Chung 2003.

Methods	Single‐blind, randomised controlled trial of acupressure, effleurage and a control group. It was not feasible for the participant and therapist to be blind to their group allocation.
Participants	127 women participated in the trial, during their first stage of labour. Participants needed to be between 37 and 42 weeks pregnant, a low‐risk pregnancy, singleton pregnancy and able to speak Chinese. Women who were induced with oxytocin, or received an epidural block or who planned a caesarean section were excluded from the study. The trial was undertaken in Taiwan; no other details were reported.
Interventions	Trained midwives administered the acupressure to women. The intervention lasted 20 minutes, consisting of 5 minutes pressure to points LI4 and BL67. 5 cycles of acupressure were completed in 5 minutes, with each cycle comprising 10 seconds of sustained pressure and 2 seconds of rest without pressure. A protocol was established to control finger pressure, accuracy of points and accuracy of technique. For the effleurage group, the left and right upper arms were massaged for 10 minutes. In the control group, the midwife stayed with the participant for 20 minutes, taking notes or talking with the participant or family members.
Outcomes	A VAS scale was used to measure the intensity of labour pain. This was administered before and after the intervention. Qualitative data were also collected on women's experience of labour pain 1‐2 hours after delivery. The frequency and intensity of uterine contractions were measured from electronic fetal monitors.
Notes	Study duration: unclear. Funding: unclear. Conflict of interest: unclear. Setting: maternity setting. Country: China There was no power analysis. An ITT analysis was not performed.
Risk of bias
Bias	Authors' judgement	Support for judgement
Random sequence generation (selection bias)	Low risk	Coin tossing.
Allocation concealment (selection bias)	Low risk	Sequentially numbered.
Blinding of participants and personnel (performance bias) All outcomes	Unclear risk	Participants and clinician not blinded. Interventions were substantially different and obvious to an observer.
Blinding of outcome assessment (detection bias) All outcomes	Unclear risk	The outcome assessors were blinded to women's group allocation but unclear for analyst.
Incomplete outcome data (attrition bias) All outcomes	Low risk	23 (18%) women withdrew from the study due to a need for a caesarean section, pain medication. The reason for attrition was similar across groups and due to the need for induction or pain relief.
Selective reporting (reporting bias)	Unclear risk	Unclear the study protocol was unavailable and limited outcomes were reported.
Other bias	Low risk	No other sources of bias detected.