Acupressure as part of comprehensive postpartum pain care: a systematic review of clinical evidence from low- and middle-income countries

Postpartum pain remains a significant yet under-addressed issue in low- and middle-income countries (LMICs), where pharmacological analgesia may be limited by availability, side effects, and breastfeeding safety concerns. This systematic review aimed to synthesize and critically appraise the clinical trial evidence on the effectiveness of acupressure for managing postpartum pain in LMIC settings. Following PRISMA 2020 guidelines, searches were conducted in PubMed, Cochrane Library, ScienceDirect, Taylor & Francis, ProQuest, and Google Scholar for studies published between 2015 and 2025. Nine eligible studies from Turkey, Iran, Taiwan, Thailand, and Indonesia were included and appraised using the CASP tool. Most studies focused on the immediate/acute postpartum phase, while a few extended into the early postpartum period. Across various postpartum pain conditions, most included studies reported reductions in pain intensity following body or auricular acupressure compared with usual care, sham, or comparator interventions. Several studies also reported additional benefits, such as decreased analgesic consumption after cesarean delivery and improvements in functional limitations and depressive symptoms. Overall, acupressure may serve as a low-cost adjunct for postpartum pain management in resource-limited maternity services. Nevertheless, protocol variability and short follow-up periods highlight the need for larger multicentre trials with standardized dosing and broader maternal outcomes.