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Abstract

Introduction

During pregnancy, women are subject to various physiological and emotional changes, which should be

monitored within the scope of antenatal care. The healthcare team may employ, where appropriate, non-

pharmacological strategies such as Auriculotherapy, a technique that stimulates specific points on the auricle

for the management of various conditions, based on the principle that the ear constitutes a microsystem in

which the entire body is represented.

Objective

and open-ended questions relating to complaints and sensations following the use of the technique. Data

collection took place between March and October 2021 with 17 low-risk pregnant women in Natal/Rio Grande

do Norte, Brazil, and 8 pregnant women in Coimbra, Portugal, between the months of February and June 2022.

The data were analysed using Bardin’s content analysis. Ethical principles for research were observed and

favourable opinions were obtained from two ethics committees.

Results

The majority of participants were married, with higher education, aged between 28 and 32, primigravida, and

had a low family income. The most frequent discomforts included lower back pain, oedema, cramps, stress and

anxiety. Auriculotherapy demonstrated positive effects, promoting physical relief and emotional well-being,

regardless of sociodemographic differences between Brazil and Portugal, with no relevant cultural influence.

The technique proved to be simple and effective and may be recommended as a first-line therapeutic strategy,

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Pensar Enfermagem / v.30 n.01 / Jan-Dec 2026 / DOI: 10.71861/pensarenf.v30i1.443 / e00443

reinforcing the nurse’s role in reducing gestational discomforts. The reduced number of participants,

attributable to the COVID-19 pandemic, constitutes a limitation of the study.

Keywords

Obstetric Nursing; Pregnant Woman; Patient Comfort; Auriculotherapy.

Introduction

resource for maintaining the stability of the pregnancy, preventing complications and monitoring the health of

the mother and the foetus. To reduce pregnancy-related discomforts, the healthcare team must be equipped to

address any factors that may adversely affect the pregnancy, whether of a clinical, obstetric, socioeconomic, or

emotional nature.

With regard to non-pharmacological strategies for relieving discomforts associated with pregnancy, studies on

the use of Auriculotherapy remain limited. In the context of pregnancy, existing research has shown that the

application of Auriculotherapy in low-risk pregnant women had positive effects in reducing certain physical

Based on the premise that Traditional Chinese Medicine (TCM) comprises several associated therapeutic

approaches — including integrative and complementary health practices — and given the scarcity of studies on

In the case of pregnant women, it is assumed that the discomforts reported result from energy imbalances

inherent to the gestational state. Accordingly, it is assumed that the use of Auriculotherapy during pregnancy

contributes to maintaining balance and, consequently, to alleviating sensations that compromise women’s well-

being throughout pregnancy.

Based on this premise, the following research question was formulated: How do women feel after the application

of the Auriculotherapy technique with regard to common discomforts of pregnancy?

The general objective of the study was: To understand the impact of Auriculotherapy on low-risk pregnant

women with regard to pregnancy-related discomforts.

Methods

under CAAE number 25685319.60000.5537. Additionally, the Ethics Committee of the Health Sciences

the conduct of the study, under number P 637-12/2019.

A convenience sample was used, involving low-risk pregnant women enrolled in the Prenatal Care Programme

of a Family Health Unit (USF) in Natal, Brazil, between March and October 2021, and in the Childbirth and

Parenthood Preparation Programme of the Extension Project “Terna Aventura”, at the Nursing School of

Coimbra in Portugal, between January and June 2022.

In Brazil, the recruitment of participants for the study was carried out in collaboration with the medical and

nursing team responsible for antenatal follow-up, who identified pregnant women meeting the eligibility criteria

for participation in the study. In Portugal, recruitment was conducted in collaboration with the team of the

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The inclusion criteria were as follows: being in the second trimester of pregnancy or at a more advanced stage;

presenting common discomforts associated with pregnancy; being aged 18 years or over; and having full mental

capacity to answer the questions during data collection adequately.

With regard to the exclusion criteria, participants who missed any of the sessions were deemed ineligible, as

were those with a documented history of contact allergy to the adhesives employed in Auriculotherapy, those

who developed auricular inflammation, or those presenting congenital malformations of the auricle, such as

microtia or anotia, characterised by unilateral or bilateral underdevelopment of the auricular structure.

In total, 25 participants who agreed to take part in the study were included, of whom 17 were in Brazil and 8

Prior to the intervention, each participant completed a semi-structured form, which included questions for

sociodemographic characterisation, obstetric profile and identification of gestational discomforts.

The intervention was carried out weekly over four weeks. At each session, the pregnant woman’s perception

of the discomforts previously reported was assessed before the application of Auriculotherapy, and a field diary

was used to record her emotional state.

The Auriculotherapy technique was applied using black mustard seeds, positioned at specific auricular points

corresponding to the discomforts reported, in accordance with auricular point protocols previously developed

by the principal investigator, a specialist in TCM and Obstetric Nursing. These protocols were defined for the

following gestational discomforts: anxiety (and/or stress), low self-esteem (and/or physical fatigue, emotional

instability, mood swings), cramps, headaches, oedema, heartburn.

participant’s own perception. After placement, a circular massage was performed at each point, at least three

times, gently yet firmly, to ensure adequate adhesion. The participant was expected to experience slight

discomfort during the procedure, thereby confirming the correct localisation of the reactive point.

During each session, the participants received guidance on the necessary care: to perform gentle massage on

the seed points at least three times a day; to exercise caution during bathing to prevent detachment of the

adhesives protecting the seeds; to use cotton wool soaked in 70% alcohol to maintain local hygiene; and to

remove the adhesives with the seeds between the fifth and seventh day of use.

In the fifth week, each pregnant woman responded to the guiding question included in the second part of the

semi-structured form: "What was it like for you to have been treated with the Auriculotherapy technique in

relation to the discomforts you reported at the beginning of the investigation?"

To organise and present the study categories, participants were identified from G1 to G25, distinguishing the

pregnant women from Brazil (G1B–G17B) and from Portugal (G18P–G25P).

Results

Regarding the participants’ profile (Table 1), the majority were married, had higher education, were aged between

28 and 32 years, were employed and had a low family income. With respect to the obstetric profile, most were

in their first pregnancy, in the third trimester, and had not planned the current pregnancy; the participants

reported satisfaction with the current pregnancy, and the most frequently reported discomforts were stress,

anxiety and lower back pain.

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Table 1. Profile of the study participants.

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The experience was very good, because it ended up relieving me of quite a few discomforts in the lower back region that I had. The

back pain, in particular, I never felt again. (G20P)

Among the emotional discomforts most frequently reported by the pregnant women, stress and anxiety stood

out. The emotional state of the participants was observed systematically throughout the sessions, making it

possible to identify significant emotional changes, as evidenced in the following testimonies:

[...] perhaps the psychological part of Auriculotherapy also worked and has given me some calm, some lightness in reacting to the

expectation of labour and the postpartum period (G18P)

CATEGORY 02 - Perceptions of pregnant women and their families regarding the effects of

Auriculotherapy

The second category addresses the effects of Auriculotherapy as perceived by the pregnant women and their

family members, and is presented under two subcategories: Changes in the attitude/behaviour of pregnant

participants’ self-perception of symptom improvement became increasingly evident, as demonstrated in the

following testimonies:

The lower back pain decreased gradually; in the first week I had it done on a Monday… by the Friday of the same week I had

already improved. On the Saturday of the same week I worked, and when night-time came I did not feel much pain; it was relieved.

(G12B)

… Anger at everything, at listening to people… at hearing sounds that are not good for me. When one of these things happened,

girl, I would become a different person and say many aggressive things. Not anymore… I am calmer and I am even sleeping much

better. (G16B).

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[…] even my husband. He and my son, they noticed straight away that I would fly off the handle easily, which is just how it is,

especially with the little one because it’s natural, isn’t it, sometimes they do such things that we… I would immediately lose my

temper and now I am much calmer, I end up thinking a little before the way I scold him and everything else. I am quite different,

I am quite different, it’s true. (G25P)

Discussion

participants, and the age distribution reflects the prevailing trend towards delayed motherhood, as indicated by

In the context of pregnancy, the majority of participants from both Brazil and Portugal had already experienced

previous pregnancies, although the current one had not been planned; nevertheless, reported satisfaction with

trimester, a period during which the anatomical and physiological adaptations of pregnancy frequently impose

functional limitations and give rise to specific complaints. According to TCM, such discomforts may be

attributable to energy imbalances arising from impaired fluidity of the Yin (Xue) and Yang (Qi) energies within

the maternal organism. This theoretical framework underscores the importance of acupressure as a modality for

experiences and other discomforts intrinsic to the gestational period. The correlation between pain and

emotional state is well established; the latter can amplify pain perception in the pregnant woman, whose body

is undergoing continuous physiological change. In this regard, the literature indicates that the experience of

Among the physiological modifications of pregnancy, anxiety frequently emerges as an adaptive response to

uncertainty and apprehension. The literature has consistently highlighted the gestational period as one of

This response is, in part, triggered by sensory stimuli and changes in the nervous system, influenced by the

production of placental hormones. Such physiological changes may manifest as episodes of anxiety and

It was evident from the results that the participants perceived Auriculotherapy as having, beyond the benefits

of minimising physical and emotional discomforts, a positive influence on relationships with family members

and other people in their social circle or support network. The family and social support network constitutes

the main pillar of trust for the pregnant woman in sharing emotional experiences. However, the literature warns

that gestational anxiety is sometimes undervalued by this network, being dismissed as a commonplace or

‘transient’ manifestation of pregnancy physiology. Such dismissal may inhibit the woman’s emotional

acceptance and recognition on the part of their support network, which appears to have fostered a more

From this perspective, TCM presents a wide range of therapeutic possibilities, including the relief of symptoms

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In this context, guidelines from the Brazilian Ministry of Health reinforce the relevance of integrative and

complementary practices as an effective strategy for alleviating physical and emotional discomforts in pregnant

women, further emphasising the role of such practices in preventing more severe puerperal disorders and

context of maternal health has been gaining relevance. Auriculotherapy is established as a safe and low-cost

strategy for maternal well-being during pregnancy and for the prevention of disorders in the puerperium, in

and for the humanisation of care throughout the gestational period.

Conclusion

The pregnant women participating in the study reported significant improvements — and, in some cases, the

cessation — of the discomforts inherent to pregnancy, with positive repercussions on the perception of

tranquillity, both on the part of the women themselves and their support network. The results demonstrate that

the Auriculotherapy technique exerted a positive impact on participants’ well-being, most notably through a

heightened sense of serenity.

The investigation, conducted in two distinct contexts — Brazil and Portugal —, enabled the analysis of the

may be recommended as a first-line therapeutic strategy by Maternal Health and Obstetric Nursing teams.

Within this framework, the fundamental role of the nurse in the follow-up of pregnant women is highlighted,

particularly within the scope of birth preparation programmes, as a professional equipped to deliver therapeutic

interventions that contribute to alleviating the prevalent discomforts of the gestational period.

Further studies are needed to deepen understanding of the effects of Auriculotherapy in alleviating discomforts

associated with pregnancy.

Study limitations

It should be noted that data collection took place during the COVID-19 pandemic period, between 2021 and

invalidating the results obtained. Accordingly, the findings should be interpreted within this contextual

framework.

Authorship and Contributions

FCBS: Study conception and design; Data collection; Data analysis and interpretation; Drafting and revising

the manuscript; Approval of the final version and taking responsibility for it.

JBLC: Critical review of the manuscript; Approval of the final version and taking responsibility for it.

TRGL: Data collection; Critical review of the manuscript; Approval of the final version and assumption of

responsibility for it.

RMSM: Study conception and design; Data collection; Supervision of the study; Critical review of the

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Conflicts of interest and Funding

The authors have declared no conflicts of interest.

Acknowledgments

The authors would like to thank: all the pregnant women who took part in this study and their partners; the

team from the Terna Aventura outreach project – Preparation for Childbirth and Parenting; Joana Figueiredo

Cunha e Silva, a nursing undergraduate student who assisted with data collection and transcription in Portugal;

the Coimbra School of Nursing and the UFRN School of Health, which made this study possible.

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