Background: Labor pain has always been a priority issue for primiparous women. Pain behaviors appear as a response to labor pain. This study aimed at examining the effect of nursing interventions integrating an Islamic praying (NIIIP) program on labor pain and pain behavior. Materials and Methods: In this experimental design, 42 women in the control group received the usual care; 41 in the experimental group received the usual care and an NIIIP program from the 32 nd week of pregnancy. This was done by providing childbirth education which they then practiced at home every day until they entered the labor room in the Bhinneka Bhakti Husada Hospital and Community Health Center Pamulang, Indonesia. They conducted 30 min of reciting from the Quran, stroking, positioning during their inter contractions, just breathing during contractions at the 1 st , 2 nd , 3 rd h after cervical dilation of 3–4 cm. The visual analogue scale (VAS) and pain behaviors observation scale (PBOS) were used to measure pain and pain behaviors. Repeated measures of the ANOVA and t test were used to analyze the data. Results: There were significant differences in experience of labor pain ([F = 113.07, df (1, 81), p < 0.001] and pain behavior ([F = 147,49 df (1, 81), p < 0.001] between the control and experimental groups. There were significant statistical differences of over four times at the points of pain [F = 82.84, df (2, 182), p < 0.001] and pain behaviors [F = 165.55, df = (2, 189), p < 0.001]. Conclusions: The program effectively resulted in lower pain and increased pain behaviors.

Fear and anxiety in labor pain may increase the duration of labor (prolonged labor) and is one of the reasons for cesarean section in first time mothers (primiparous women). Prevention could be implemented through a childbirth preparation program with childbirth education on positioning, breathing, stroking, and Islamic praying conducted from pregnancy until labor room with family support. An experimental study design was conducted with 83 participants randomly assigned into an intervention group (n = 41) and control group (n = 42) to examine the effect of nursing interventions integrating an Islamic praying (CPNsIIIP) program on duration of active phase of labor and neonatal outcomes. The experimental group received the usual care and the program from 32 weeks of pregnancy by providing childbirth education then practice it at home every day until childbirth. In the labor room, the women recited 14 verses of the Quran, stroking, positioning during inter contractions, and just breathing during contractions of the active phase of labor at the Bhinneka Bhakti Husada Hospital and Community Health Center Pamulang, Indonesia. The control group received only the usual care. Duration of labor was measured in minutes, and neonatal outcomes were measured using the APGAR (Appearance, Pulse, Grimace, Activity, and Respiration) scale and complication of fetus after birth by collaborating with doctor. An Independent t-test was conducted to determine the between group effect of the program. Findings showed that duration of the active phase of labor was significantly shorter in the experimental group than in the control group after receiving the program (t = 7.51; p = 0.00) and improved the neonatal outcomes, except for the APGAR scores of the babies; at 1 and 5 min, the experimental group were 8.8 ± 0.4 and 8.79 ± 0.4 (p > .05). The program in this study clearly indicated positive effects on shortening of the active phase of labor, with no complications of neonatal outcomes, in primiparous Muslim women.

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Background: Many factors influence the expressions of pain in primiparous women aside from contractions of the uterus. Objective: This study aimed to describe the level labor pain, level of labor pain behaviors based on cultural pain behaviors at 3 -4 cm of cervical dilation or the beginning of the active phase of labor among primiparous Muslim women in Indonesia. Methods: This was a study with 42 primiparous Muslim women who gave birth in the labor room at Bhinneka Bhakti Husada Hospital and Community Health Center Pamulang, Indonesia from June until January 2017. The women were asked to describe on a 100 mm Visual Analogue Scale the intensity of level of labor pain in their abdomen during the last contractions at 3 -4 cm of cervical dilation, and Pain Behaviors Observation Scale to observe pain behaviors. Descriptive statistics were used to analyze the data. Results: The findings showed that the mean score of level of labor pain at 3 -4 cm of cervical dilation was 86.38 (SD = 4.47) and most participants experienced high level of labor pain (97.6%). The expression of cultural labor pain behaviors including saying praises to Allah, Asma'aul husna, reciting the Qur'an, sholawat.