Trends in Perinatal Care and Implications for Frontline Nurse Leaders

Comfort and Satisfaction Among Women Who Used Different Options for Analgesia During Labor and Birth

OBJECTIVE

To determine if comfort and satisfaction with the birth experience differed among women who used nitrous oxide (N₂O), epidural analgesia, or no analgesia during labor and birth.

DESIGN

Nonexperimental, cross-sectional, between-subjects.

SETTING

Maternity care units in three U.S. Midwest hospitals from June to October 2019.

PARTICIPANTS

A total of 84 women with spontaneous vaginal birth at term gestation (≥37 weeks).

METHODS

Women were grouped according to self-selected pain management method: N₂O and oxygen (50%/50% mixture) only (n = 28), epidural analgesia (may have been in combination with other analgesia options; n = 28), or no analgesia (n = 28). We collected data within 6 hours after childbirth using the Birth Satisfaction Scale-Revised and the researcher-modified Childbirth Comfort Questionnaire. We analyzed data for differences in comfort and satisfaction scores among the three groups of women using analysis of variance.

RESULTS

We found no statistically significant differences related to comfort during labor and birth among women who used N₂O only, epidural analgesia, or no analgesia during labor and birth, F(2, 81) = 1.11, p = .34. We also found no statistically significant differences related to satisfaction with the birth experience among women who used N₂O only, epidural analgesia, or no analgesia during labor and birth, F(2, 81) = .084, p = .92.

CONCLUSION

Our finding of no statistically significant differences in comfort and satisfaction with the birth experience across groups highlights the need to present comprehensive pain management options to women for labor and birth, such as N₂O.

Fostering Collegial Collaboration Between Labor Nurses and Doulas

Nurses and doulas do not always have positive views of each other. When labor nurses face challenges in their ability to provide continuous labor support, one might believe that a doula would be welcomed, yet this is not always true. Conflicts can arise between nurses and doulas, often because of overlapping roles. However, an optimal health care system is one for which there is an integrated system that fosters collegial interprofessional collaboration. This commentary explores the role of doulas and the care they provide and describes strategies to promote collegial relationships between nurses and doulas.