their respective inception to January 2019. Additionally, Google Scholar was also searched to explore citations of eligible final studies which were subsequently included in the systematic review. The search strategy used was: (pregnancy or pregnant or prenatal or antenatal or perinatal or maternal) AND (aromatherapy or essential oils or aroma therapy). Per inclusion and exclusion criteria established by the current study, nine RCTs were included in the systematic review. Results from the current study suggested that aromatherapy significantly decreased pain and anxiety in the first stage of labour.IMPACT STATEMENTWhat is already known on this subject? Several studies have shown aromatherapy's effectiveness in relieving pain and anxiety for hospitalised patients and on relieving nausea and vomiting for women during pregnancy. Some results have further indicated that aromatherapy was effective in facilitating episiotomy healing and in reducing pain, fatigue and distress. Aromatherapy was also found to play a role in improving maternal moods; reducing post-caesarean pain; and preventing or mitigating stress, anxiety and depression after childbirth. Though most non-pharmaceutical pain management options were considered non-invasive and presumably safe for mothers and their foetuses, their exact efficacies remained unclear due to a lack of high quality evidence.What the results of this study add? This systematic review and meta-analysis summarises all evidence derived from RCTs wherein aromatherapy was performed as a supportive analgesic method during labour. Results of this meta-analysis identified more credible evidence validating that aromatherapy could significantly decrease labour pain both in early active and late active phases.What the implications are of these findings for clinical practice and/or further research? Availability of credible evidence supporting aromatherapy's effectiveness on reducing physiological and psychological stress during pregnancy and childbirth would be useful, both theoretically and practically, for all stakeholders concerned, such as pregnant women, medicine and midwifery students, midwives, nurses, gynaecologists and health policymakers.

Keywords: Aromatherapy; anxiety; labour pain.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Adult
  • Anxiety / therapy*
  • Aromatherapy / methods*
  • Female
  • Humans
  • Labor Pain / therapy*
  • Labor Stage, First / psychology*
  • Obstetric Labor Complications / psychology
  • Obstetric Labor Complications / therapy*
  • Parity
  • Pregnancy
  • Young Adult