Red ginger – date beverage improves labor progress in primigravidas
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Abstract
Background: Maternal fatigue during active labor is associated with ineffective uterine contractions, prolonged labor, and increased obstetric interventions. Although date fruit and red ginger have each demonstrated potential benefits for maternal endurance and labor outcomes, no previous clinical study has evaluated their standardized combination as a functional nutritional beverage during active labor. This evidence gap limits the development of affordable complementary nutritional strategies for intrapartum care. Objective: To evaluate the effectiveness of JAKUMA, a standardized beverage containing red ginger (Zingiber officinale var. rubrum) and dates (Phoenix dactylifera L.), in reducing maternal fatigue and improving first-stage labor progress among primigravida women. Methods: A quasi-experimental, non-randomized, posttest-only control group study was conducted among 60 primigravida women during active labor. Thirty participants received JAKUMA (3 g standardized red ginger powder, 50 g seedless dates, and 250 mL warm water) in addition to standard intrapartum care, while 30 received standard care alone. Maternal fatigue was assessed using the Numerical Fatigue Scale, whereas labor progress was evaluated by active labor duration and cervical dilatation rate. Results: Compared with standard care, JAKUMA significantly reduced maternal fatigue (4.42 ± 1.47 vs. 5.58 ± 1.61; Cohen's d = 0.75; p = 0.005), shortened active labor duration (258.4 ± 41.7 vs. 289.3 ± 46.1 minutes; Cohen's d = 0.70; p = 0.008), and increased cervical dilatation rate (1.42 ± 0.23 vs. 1.25 ± 0.29 cm/hour; Cohen's d = 0.65; p = 0.013), indicating moderate clinically meaningful effects. Conclusion: This study is the first to demonstrate the effectiveness of a standardized red ginger–date beverage administered during active labor. The findings provide preliminary evidence supporting JAKUMA as an affordable, culturally acceptable complementary nutritional intervention to improve maternal endurance and physiological labor progression, while contributing to the evidence base for complementary intrapartum care and informing future clinical research.
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Ahmed, I. E., Mirghani, H. O., Mesaik, M. A., Ibrahim, Y. M., & Amin, T. Q. (2018). Effects of Date Fruit Consumption on Labour and Vaginal Delivery in Tabuk, KSA. Journal of Taibah University Medical Sciences, 13(6), 557–563. https://doi.org/10.1016/j.jtumed.2018.11.003
Bonet, M., Ciabati, L., De Oliveira, L. L., Souza, R., Browne, J. L., Rijken, M., … Oladapo, O. T. (2024). Constructing Evidence-Based Clinical Intrapartum Care Algorithms for Decision-Support Tools. BJOG?: An International Journal of Obstetrics and Gynaecology, 131(Suppl 2), 6–16. https://doi.org/10.1111/1471-0528.16958
Chaisitsanguan, K., Kongwattananon, P., & Hawthrone, D. (2023). Managing Maternal Fatigue During Childbirth: A Systematic Review. Current Women’s Health Reviews, 19(4), 115–132. https://doi.org/10.2174/1573404819666220804163125
Charan, J., & Biswas, T. (2013). How to Calculate Sample Size for Different Study Designs in Medical Research? Indian Journal of Psychological Medicine, 35(2), 121–126. https://doi.org/10.4103/0253-7176.116232
Crichton, M., Davidson, A. R., Innerarity, C., Marx, W., Lohning, A., Isenring, E., & Marshall, S. (2022). Orally Consumed Ginger and Human Health: An Umbrella Review. The American Journal of Clinical Nutrition, 115(6), 1511–1527. https://doi.org/10.1093/ajcn/nqac035
Cunningham, F. G., Leveno, K. J., Dashe, J. S., Hoffman, B. L., Spong, C. Y., & Casey, B. M. (2022). Williams Obstetrics (26th ed.). New York: McGraw Hill LLC.
Fraser, D. M., & Cooper, M. A. (2021). Myles Textbook for Midwives (17th ed.). London: Elsevier.
Lavender, T., Cuthbert, A., & Smyth, R. M. (2018). Effect of Partograph Use on Outcomes for Women in Spontaneous Labour at Term and Their Babies. The Cochrane Database of Systematic Reviews, 8(8), CD005461. https://doi.org/10.1002/14651858.CD005461.pub5
Maaløe, N., van Roosmalen, J., Dmello, B., Kwast, B., van den Akker, T., Housseine, N., … Kidanto, H. (2022). WHO Next-Generation Partograph: Revolutionary Steps Towards Individualised Labour Care? BJOG?: An International Journal of Obstetrics and Gynaecology, 129(5), 682–684. https://doi.org/10.1111/1471-0528.16914
Malin, G. L., Bugg, G. J., Thornton, J., Taylor, M. A., Grauwen, N., Devlieger, R., … Jones, N. W. (2016). Does Oral Carbohydrate Supplementation Improve Labour Outcome? A Systematic Review And Individual Patient Data Meta-Analysis. BJOG?: An International Journal of Obstetrics and Gynaecology, 123(4), 510–517. https://doi.org/10.1111/1471-0528.13728
Miller, S., Abalos, E., Chamillard, M., Ciapponi, A., Colaci, D., Comandé, D., ... Langer, A. (2016). Beyond too little, too late and too much, too soon: A pathway towards evidence-based, respectful maternity care worldwide. The Lancet, 388(10056), 2176–2192. https://doi.org/10.1016/S0140-6736(16)31472-6
Morvaridzadeh, M., Fazelian, S., Agah, S., Khazdouz, M., Rahimlou, M., Agh, F., … Heshmati, J. (2020). Effect of Ginger (Zingiber Officinale) on Inflammatory Markers: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Cytokine, 135, 155224. https://doi.org/10.1016/j.cyto.2020.155224
NICE. (2023). Intrapartum Care: NICE Guideline NG235. London: National Institute for Health and Care Excellence.
Oladapo, O. T., Souza, J. P., Fawole, B., Mugerwa, K., Perdona, G., Alves, D., … Maiorano, A. (2018). Progression of The First Stage of Spontaneous Labour: A Prospective Cohort Study in Two Sub-Saharan African Countries. PLoS Medicine, 15(1), e1002492. https://doi.org/10.1371/journal.pmed.1002492
Pasquale, J., Gialdini, C., Chamillard, M., Diaz, V., Rijken, M. J., Browne, J. L., … Group, W. H. O. I. C. A. W. (2024). Clinical Algorithms for The Monitoring and Management of Spontaneous, Uncomplicated Labour and Childbirth. BJOG : An International Journal of Obstetrics & Gynaecology, 131(S2), 17–27. https://doi.org/10.1111/1471-0528.17895
Salajegheh, Z., Nasiri, M., Imanipour, M., Zamanifard, M., Sadeghi, O., Ghasemi Dehcheshmeh, M., & Asadi, M. (2024). Is Oral Consumption of Dates (Phoenix Dactylifera L. Fruit) in The Peripartum Period Effective and Safe Integrative Care to Facilitate Childbirth and Improve Perinatal Outcomes: A Comprehensive Revised Systematic Review and Dose-Response Meta-Analysis. BMC Pregnancy and Childbirth, 24(1), 12. https://doi.org/10.1186/s12884-023-06196-y
Tiani, K. A., Arenaz, C. M., Spill, M. K., Foster, M. J., Davis, J. S., Bailey, R. L., … MacFarlane, A. J. (2024). The Use of Ginger Bioactive Compounds in Pregnancy: An Evidence Scan and Umbrella Review of Existing Meta-Analyses. Advances in Nutrition (Bethesda, Md.), 15(11), 100308. https://doi.org/10.1016/j.advnut.2024.100308
World Health Organization. (2018). WHO Recommendations: Intrapartum Care for A Positive Childbirth Experience. Geneva: World Health Organization.
World Health Organization. (2023). Standards for Improving Quality of Maternal and Newborn Care in Health Facilities. Geneva: World Health Organization.
World Health Organization. (2025). WHO Recommendations on Maternal Health: Guidelines Approved by The WHO Guidelines Review Committee (2nd ed.). Geneva: World Health Organization.
Wright, A., Nassar, A. H., Visser, G., Ramasauskaite, D., & Theron, G. (2021). FIGO Good Clinical Practice Paper: Management of The Second Stage of Labor. International Journal of Gynecology & Obstetrics, 152(2), 172–181. https://doi.org/10.1002/ijgo.13552
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