{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T09:39:40Z","timestamp":1792489180457,"version":"4.5.0"},"reference-count":40,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T00:00:00Z","timestamp":1786579200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Japan Journal Nursing Sci"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the benefits and harms of bathing during the first stage of labor among healthy women with uncomplicated singleton cephalic pregnancies at \u2265\u200936\u2009weeks' gestation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Randomized controlled trials comparing warm\u2010water bathing during the first stage of labor with no bathing were included. MEDLINE (PubMed), Cochrane Database of Systematic Reviews, CENTRAL, and Ichu\u2010shi Web (updated to December 2024) were searched for English\u2010 and Japanese\u2010language studies. Two reviewers independently assessed risk of bias using the Cochrane Risk of Bias 1.0 tool, and evidence certainty was appraised with GRADE. Random\u2010effects meta\u2010analyses reported risk ratios (RRs) or mean differences with 95% prediction intervals (PIs), and\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      statistics.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies from eight countries (1994\u20132018;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20091823) met inclusion criteria. Bathing did not significantly affect regional analgesia use (RR 0.91, 95% PI 0.82\u20131.01;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%), perineal trauma, spontaneous vaginal birth, intact perineum, caesarean section, abnormal fetal heart rate patterns, neonatal infection, or episiotomy. Instrumental vaginal birth was reduced (RR 0.78, 95% PI 0.61\u20130.98;\n                      <jats:italic>I<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). Satisfaction tended to be higher in the bathing group, though evidence was limited to two small heterogeneous trials.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Evidence certainty was low to very low because of risk of bias, imprecision, lack of blinding, and limited woman\u2010reported outcomes. Bathing appears safe for mothers and infants and may reduce instrumental delivery, but a clear analgesic\u2010sparing effect was not shown. Implementation should ensure tub hygiene, water temperature regulation, and regular maternal and fetal monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      Register name: Effect of Bathing for Pain Relief During the First Stage of Labor: A protocol for a systematic review and meta\u2010analysis. Registration DOI:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/doi.org\/10.17605\/OSF.IO\/J9GTS\">https:\/\/doi.org\/10.17605\/OSF.IO\/J9GTS<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jjns.70071","type":"journal-article","created":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T08:20:14Z","timestamp":1786609214000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Bathing for Pain Relief During the First Stage of Labor: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1111","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7986-2441","authenticated-orcid":false,"given":"Kayo","family":"Ueda","sequence":"first","affiliation":[{"name":"Department of Reproductive Health, Institute of Biomedical Sciences Nagasaki University  Nagasaki\u2010city Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukiko","family":"Honda","sequence":"additional","affiliation":[{"name":"Department of Social Epidemiology, Graduate School of Medicine and School of Public Health Kyoto University, Kyoto University School of Public Health  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4629-2371","authenticated-orcid":false,"given":"Yuko","family":"Masuzawa","sequence":"additional","affiliation":[{"name":"Faculty of Nursing Niigata College of Nursing  Joetsu Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1850-6301","authenticated-orcid":false,"given":"Mai","family":"Takeshita","sequence":"additional","affiliation":[{"name":"Department of Implementation Science in Public Health Kyoto University School of Public Health  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rie","family":"Toyomoto","sequence":"additional","affiliation":[{"name":"Department of Health Promotion and Behavioral Sciences Kyoto University Graduate School of Medicine\/School of Public Health  Kyoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kumiko","family":"Adachi","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, School of Nursing Tokyo Metropolitan University  Arakawa\u2010Ku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2652-4000","authenticated-orcid":false,"given":"Hiromi","family":"Eto","sequence":"additional","affiliation":[{"name":"Department of Reproductive Health, Institute of Biomedical Sciences Nagasaki University  Nagasaki\u2010city Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6224-5391","authenticated-orcid":false,"given":"Yuriko","family":"Usui","sequence":"additional","affiliation":[{"name":"Division of Health Sciences and Nursing, Department of Midwifery and Women's Health, Graduate School of Medicine The University of Tokyo  Bunkyo\u2010ku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rieko","family":"Fukuzawa","sequence":"additional","affiliation":[{"name":"Maternal Nursing &amp; Midwifery Nagano College of Nursing  Komagane Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Nishino","sequence":"additional","affiliation":[{"name":"School of Public Health, Graduate School of Medicine The University of Tokyo  Bunkyo\u2010ku Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,13]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1523\u2010536x.2001.00084.x"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010056517"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016349409013433"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1590\/1983\u20101447.2019.20190026"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000111.pub4"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.midw.2023.103824"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1590\/s0080\u201062342006000100008"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1552\u20106909.2008.00259.x"},{"key":"e_1_2_12_10_1","unstructured":"Dalkey N. 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