Practices of Counter Pressure and Birth Ball Exercise Combination to Increase β-Endorphin Hormone Levels in Labor Pain

Labor pain is a subjective experience regarding physical sensations that occur due to uterine contractions, dilation and thinning of the cervix and is a physiological sensation. The pain occurs due to the transmission of pain impulses through certain nerves. Inefficient uterine contractions could affect the mother's condition in the form of fatigue, fear, and stress. Nonpharmacological methods used to reduce labor pain is counterpressure and birth ball exercise combination which applying pressure using the base of the hand on the sacral bone and lumbar of the mother by sitting on the birth ball during a contraction so that can reduce the sensation of pain transmission impulses to the brain. This type of research used a Quasi Experiment with a random cluster design pretest and posttest control group was used to determine the effect of the combination intervention to increase β-endorphin levels. 40 samples were divided into 2 groups using purposive sampling technique. Each group consisted of 20 respondents. The result shows that the combination was more effective in increasing β-endorphin levels compared to back massage seen from the p-value 0.002 (p <0.05) which means there is a difference in betaendorphin levels of the treatment group and the control