The Effect of Head Massage on Preoperative Anxiety Levels in Women Candidates for Cesarean Section: A Randomized Controlled Trial

Background: Preoperative anxiety is common among women undergoing cesarean delivery and may negatively affect surgical outcomes. Head massage, a non-pharmacological technique, has been shown to reduce anxiety by stimulating the central nervous system and lowering stress hormones. Objectives: This study aimed to assess the effectiveness of head massage in reducing preoperative anxiety in women scheduled for cesarean delivery. Methods: This single-blind clinical trial involved 56 pregnant women (aged ≥ 16 years) undergoing elective cesarean sections at hospitals in Behbahan, southwestern Iran. Participants were randomly assigned to two groups: The control group (n = 28) received standard hospital care, while the intervention group (n = 28) received a 30-minute head massage one hour before surgery. Baseline demographic characteristics and anxiety scores were comparable between groups (P > 0.05). Anxiety levels were measured using the Spielberger Anxiety Questionnaire before the intervention and surgery. Data were analyzed using paired and independent t-tests. Results: Significant intra-group differences in anxiety levels were observed. In the control group, state anxiety increased from 50.6 ± 5.63 (baseline) to 56.10 ± 5.78 (post-intervention), trait anxiety increased from 49.50 ± 7.07 to 57.75 ± 11.04, and total anxiety rose from 95.46 ± 15.37 to 111.07 ± 21.22 (P < 0.001). In contrast, the intervention group experienced a reduction in state anxiety from 49.4 ± 3.06 to 33.7 ± 2.09, trait anxiety from 48.18 ± 6.08 to 32.75 ± 6.80, and total anxiety decreased from 94.28 ± 11.92 to 64.03 ± 12.71 (P < 0.001). All differences were statistically significant (P < 0.001). Conclusions: Head massage is a simple, non-invasive, low-cost method that significantly reduces preoperative anxiety in women preparing for cesarean surgery and may be a useful adjunct to routine preoperative care.