A qualitative interview study into experiences of management of labor pain among women in midwife-led care in the Netherlands

Undisturbed Physiological Birth: Insights from Women Who Freebirth in the United Kingdom

OBJECTIVE

To understand women's experiences of undisturbed physiological birth by exploring the narratives of women who have freebirthed their babies in the United Kingdom (intentionally giving birth without midwives or doctors present).

DESIGN

Unstructured narrative face-to-face interviews were carried out and data were analysed using the Voice Centred Relational Method (VCRM).

PARTICIPANTS

Sixteen women who had freebirthed their babies.

FINDINGS

Women discussed a range of phenomena including birth positions, the fetus ejection reflex, pain, altered states of consciousness, physiological third stages and postnatal experiences that were physically and emotionally positive.

KEY CONCLUSIONS

There is a paucity of literature on physiological birth and limited opportunity for practitioners to witness it. Further research is required on phenomena related to physiological birth so as to better understand how to promote it within the maternity setting and when intervention is justified.

IMPLICATIONS FOR PRACTICE

Standard maternity settings and practice may not be conducive to or reflective of physiological birth. Better understanding of physiological birth is required so that pregnant women and people can be appropriately supported during labour and birth.

A review and comparison of common maternal positions during the second-stage of labor

The second-stage of labor is the most stressful part of childbirth process and the proper maternal position during this period is paramount for women's safe vaginal birth. Midwives play a pivotal role in managing maternal positions during the second-stage of labor. However, there is limited evidence to support an ideal maternal position during the second-stage of labor. Further, the difference between different maternal positions might not be apparent. This paper aims to review and compare the benefits and risks of common maternal positions during the second-stage of labor, thereby to provide midwives evidence-based practical guidelines.

Experiences of midwives on pharmacological and non-pharmacological labour pain management in Ghana

BACKGROUND

Due to the debilitating effects of severe labour pains, labour pain management continues to be an important subject that requires much attention. Thus, this study sought to gain a detailed insight into the experiences of midwives on pharmacological and non-pharmacological labour pain management strategies in a resource limited clinical context.

METHODS

A descriptive exploratory qualitative design was adopted for this study which allowed in-depth follow-up of the midwives' comments resulting in a full understanding of emerging findings. Face-to-face individual interviews were conducted, transcribed and data were analysed using content analysis procedures. Verbatim quotes were used to support the findings.

RESULTS

Midwives employed different pain control measures including pharmacological and non-pharmacological methods such as psychological care, sacral massage and deep breathing exercises. Doctors prescribed analgesics most of the time while in some cases, the midwives independently administered the drugs. They assisted women who had epidural anaesthesia given by anaesthetists. The midwives did not administer adequate analgesics because of fear of side effects of analgesics. Although the midwives exhibited knowledge on drugs used for labour pain management, they did not regularly administer analgesics and non-pharmacological care provided were inadequate due to increased workload. Some of the midwives showed empathy towards women and supported the women. Most of the midwives perceived labour pain as normal and encouraged women to bear pain.

CONCLUSION

Midwives require regular education on labour pain management and they should pay attention to women in labour individually and administer the care that meets their need.