Discussion
This study found that pain scores reported by subjects in the group with sacrum-perineum heat therapy were lower than the pain scores of the women in the control group 60,90, and 120 minutes after intervention during the active phase of labor.This is consistent with the Behmanesh et al. study in which the pain severity in the group with heat application on the back at first stage and on the perineum at thesecond stage of labor was less than that in the control group in the first and second labor stages [24]. A potentialsource of bias is that the study subjects in the interventiongroup received more personal attention from the investigator than subjects in the control group that might have favorably biased pain scores and satisfaction. It is noteworthy that the design and the application time of heat in this study were different from other studies. In this study, the moist pack with towel was applied during the first stage of labor, while previously mentioned studies have used warm packs (bags) during the second stage of
labor. Behmanesh et al. evaluated pain at cervical dilation of 3–4, 6–7, and 9–10 cm [24]. Dahlen et al. [10,13]