{
  "abstract": "Background\n\nNon-pharmacological strategies can complement pharmacological labor analgesia, yet their clinical use is often fragmented across techniques and labor stages, limiting consistent and continuous support during vaginal delivery.Objective\n\nTo develop a consensus-based, implementation-oriented clinical practice protocol that organizes full-process non-pharmacological labor pain management from prenatal preparation through early postpartum evaluation.Methods\n\nGuided by the Manchester pain management model and CREDES recommendations, this Delphi-based protocol development study generated an initial framework through structured evidence review, focus group discussion, and expert consultation. Eleven interdisciplinary experts completed two anonymous Delphi rounds. Group-level statistical feedback and anonymized comments from round 1 informed the round-2 questionnaire, and predefined consensus criteria guided protocol finalization.Results\n\nThe response rate was 100% in both rounds, and the expert authority coefficient was 0.92. First-round coefficients of variation ranged from 0.00 to 0.28; Kendall's W values were 0.230, 0.215, and 0.208 for primary, secondary, and tertiary items, respectively (P = 0.021, 0.001, and < 0.001). Second-round coefficients of variation ranged from 0.00 to 0.19; cold therapy (D4-4; CV = 0.19) was retained as a conditional item requiring individualized assessment. Kendall's W values were 0.240, 0.225, and 0.212, respectively (P = 0.010, 0.001, and < 0.001). The final protocol comprised five primary domains, 20 secondary items, and 57 tertiary items integrating pain-management objectives, team building, dynamic assessment, mechanism-organized interventions, shared decision-making, and outcome evaluation from prenatal preparation to 24 h postpartum.Conclusion\n\nThis study shows that dispersed evidence on non-pharmacological labor pain management can be translated through multidisciplinary consensus into a coherent full-process clinical pathway. The protocol offers a standardized framework to complement pharmacological analgesia and support consistent, individualized care; its feasibility, acceptability, and clinical effects require prospective multicenter evaluation.",
  "abstract_shown": true,
  "affiliations": [
    "Delivery Room, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China.",
    "Postpartum Maternal and Child Health Centers, Women and Children's Hospital of Ningbo University, Ningbo, Zhejiang, China."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Xiaoxing Xie"
    },
    {
      "affs": [
        0
      ],
      "name": "Rongrong Wu"
    },
    {
      "affs": [
        0
      ],
      "name": "Jianwen Zhang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yan Shen"
    },
    {
      "affs": [
        1
      ],
      "name": "Xinqun Li"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/f20r5jmm0acvq.bib",
  "cited_by": 0,
  "doi": "10.3389/fmed.2026.1849246",
  "fulltext_url": "https://europepmc.org/articles/PMC13683653",
  "id": "f20r5jmm0acvq",
  "issns": [
    "2296-858X"
  ],
  "landing_url": "https://europepmc.org/article/MED/42908957",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Anesthesia and Pain Management"
    ]
  ],
  "openalex": "W7220834795",
  "pdf_url": "https://europepmc.org/articles/PMC13683653?pdf=render",
  "pmcid": "PMC13683653",
  "pmid": "42908957",
  "published": "2026-10-07",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/f20r5jmm0acvq.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:10Z",
      "native_id": "MED:42908957",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42908957"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Anesthesia and Pain Management",
      "subfield": "surgery"
    }
  ],
  "title": "Development of a full-process non-pharmacological labor pain management protocol for vaginal delivery: a Delphi study.",
  "title_text": "Development of a full-process non-pharmacological labor pain management protocol for vaginal delivery: a Delphi study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:10Z",
  "url": "https://research.draconitic.com/paper/f20r5jmm0acvq",
  "venue": "Frontiers in medicine",
  "versions": []
}