Conclusion
Application of perineal warm packs to the sacrum andperineum during the first stage of active phase of physiological labor is a low-cost intervention not requiring special training that may reduce pain and improve maternal satisfaction. In countries where epidural anesthesia is
routine, this non-invasive, non-pharmacological modality provides a safe alternative for mother and fetus [40], and also provides mothers with a choice if they would prefer to avoid invasive pharmacological methods of pain management in labor [41]. This method may be particularly attractive to mothers who want to be more involved and in control of their own care [42].
More research, in controlled clinical trials, is needed to evaluate the effectiveness of heat therapy alone and when combined with other non-pharmacological methods.