BACKGROUND: Divergent findings reported in the literature on the impact of acupressure on improvement in mothers' anxiety during labor and consequently on birth outcomes. However, there is no existing meta-analysis on this issue. OBJECTIVES: This systematic review assesses the effect of acupressure and auriculotherapy on anxiety during labor, neonatal outcomes, and maternal-fetal attachment. METHODS: The Cochrane central register of controlled trials, MEDLINE/PubMed, ISI, and Scopus online databases were searched by two researchers up to January 2023. The quality of studies was assessed based on the Jade scale. RESULTS: Nine studies were included in the systematic review and meta-analysis. Acupressure significantly decreased anxiety compared to touching (standardized mean difference -3.29; p < 0.001; I2 8%; p = 0.295; the fixed effect model) and routine care (standardized mean difference -1.08; confidence interval -2.46 to 0.30; p = 0.12; I2 96.19%; p < 0.001). Maternalfetal attachment was higher in both groups who received acupressure and auriculotherapy compared to the control group (p < 0.001). Meanwhile, auriculotherapy did not impact neonatal outcomes, such as newborns' weight and Apgar score. CONCLUSIONS: Acupressure was an effective tool to improve anxiety during labor and it consequently improved fetal oxygenation.

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