Effect of Neroli (Citrus aurantium) Inhalation Aromatherapy on Active Phase First-Stage Labor Pain

Abstract

Childbirth is a stressful physiologic and psychological event that may intensify pain, fear, and anxiety. Aromatherapy is a complementary technique used to support pain relief during labor, and neroli essential oil derived from Citrus aurantium has been reported to reduce anxiety and pain. This study aimed to determine differences in active-phase first-stage labor pain between women receiving neroli inhalation aromatherapy and those in a control group. A quasi-experimental pretest-posttest nonequivalent control-group design was used in two hospitals in Gresik Regency, Indonesia. Participants were recruited by consecutive sampling and included 66 laboring women who met the inclusion criteria, with 33 women assigned to each group. Labor pain was measured using the Numeric Rating Scale, and anxiety was measured using the Hamilton Anxiety Rating Scale. Data were analyzed using descriptive statistics, independent-samples t tests, Mann-Whitney U tests, Pearson correlation, and linear regression. The mean decrease in labor pain was greater in the aromatherapy group than in the control group (3.06 +/- 0.659 vs. 1.97 +/- 0.684). The between-group difference was statistically significant (p < .001; 95% CI: -1.421 to -0.761). Anxiety was the external variable associated with pain-score reduction (p = .026 in multivariable analysis). These findings indicate that neroli inhalation aromatherapy can reduce active-phase first-stage labor pain and may be considered a nonpharmacological complementary approach to labor pain management