The Effect of Juniperus Capsule on Severity of Postpartum Pain in Multiparous Women: A Randomized Clinical Trial

Document Type : Original Article

Authors

1 M.Sc. of Midwifery, Department of Midwifery, Karaj Branch, Islamic Azad University, Karaj, Iran.

2 M.Sc. of Midwifery, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

3 PhD Student in Reproductive Health, Student Research and Technology Committee, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

4 M.Sc. of Health and Social Welfare, Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

5 Professor, Department of Pharmacognosy, Pharmaceutical Sciences Research Center, School of Pharmacy, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

6 Professor, Department of Obstetrics and Gynecology, School of Medicine, Mahdieh Hospital Shahid Beheshti University of Medical Sciences, Tehran, Iran.

7 Professor, Department of Obstetrics and Gynecology, Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

10.22038/ijogi.2026.90084.6511

Abstract

Introduction: Postpartum pain is one of the common problems during the postpartum period. Due to the harmful effects of chemical drugs, the use of herbal medicines has become popular. Therefore, this study was conducted with aim to investigate the effect of Juniperus sabina L plant capsule on the severity of postpartum pain in multiparous women.
Methods: This triple-blind, randomized, controlled, clinical trial was conducted on 66 mothers who gave birth in 2024-2025 at the hospitals affiliated with Shahid Beheshti University of Medical Sciences. During the first 24 hours after delivery, the intervention group was given up to 4 doses of Juniperus sabina L capsules every 8 hours and the control group was given placebo capsules. The intensity of postpartum pain was recorded using the VAS tool half an hour, one hour, and two hours after each intervention. Data analysis was performed using SPSS statistical software (version 21) and statistical tests such as Chi-square, Fisher's exact, independent t-test, and regression analysis.
Results: There was a significant difference between the mean pain score in the two groups over time (P<0.001), so that the mean pain intensity score before the first dose in the intervention group decreased from 7.6±1.7 to 0.44±0.86 2 hours after the fourth dose. The results of repeated measures analysis of variance showed that there was a significant difference between the mean pain score within the group over time in the intervention group (Eta2=0.530, P<0.001), so that the use of Juniperus sabina L capsules was effective in reducing postpartum pain by about 0.53%.
Conclusion: Considering the reduction in pain intensity and the absence of complications, the use of Juniperus sabina L capsules can be recommended.

Keywords

Main Subjects


  1. Wisner K. Postpartum Pain Management. MCN: The American Journal of Maternal/Child Nursing 2022; 47(1):52.
  2. Mozafari S, Esmaeili S, Momenyan S, Modarres SZ, Ozgoli G. Effect of Zingiber officinale Roscoe rhizome (ginger) capsule on postpartum pain: Double-blind randomized clinical trial. Journal of Research in Medical Sciences 2021; 26(1):105.
  3. Deussen AR, Ashwood P, Martis R. Analgesia for relief of pain due to uterine cramping/involution after birth. Cochrane database of systematic reviews; 2011(5).
  4. Moradian T, Asgharzadeh A, Tatari M. Exploring Phytochemical Diversity and Physiological Attributes of Juniper Species in Iran. Journal of Medicinal plants and By-products 2025.
  5. Collins S, Hayes K, Arulkumaran S, Arambage K, Impey L. Oxford handbook of obstetrics and gynaecology. Oxford University Press; 2023.
  6. Dhanuja V, KalaBarathi S, Jagadeeswari J. Effect of kegel exercise and prone position on after pain among postpartum mothers. Journal of Pharmacy and Bioallied Sciences 2024; 16(Suppl 3):S2006-8.
  7. Bardar MM, Karimi FZ, Mazloum SR, Salari R. The impact of sesame oil on postpartum after-pain in multiparous women: a randomised, triple-blind, placebo-controlled clinical trial. Journal of Herbal Medicine 2024; 45:100885.
  8. Brito AP, Caldeira CF, Salvetti MD. Prevalence, characteristics, and impact of pain during the postpartum period. Revista da Escola de Enfermagem da USP 2021; 55:e03691.
  9. Hadiningsih EF. The Impact Of Effleurage Massage On Postpartum Women In The Mother's Care Unit At SMC Hospital's Afterpains Pain. Indonesian Journal of Wiyata Health Administration (IJWHA) 2022; 2(1):33-8.
  10. Evcili F, Kaya D. The effect of postpartum afterpain on breastfeeding self-efficacy. Cukurova Medical Journal 2019; 44:296-307.
  11. Lufianti A, Masrinia F, Mika A. The Influence of Postpartum Exercise on Level of Afterpains in Postpartum Women. Jurnal Smart Keperawatan Учредители: STIKes Karya Husada Semarang. 2024; 12(1):61-6.
  12. Abdel Rahman H, Mamdouh SM, Mourad MH, Shokhba NS. Effect of Progressive Muscle Relaxation technique on postpartum afterpains intensity among multiparous women. Alexandria Scientific Nursing Journal 2022; 24(4):48-63.
  13. Motakef HI, Basyouni NR, Gohar IE. Effect of Hoku point massage on postpartum afterpains intensity among multiparous women. International Journal of Health Sciences; 6(S8):2957-79.
  14. Bindu S, Mazumder S, Bandyopadhyay U. Non-steroidal anti-inflammatory drugs (NSAIDs) and organ damage: A current perspective. Biochemical pharmacology. 2020 Oct 1;180:114147.
  15. Sohail R, Mathew M, Patel KK, Reddy SA, Haider Z, Naria M, et al. Effects of non-steroidal anti-inflammatory drugs (NSAIDs) and gastroprotective NSAIDs on the gastrointestinal tract: a narrative review. Cureus 2023; 15(4).
  16. Kwon NY, Lee HY, Hwang SI, Sung SH, Cho SJ, Yoon YJ, et al. Herbal medicine for postpartum pain: A systematic review of puerperal wind syndrome (Sanhupung). InHealthcare 2023; 11(20):2743.
  17. Dastjerdi MN, Darooneh T, Nasiri M, Moatar F, Esmaeili S, Ozgoli G. Investigating the effect of Melissa officinalis on after-pains: A randomized single-blind clinical trial. Journal of Caring Sciences 2019; 8(3):129.
  18. Pan L, Zhou T, Chen C, Xu H, Wang W. Phytochemistry, pharmacology, and traditional medicine applications of juniperus sabina L.: A comprehensive overview. Molecules 2024; 29(24):5876.
  19. Salih AM, Al-Qurainy F, Nadeem M, Tarroum M, Khan S, Shaikhaldein HO, et al. Optimization method for phenolic compounds extraction from medicinal plant (Juniperus procera) and phytochemicals screening. Molecules 2021; 26(24):7454.
  20. Jojić AA, Liga S, Uţu D, Ruse G, Suciu L, Motoc A, et al. Beyond essential oils: diterpenes, lignans, and biflavonoids from Juniperus communis L. as a source of multi-target lead compounds. Plants 2024; 13(22):3233.
  21. Mortadi K, El Amri A, Ouakki M, Hsissou R, Jebli A, Lebkiri A, et al. Electrochemical and theoretical studies on a bioactive Juniperus oxycedrus essential oil as a potential and ecofriendly corrosion inhibitor for mild steel in 1.0 M HCl environment. Inorganic Chemistry Communications 2024; 162:112196.
  22. Smeu A, Marcovici I, Dehelean CA, Dumitrel SI, Borza C, Lighezan R. Flavonoids and flavonoid-based nanopharmaceuticals as promising therapeutic strategies for colorectal cancer—an updated literature review. Pharmaceuticals 2025; 18(2):231.
  23. Ramezani Motlagh M, Golmakani N, Rakhshandeh H, Mazloum SR, Akhlaghi F. Effect of purslane seed capsule in prevention of postpartum after pain in multiparous mothers: a randomized clinical trial. The Iranian Journal of Obstetrics, Gynecology and Infertility 2019; 22(7):47-57.
  24. Leung JL, Twohig H, Muller S, Maxwell L, Mackie SL, Neill LM, et al. Test-retest reliability of pain VAS/NRS, stiffness VAS/NRS, HAQ-DI and mHAQ in polymyalgia rheumatica: An OMERACT study. InSeminars in Arthritis and Rheumatism 2023; 62:152239.
  25. Syinta AN, Komalasari DR. Reliability and Validity of The Visual Analogue Scale in Non-Myogenic Low Back Pain Patients. InAcademic Physiotherapy Conference Proceeding 2024:9-19.
  26. Sousa‐Pinto B, Ramanauskaite A, Neisinger S, Witte‐Händel E, Gimenez‐Arnau AM, Guillet C, et al. Validity, reliability and responsiveness of digital visual analogue scales for chronic spontaneous urticaria monitoring: A CRUSE® mobile health study. Allergy 2025; 80(3):750-61.
  27. Zhao J, Maitituersun A, Li C, Li Q, Xu F, Liu T. Evaluation on Analgesic and Anti‐Inflammatory Activities of Total Flavonoids From Juniperus sabina. Evidence‐Based Complementary and Alternative Medicine 2018; 2018(1):7965306.
  28. Zhao J, Liu T, Xu F, You S, Li C, Gu Z. Anti-arthritic effects of total flavonoids from Juniperus sabina on complete freund's adjuvant induced arthritis in rats. Pharmacognosy magazine 2016; 12(47):178-83.
  29. Banu T, Sultana A, Begum A, Rahman K. Efficacy and safety of abhal (Juniperus communis L). on pain intensity, uterine artery doppler flow, and quality of life in primary dysmenorrhea: A double-blind, randomized controlled trial. Journal of Ethnopharmacology 2025; 342:119388.
  30. Parsa L, Ozgoli GI, Mojab FA, Nasiri MA, Moramezi F, Ghezi M. Comparison of effects of Zataria multiflora capsule and Ibuprofen on postpartum pain. The Iranian Journal of Obstetrics, Gynecology and Infertility 2019; 22(3):32-40.
  31. Dastjerdi MN, Darooneh T, Nasiri M, Moatar F, Esmaeili S, Ozgoli G. Investigating the effect of Melissa officinalis on after-pains: A randomized single-blind clinical trial. Journal of Caring Sciences 2019; 8(3):129-38.
  32. Abedian Z, Rezvani Fard M, Asili J, Esmaeili H, Dadgar S. Comparison of the Effect of Chamomile Matricaria and Mefenamic Acid capsules on postpartum hemorrhage in women with postpartum Pain. The Iranian Journal of Obstetrics, Gynecology and Infertility 2016; 19(14):1-8.
  33. Heydari M. Effect of Hydro-Alcoholic Extract of Capsella Bursa Pastoris on Postpartum Pain and Volume of Bleeding, a Randomized Clinical Trial. Journal of Health and Care 2023; 24(4):331-41.