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Geltore TE, Alemu G, Taye A, Sileshi E, Bekele M, Foto LL. Determinants and willingness to practice obstetric analgesia among women attending antenatal clinic at Dr. Bogalech Gebre Memorial General Hospital Central Ethiopia: a cross-sectional study. BMC Pregnancy Childbirth 2024; 24:470. [PMID: 38987713 PMCID: PMC11238436 DOI: 10.1186/s12884-024-06674-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 07/03/2024] [Indexed: 07/12/2024] Open
Abstract
BACKGROUND Labor pain is uniquely experienced and described by the woman giving birth, and it is often considered one of the most excruciating experiences for many women. This study aimed to evaluate factors associated with the willingness to receive labor analgesia among women attending the antenatal clinic at Dr. Bogalech Gebre Memorial General Hospital Central Ethiopia in 2022. METHODS An institution-based, cross-sectional study was conducted from January to March 2022. Data were collected using semi-structured questionnaires by a convenience sampling technique. Data was entered in EpiData 4.2 and exported to SPSS version 20 for analysis. Both Bivariable and multivariable logistic regressions were conducted to determine factors associated with pregnant women's willingness to choose labor analgesia. Crude odds ratio (COR) and adjusted odds ratio (AOR) were computed to assess the association between variables. RESULTS A total of 398 pregnant women have participated in the study with a response rate of 94%. Nearly 30%, (29.4%) of the pregnant women had a willingness to practice labor pain management. Being a housewife (AOR: 8.35, 95% CI: 2.07, 33.63). Women who live in urban (AOR: 2.60, 95% CI: 1.29, 5.29). Having had awareness about labor analgesia (AOR: 1.70, 95% CI: 1.00, 2.60) and the short duration of labor time (AOR: 1.84, 95% CI: 1.15, 2.96) were statistically significant with a willingness to practice labor analgesia. CONCLUSION We conclude that the willingness of pregnant mothers' toward obstetric analgesia practice was low in the study area. Being a housewife, urban residence, awareness about labor analgesia, and short duration of labor were statistically significant with the willingness of the mothers to practice labor analgesia. To increase willingness to use labor analgesia, authorities should prioritize delivering health education on pain management choices to address concerns and promote effective methods and practices.
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Affiliation(s)
- Teketel Ermias Geltore
- Department of Midwifery, College of Medicine and Health Science, Wachemo University, Durame Campus, Durame, Ethiopia.
- Teketel Ermias Geltore, PO Box 667, Wachemo, Ethiopia.
| | - Getachew Alemu
- Department of Medical Laboratory Science, College of Medicine and Health Science, Wachemo University, Durame Campus, Durame, Ethiopia
| | - Ayanos Taye
- Nursing Department, School of Nursing and Midwifery, College of Health Sciences and Medicine, Jimma University, Jimma, Ethiopia
| | - Eden Sileshi
- Department of Midwifery, College of Medicine and Health Science, Wachemo University, Durame Campus, Durame, Ethiopia
| | - Merkin Bekele
- Department of Midwifery, College of Medicine and Health Science, Wachemo University, Durame Campus, Durame, Ethiopia
| | - Lakew Lafebo Foto
- School of Public Health, Institute of Health Science, BuleHora University, BuleHora, Ethiopia
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Thorgaard-Rasmussen K, Alvesson HM, Pembe AB, Mselle LT, Unkels R, Metta E, Alwy Al-Beity FM. Women's and maternity care providers' perceptions of pain management during childbirth in hospitals in Southern Tanzania. BMC Pregnancy Childbirth 2024; 24:417. [PMID: 38858626 PMCID: PMC11163787 DOI: 10.1186/s12884-024-06606-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/26/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND The majority of women experience pain during childbirth. Offering and supporting women to use different methods for coping with pain is an essential competency for maternity care providers globally. Research suggests a gap between what women desire for pain management and what is available and provided in many low-and middle-income settings. The study aimed to understand how pain management is perceived by those involved: women experiencing childbirth and maternity care providers. METHODS Individual semi-structured interviews with women (n = 23), maternity care providers (n = 17) and focus group discussions (n = 4) with both providers and women were conducted in two hospitals in Southern Tanzania in 2021. Transcribed interviews were analysed using reflexive thematic analysis. Coding and analysis were supported by the software MAXQDA. RESULTS Three main themes were generated from the data. The first, 'pain management is multifaceted', describes how some providers and women perceived pain management as entailing various methods to manage pain. Providers perceived themselves as having a role in utilization of pain management to varying degree. The second theme 'pain management is primarily a woman's task' highlights a perception of pain management as unnecessary, which appeared to link with some providers' perceptions of pain as natural and necessary for successful childbirth. Few women explicitly shared this perception. The third theme 'practice of pain management can be improved' illustrates how women and maternity care providers perceived current practices of pain management as suboptimal. According to providers, this is primarily due to contextual factors such as shortage of staff and poor ward infrastructure. CONCLUSION Women's and maternity care providers' perceptions ranged from perceiving pain management as involving a combination of physiological, psychological and social aspects to perceive it as related with limited to no pain relief and/or support. While some women and providers had similar perceptions about pain management, other women also reported a dissonance between what they experienced and what they would have preferred. Efforts should be made to increase women's access to respectful pain management in Tanzania.
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Affiliation(s)
| | | | - Andrea B Pembe
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Lilian T Mselle
- Department of Clinical Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Regine Unkels
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Emmy Metta
- Department of Behavioural Sciences, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Fadhlun M Alwy Al-Beity
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden.
- Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
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Weerasingha TK, Ratnayake C, Abeyrathne R, Tennakoon SU. Evidence-based intrapartum care during vaginal births: Direct observations in a tertiary care hospital in Central Sri Lanka. Heliyon 2024; 10:e28517. [PMID: 38571647 PMCID: PMC10988013 DOI: 10.1016/j.heliyon.2024.e28517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 03/20/2024] [Accepted: 03/20/2024] [Indexed: 04/05/2024] Open
Abstract
Background Evidence-based practice (EBP) is an effective approach to improve maternal and newborn outcomes at birth. Objective This study aimed to assess the current intrapartum practices of a tertiary care hospital in Central Province, Sri Lanka, during vaginal births. The benchmark for this assessment was the World Health Organisation's (WHO) recommendations on intrapartum care for a positive childbirth experience. Methods An observational study was conducted at the delivery room of Teaching Hospital, Peradeniya with the participation of 196 labouring women who were selected using systematic random sampling. A non-participant observation checklist covering labour room admission procedures, management of the first, second, and third stages of labour, and immediate care of the newborn and postpartum mother was used for the data collection. The care interventions implemented throughout labour and childbirth were observed and recorded. The data analysis was done using SPSS version 22. Results WHO-recommended practices such as providing privacy (33.2%), offering oral fluids (39.3%), and opioids for pain relief (48.5%) were found to be infrequent. Encouraging correct pushing techniques (77.6%), early breastfeeding (83.2%), regular assessment of vaginal bleeding (91.3%), skin-to-skin contact (93.4%), and using prophylactic uterotonics (100.0%) were found to be frequent. However, labour companionship, use of upright positions during labour, women's choice of birth position, and use of manual or relaxation techniques for pain relief were not observed in hospital intrapartum care. Conclusion The findings of the study indicate that additional attention and monitoring are required to align the current intrapartum care practices with the WHO recommendations. Moreover, the adoption of evidence-based intrapartum care should be encouraged by conveying the standard evidence-based intrapartum care guidelines to the grassroots level healthcare workers to avoid intrapartum interventions.
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Affiliation(s)
| | - Chathura Ratnayake
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University of Peradeniya, Sri Lanka
| | - R.M. Abeyrathne
- Department of Sociology, Faculty of Arts, University of Peradeniya, Sri Lanka
| | - Sampath U.B. Tennakoon
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Sri Lanka
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Parkies LE, Murray D, Okafor UB. Pharmacological labour pain interventions: South African midwives' perspective. BMC Nurs 2024; 23:176. [PMID: 38486184 PMCID: PMC10938825 DOI: 10.1186/s12912-024-01844-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Women of childbearing age feel great about giving birth, but the pain could be excruciating depending on their pain tolerances. Midwives requires obstetrical knowledge and skills such as pain management during labour and safety. We explored midwives' perspectives on the utilisation of pharmacological pain alleviation interventions during labour in selected hospitals in Matjhabeng Municipality, Free State province, South Africa. A qualitative study was undertaken, involving a sample of ten midwives, using a semi-structured interview guide. The interviews were audio-recorded and transcribed verbatim. Tesch's open coding data analysis method was applied to analyse the data. The midwives were restricted to use Pethidine and Phenergan prescribed by doctors for labour pain relief, which disrupted labour pain management and obliged them either to wait for a physician or follow telephone instructions. According to the midwives, women taking Pethidine and Phenergan encountered adverse effects and discomfort. Midwives identified high workload, inadequate personnel, lack of skill and knowledge, lack of medication availability, and lack of infrastructure as the primary challenges of administering pharmacological methods to women in labour. The lack of standing orders, which delays the administration of medications pending a physician's prescription, constituted an additional difficulty. In the instance that Pethidine and Phenergan were unavailable or ineffective for some women, the midwives recommended that women be administered alternative pharmacological pain relievers. They also advocated for institutionalization of pharmacological guidelines allowing them to use their discretion when treating labour pain. Midwives can only utilise a few standardised and regulated pharmacological medications for labour pain management. The midwives' ability to administer pharmacological pain relief during labour was hampered by a high workload burden, insufficient staff, lack of skill and understanding, drug unavailability, and inadequate infrastructure. Midwives advocated for supported guidelines that would allow them to treat labour pain at their discretion. Intersectoral stakeholders are required to improve midwife skills and attitudes. Health facilities need to train and supply analgesics to midwives. Midwives ought to be familiar with pharmacological pain relievers.
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Affiliation(s)
- L E Parkies
- Department of Nursing Science, University of Fort Hare, 50 Church Street, 5201, East London, South Africa
| | - D Murray
- Department of Public Health, University of Fort Hare, 5 Oxford Street, 5201, East London, South Africa
| | - U B Okafor
- Faculty of Health Sciences, University of Fort Hare, 5 Oxford Street, 5201, East London, South Africa.
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Elgzar WT, Alshahrani MS, Ibrahim HA. Non-pharmacological labor pain relive methods: utilization and associated factors among midwives and maternity nurses in Najran, Saudi Arabia. Reprod Health 2024; 21:11. [PMID: 38268021 PMCID: PMC10809473 DOI: 10.1186/s12978-023-01737-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND Traditionally, pharmacological pain relief methods have been the most acceptable option for controlling labor pain, accompanied by numerous adverse consequences. Non-pharmacological labor pain relive methods can reduce labor pain while maintaining an effective and satisfying delivery experience and delaying the use of pharmacological methods. This study explores the utilization of non-pharmacological labor pain relive methods and its associated factors among midwives and maternity nurses. METHODS A cross-sectional research was conducted in Maternal and Children Hospital/Najran, Saudi Arabia, from April to May 2023 and incorporated a convenience sample of 164 midwives and maternity nurses. The data was collected using a self-reported questionnaire composed of five sections; basic data, facility-related factors, non-pharmacological labor pain relive utilization and attitude scales, and knowledge quiz. A logistic regression was used to determine the associated factors with non-pharmacological labor pain relive utilization. RESULTS The results revealed that 68.3% of participants utilized non-pharmacological labor pain relive methods. The midwives and maternity nurses helped the parturient to tolerate labor pain by applying the non-pharmacological labor pain relive methods, including; positioning (55.5%), breathing exercises (53.7%), comfortable and relaxing environment (52.4%), therapeutic communication (47%), positive reinforcement (40.9%), relaxation (40.2%), and therapeutic touch (31%). In addition, working unit, providers-patient ratio, working hours, non-pharmacological labor pain relive training, years of experience, and non-pharmacological labor pain relive attitude were significant determinants of non-pharmacological labor pain relive utilization (P < 0.05). CONCLUSIONS High non-pharmacological labor pain relive utilization was significantly associated with nurses' older age and higher education, working in the delivery room, lower nurse-patient ratio, lower working hours, in-services training, increased years of experience, and positive attitude. The study sheds light on the importance of handling the pre-mentioned factors to enhance non-pharmacological labor pain relive utilization.
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Affiliation(s)
- Wafaa T Elgzar
- Department of Maternity and Childhood Nursing, Nursing College Najran University, Najran, Kingdom of Saudi Arabia
| | - Majed S Alshahrani
- Department of Obstetrics and Gynecology, Faculty of Medicine, Najran University, Najran, Saudi Arabia
| | - Heba A Ibrahim
- Department of Maternity and Childhood Nursing, Nursing College Najran University, Najran, Kingdom of Saudi Arabia.
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Socha MW, Flis W, Pietrus M, Wartęga M. Results of Induction of Labor with Prostaglandins E1 and E2 (The RIPE Study): A Real-World Data Analysis of Obstetrical Effectiveness and Clinical Outcomes of Pharmacological Induction of Labor with Vaginal Inserts. Pharmaceuticals (Basel) 2023; 16:982. [PMID: 37513894 PMCID: PMC10384291 DOI: 10.3390/ph16070982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
Despite extensive knowledge of the mechanisms responsible for childbirth, the course of labor induction is often unpredictable. Therefore, labor induction protocols using prostaglandin analogs have been developed and tested to assess their effectiveness in labor induction unequivocally. A total of 402 women were collected into two groups-receiving vaginal Misoprostol or vaginal Dinoprostone for induction of labor (IOL). Then, the patients were compared in groups depending on the agent they received and their gestational age. Most patients delivered within 48 h, and most of these patients had vaginal parturition. Patients who received the Dinoprostone vaginal insert required statistically significantly more oxytocin administration than patients who received the Misoprostol vaginal insert. Patients who received the Misoprostol vaginal insert used anesthesia during labor statistically more often. Patients who received Misoprostol vaginal inserts had a statistically significantly shorter time to delivery than those with Dinoprostone vaginal inserts. The prevalence of hyperstimulation was similar in all groups and remained low. Vaginal Misoprostol-based IOL is characterized by a shortened time to delivery irrespective of the parturition type, and a lower need for oxytocin augmentation, but also by an increased demand for intrapartum analgesia administration. A vaginal Dinoprostone-based IOL protocol might be considered a more harmonious and desirable option in modern perinatal care.
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Affiliation(s)
- Maciej W Socha
- Department of Perinatology, Gynecology and Gynecologic Oncology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Łukasiewicza 1, 85-821 Bydgoszcz, Poland
- Department of Obstetrics and Gynecology, St. Adalbert's Hospital in Gdańsk, Copernicus Healthcare Entity, Jana Pawła II 50, 80-462 Gdańsk, Poland
| | - Wojciech Flis
- Department of Perinatology, Gynecology and Gynecologic Oncology, Faculty of Health Sciences, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Łukasiewicza 1, 85-821 Bydgoszcz, Poland
- Department of Obstetrics and Gynecology, St. Adalbert's Hospital in Gdańsk, Copernicus Healthcare Entity, Jana Pawła II 50, 80-462 Gdańsk, Poland
| | - Miłosz Pietrus
- Department of Gynecology and Oncology, Jagiellonian University Medical College, 31-501 Kraków, Poland
| | - Mateusz Wartęga
- Department of Pathophysiology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, M. Curie- Skłodowskiej 9, 85-094 Bydgoszcz, Poland
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Jin Y, Wu Y, Li J. Midwife empathy and its association with the childbirth experience: a cross-sectional study. BMC Pregnancy Childbirth 2022; 22:960. [PMID: 36550461 PMCID: PMC9774080 DOI: 10.1186/s12884-022-05309-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Although pregnancy and childbirth comprise a life-course that most midwives experience, whether their own experiences of childbirth resonate with other women during childbirth remains to be determined. In this study, we therefore characterized midwives' empathic capabilities and defined their underlying factors. METHOD We conducted a cross-sectional study with data from 464 midwives in Guangdong, China, that were collected through the "Chinese version of the Jefferson Scale of Empathy for Health Professionals (JSE-HP)." This questionnaire contains sections related to midwife demographics and delivery characteristics. We then implemented multivariate logistic regression analysis to identify empathy-related factors. RESULTS Our analysis revealed 303 (65.3%) participants in the high-empathy group while 161 (34.7%) were in the middle-empathy group. Compared with the reference groups, these results indicated that higher empathy was associated with an elevated educational level (OR, 1.83; 95% CI, 1.04-3.25), high monthly salary (OR, 2.30; 95% CI, 1.11-4.80), and no shift work (OR, 2.89; 95% CI, 1.09-7.63). The odds of a high empathy score were higher for midwives who experienced two childbirths (2.27, 1.11-4.66) and for those who had children under the age of 3 years (2.81, 1.34-5.92). CONCLUSION Midwives possess a moderate-to-high level of empathy, and the greater the number of childbirths they experienced and the younger their children, the higher their reported empathy score. This study contributes novel information regarding the empathic behavior of midwives toward women who give birth in China.
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Affiliation(s)
- Yuhua Jin
- Department of Obstetrics and Gynecology, Shenzhen Samii Medical Center, Shenzhen, 518118 Guangdong Province China
| | - Yanpeng Wu
- grid.8547.e0000 0001 0125 2443School of Public Health, Fudan University, Shanghai, 200433 China
| | - Jing Li
- grid.488521.2Department of Obstetrics and Gynecology, Shenzhen Hospital, Southern Medical University, Shenzhen, 518100 Guangdong Province China ,grid.443187.d0000 0001 2292 2442School of Nursing, Philippine Women’s University, 1743 Taft Avenue, 1004 Malate, Manila, Philippines
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Shiferaw A, Temesgen B, Alamirew NM, Wube T, worku Y. Utilization of labor pain management methods and associated factors among obstetric care givers at public health institutions of East Gojjam Zone, Amhara region, Ethiopia, 2020: a facility based cross - sectional study. BMC Pregnancy Childbirth 2022; 22:803. [PMID: 36319950 PMCID: PMC9623903 DOI: 10.1186/s12884-022-05094-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 10/04/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Labor Pain is "unpleasant sensory and emotional experience associated with actual or potential tissue damage, affects parturient and fetuses'. Developed countries regularly use obstetric analgesia but in developing countries, including Ethiopia pain is neglected and most women go through painful labor. The study was conducted in public health institutions of East Gojjam Zone; Amhara region, Ethiopia. The aim of this study was to assess utilization of labor pain management methods and associated factors among obstetric care givers in the study setting. METHOD Facility-based cross sectional study design was carried out in public health institutions of East Gojjam Zone from April 15 to May 15, 2020. Semi Structured questionnaires were used and 305 obstetric care givers were participated. Stratified sampling technique was used. Data was entered by Epi- data version 3.1 and exported to SPSS version 20. Descriptive analysis was done and Bivariate and multivariate logistic regression with 95% CI was used to saw the association of dependent and independent variables at p < 0.05. RESULT Utilization of labor pain management methods in this study was 48.9%. In Multivariate logistic regression; Professional knowledge [AOR = 2.006, 95% CI = ((1.032-3.898)], availability of drug and equipment [AOR = 2.937, 95% CI= (1.311-6.578)] and allow companionship [AOR = 2.587, 95% CI= (1.322-5.063)] were significantly associated with utilization of labor pain management methods. CONCLUSION AND RECOMMENDATION This study showed low utilization of labor pain management methods. Adequate knowledge, allow accompany and availability of drug & equipment were factors associated with use of labor pain relief options .so it is important to build knowledge of obstetric care givers, availing drugs and materials and make safe the environment for accompany ship to improving use of labor pain management.
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Affiliation(s)
- Aster Shiferaw
- grid.449044.90000 0004 0480 6730College of medicine and health science, Department of Midwifery, Debre Markos University, Debre Markos, Ethiopia
| | - Belsity Temesgen
- grid.449044.90000 0004 0480 6730College of medicine and health science, Department of Midwifery, Debre Markos University, Debre Markos, Ethiopia
| | - Nakachew Mekonnen Alamirew
- grid.449044.90000 0004 0480 6730College of medicine and health science, Department of Midwifery, Debre Markos University, Debre Markos, Ethiopia
| | - Tejitu Wube
- grid.449044.90000 0004 0480 6730College of medicine and health science, Department of Midwifery, Debre Markos University, Debre Markos, Ethiopia
| | - Yichalem worku
- grid.449044.90000 0004 0480 6730College of medicine and health science, Department of Midwifery, Debre Markos University, Debre Markos, Ethiopia
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Ingram MA, Brady S, Peacock AS. The barriers to offering non-pharmacological pain management as an initial option for laboring women: A review of the literature. Eur J Midwifery 2022; 6:37. [PMID: 35794877 PMCID: PMC9186088 DOI: 10.18332/ejm/149244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/14/2022] [Accepted: 04/15/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Many women use pharmacological or non-pharmacological pain management (NPPM) during childbirth, however, evidence shows the usage rates of pharmacological pain management are increasing. The shift towards a biomedical approach to birth care opposes the enduring midwifery philosophy of trusting the woman and her body. Identifying midwives’ beliefs and attitudes towards perceived and actual barriers to offering NPPM as an initial option will provide insight into the factors that affect this. METHODS This review of the literature sought to understand midwives’ beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Peer-reviewed journals were searched for primary research that met the inclusion criteria and explored midwives’ beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Included studies were evaluated for quality according to the Critical Appraisal Skills Programme (CASP) checklists. RESULTS Thirteen qualitative studies met the inclusion criteria and four main themes of barriers to midwives offering NPPM emerged: health system-related, health facility-related, health practitioner-related, and health consumer-related barriers. CONCLUSIONS The review of the literature highlighted there are barriers that prevent or delay the initial utilization of non-pharmacological methods of pain management in labor by midwives. These findings can be used as a platform to inform further research into this topic.
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Affiliation(s)
- Matilda A. Ingram
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
- School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia
| | - Susannah Brady
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
- College of Healthcare Sciences, James Cook University, Townsville, Australia
| | - Ann S. Peacock
- School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia
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Mwakawanga DL, Mselle LT, Chikwala VZ, Sirili N. Use of non-pharmacological methods in managing labour pain: experiences of nurse-midwives in two selected district hospitals in eastern Tanzania. BMC Pregnancy Childbirth 2022; 22:376. [PMID: 35490235 PMCID: PMC9055707 DOI: 10.1186/s12884-022-04707-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 04/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background Labour pain usually brings with it many concerns for a parturient and her family. The majority of the women in labour pain may require some sort of pain relief method during this period, be it pharmacological or non-pharmacological. In Tanzania, the use of non-pharmacological methods to relief labour pain remains low among nurse-midwives. We analysed the experiences of nurse-midwives in the use of non-pharmacological methods to manage labour pain, in two selected districts of Pwani and Dar es Salaam regions in eastern Tanzania. This paper describes Non-pharmacological Methods (NPMs) currently used by nurse-midwives, the facilitators, myths and fears related to the use of NPMs. Materials and Methods An exploratory qualitative study using in-depth interviews was conducted with 18 purposively recruited nurse-midwives working in labour wards in two selected district hospitals in Pwani and Dar es Salaam regions in eastern Tanzania. Qualitative conventional content analysis was used to generate categories describing the experience of using non-pharmacological methods in managing labour pain. Results This study revealed that nurse-midwives encouraged women to tolerate labour pain and instructed them to change positions and to do deep breathing exercises as a means to relief labour pain. Nurse-midwives’ inner motives facilitated the use of non-pharmacological strategies for labour pain relief despite the fear of using them and myths that labour pain is necessary for childbirth. Conclusion This study generates information about the use of non-pharmacological strategies to relief labour pain. Although nurse-midwives are motivated to apply various non-pharmacological strategies to relief labour pain, fear and misconceptions about the necessity of labour pain during childbirth prohibit the effective use of these strategies. Therefore, together with capacity building the nurse-midwives in the use of non-pharmacological strategies to relief labour pain, efforts should be made to address the misconceptions that may partly be of socio-cultural origin.
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Affiliation(s)
- Dorkasi L Mwakawanga
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, P.O Box 65001, Dar es Salaam, Tanzania.
| | - Lilian T Mselle
- Department of Clinical Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, P.O Box 65001, Dar es Salaam, Tanzania
| | - Victor Z Chikwala
- Department of Community Health Nursing, School of Nursing, Muhimbili University of Health and Allied Sciences, P.O Box 65001, Dar es Salaam, Tanzania
| | - Nathanael Sirili
- Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, P.O Box 65454, Dar es Salaam, Tanzania
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Wassihun B, Alemayehu Y, Gultie T, Tekabe B, Gebeyehu B. Non-pharmacological labor pain management practice and associated factors among skilled attendants working in public health facilities in Gamo and Gofa zone, Southern Ethiopia: A cross-sectional study. PLoS One 2022; 17:e0266322. [PMID: 35446867 PMCID: PMC9022872 DOI: 10.1371/journal.pone.0266322] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 03/19/2022] [Indexed: 11/18/2022] Open
Abstract
Background Labor pain management is crucial to ensure the quality of obstetric care but it is one of the neglected areas in obstetrics. This study aimed to assess the practice of labor pain management and associated factors among skilled attendants working in public health facilities in Southern, Ethiopia from November 1–January 26, 2019. Methods An Institution-based cross-sectional study design was conducted from November 1–January 26, 2019. A simple random sampling technique was used to select a total of 272 obstetric care providers. Data were collected using pretested, and structured questionnaires. Data were entered to Epi data version 3.1 statistical software and exported to SPSS 22 for analysis. Bivariate and multivariate logistic regression analyses were performed to identify associated factors. P-value <0.05 with 95% confidence level were used to declare statistical significance. Result Overall, 37.5% (95%CI: 32%, 43%) of health care providers had a good practice on non-pharmacological labor pain management. Clinical experience of 5 years and above (AOR = 2.91, 95%CI: 1.60, 5.42), favorable attitude (AOR = 2.82, 95%CI: 1.56, 5.07), midwife profession (AOR = 1.45, 95%CI: 1.98, 4.27), and working in satisfactory delivery rooms (AOR = 3.45, 95%CI: 2.09, 7.43), were significantly associated with a health professional good practice of labor pain management. Conclusion This study showed that the practice of non-pharmacological labor pain management was poor in public health facilities in Gamo and Gofa zone. It was observed that having a favorable attitude, having ≥5 years of work experience, being a midwife by professional, and having a satisfactory delivery room were found to be significant predictors of the practice of non -pharmacological labor pain management. Therefore, all health facilities and concerned bodies need efforts to focus on providing training to midwives on non-pharmacological labor pain management practice.
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Affiliation(s)
- Biresaw Wassihun
- Department of Midwifery, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
- * E-mail:
| | - Yosef Alemayehu
- Department of Midwifery, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Teklemariam Gultie
- Department of Midwifery, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Beemnet Tekabe
- Department of Health Informatics, College of Medicine and Health Science, Arba Minch University, Arba Minch, Ethiopia
| | - Birhaneselasie Gebeyehu
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Science, University of Gondar, Gondar, Ethiopia
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Terfasa EA, Bulto GA, Irenso DY. Obstetric analgesia utilization in labor pain management and associated factors among obstetric care providers in the West Shewa Zone, Central Ethiopia. SAGE Open Med 2022; 10:20503121221088705. [PMID: 35342628 PMCID: PMC8943529 DOI: 10.1177/20503121221088705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 03/03/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives: Labor pain is the worst pain that almost every woman experiences during
childbirth. Labor pain management plays a crucial role in promoting
maternal-wellbeing, contributing enormously to maternal satisfaction with
the childbirth experience and the high quality of services. Although there
have been previous studies, they have primarily been conducted at referral
or general hospitals located in urban settings. Thus, this study aimed to
assess the utilization of labor pain analgesia and associated factors among
obstetric care providers at all levels of health facilities in central
Ethiopia. Methods: A multicenter institution-based cross-sectional study design was employed
from 1 July to 30 September 2020. Simple random sampling using the lottery
method was employed to select 399 obstetric care providers. The data were
entered into Epi-data version 4.2 and analyzed using SPSS version 26.
Bivariate and multivariable logistic regression analysis were used to
identify the associated factors. The adjusted odds ratio with its 95%
confidence interval and p value ⩽ 0.05 were used to identify associated
factors. Results: The overall utilization of obstetric analgesia was 46% (95% confidence
interval: 41.2%–50.8%). Being a Midwife (adjusted odds ratio: 2.10, 95%
confidence interval: 1.27–3.47), having heard of the World Health
Organization pain ladder (adjusted odds ratio: 2.95, 95% confidence
interval: 1.73–5.01), having favorable attitude (adjusted odds ratio: 1.89,
95% confidence interval: 1.17–3.05), the expectation of obstetric care
providers about labor pain (adjusted odds ratio: 3.26, 95% confidence
interval: 1.27–8.36), having training on labor pain management (adjusted
odds ratio: 2.51, 95% confidence interval: 1.03–6.07), and presence of
chance for preference of obstetric analgesia for mothers in the facility
(adjusted odds ratio = 2.30, 95% confidence interval: 1.33–3.98) were
identified as factors significantly associated with the practice of
obstetric analgesia among obstetric care providers. Conclusion: The overall use of labor pain management methods among obstetric care
providers is low. Professional category, provider attitude, labor pain
severity expectations, and having training were found to be factors
associated with the use of obstetric analgesia. Therefore, working on
adapting and disseminating the harmonized guideline and protocols on labor
pain management and provision of training for obstetric care providers on
labor pain management techniques were recommended.
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Affiliation(s)
- Eba Abera Terfasa
- Maternity and Reproductive Health Nursing, Oromia Regional Health Bureau, Addis Ababa, Ethiopia
| | - Gizachew Abdissa Bulto
- Department of Midwifery, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
| | - Dereje Yadesa Irenso
- Department of Obstetrics and Gynecology, College of Medicine and Health Sciences and Referral Hospital, Ambo University, Ambo, Ethiopia
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Terapia floral na evolução do parto e na tríade dor-ansiedade-estresse: estudo quase-experimental. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao02491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Gido R, Yadeta TA, Tura AK. Utilization of Obstetric Analgesia for Labor Pain Management and Associated Factors among Obstetric Care Providers in Public Hospitals of Addis Ababa, Ethiopia: A Cross-Sectional Study. Obstet Gynecol Int 2021; 2021:9973001. [PMID: 34853595 PMCID: PMC8629664 DOI: 10.1155/2021/9973001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 07/28/2021] [Accepted: 10/30/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND In low-income countries, pain-free labor initiative is an emerging concept and still parturient undergoes through painful labor; this is not different in Ethiopia; despite the national direction to use analgesia for labor pain and strong demand from the women, evidence on utilization of obstetric analgesia for labor pain management in Ethiopia is scarce. The objective of this study was to assess level of obstetric analgesia utilization and associated factors among obstetric care providers in public hospitals in Addis Ababa, Ethiopia. METHODS An institution-based cross-sectional study was used. All obstetric care providers working in labor and delivery units in public hospitals in Addis Ababa were included. The data were collected using a self-administered structured questionnaire. After checking for completeness, data were entered into Epi-data 3.1 and analyzed using SPSS 20. Bivariate and multivariable logistic regressions were used to identify factors associated with utilization of obstetric analgesia. RESULT Of 391 obstetric care providers included in the study, 143 (36.6%; 95% CI: 31.5-40.9%) reported providing labor analgesia. Having adequate knowledge (AOR 2.7; 95% CI: 1.37-5.23), ten and more years of work experience (AOR 4.3; 95% CI: 1.81-10.13), and availability of analgesics (AOR 3.3; 95% CI: 1.99-5.53) were significantly associated with providing labor analgesia. CONCLUSION Slightly more than 3 in 10 obstetric care providers reported providing labor analgesics to women. Training of providers and ensuring adequate supply of analgesics is required to make sure that women in labor would not suffer from labor pain.
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Affiliation(s)
- Rediet Gido
- Department of Midwifery, College of Health Science and Medicine, Dilla University, Dilla, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Abera Kenay Tura
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
- Department of Obstetrics and Gynaecology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
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Gu C, Wang X, Li L, Ding Y, Qian X. Midwives’ views and experiences of providing midwifery care in the task shifting context: a meta-ethnography approach. GLOBAL HEALTH JOURNAL 2020. [DOI: 10.1016/j.glohj.2020.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Khumalo N, Rwakaikara E. Patient satisfaction with peri-partum care at Bertha Gxowa district hospital, South Africa. Afr J Prim Health Care Fam Med 2020; 12:e1-e8. [PMID: 32787408 PMCID: PMC7479382 DOI: 10.4102/phcfm.v12i1.2409] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/10/2020] [Accepted: 06/03/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Patient satisfaction is one of the key outcome measures of healthcare services.Aim and Setting: To explore factors that influence women's satisfaction with peri-partum care at Bertha Gxowa district hospital, South African primary care. METHODS A cross-sectional study involving 260 women was conducted. A structured questionnaire collected information from participants on pain relief, health education provided by healthcare providers, privacy, cleanliness of the ward and their participation in decision-making about care received in the peri-partum period. RESULTS Most respondents were co-habiting with their partners (100, 38%) and had completed only secondary school education (119, 46%). The average participant age was 27 years, with an average parity of two children. Most participants were satisfied with the privacy (218, 84%) and the general cleanliness of the wards (233, 90%). However, large proportions of women were dissatisfied with the information given to them by doctors (104, 55%) and nurses (89, 37%), and the rest were unsure. About 189 (73%) participants were dissatisfied with the extent of their participation in decision-making about their own care. The study had a caesarean rate of 53 (20%). Compared to normal vaginal delivery, participants who had caesarean section were significantly more likely to report being satisfied with pain relief during labour (p 0.001). CONCLUSION The study findings showed varying levels of satisfaction with different aspects of peri-partum care and suggested the need for better pain relief during vaginal delivery, information sharing by doctors and patient emancipation for decision-making about their own care.
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Affiliation(s)
- Nonhlanhla Khumalo
- Department of Family Medicine and Primary Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.
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Bishaw KA, Sendo EG, Abebe WS. Knowledge, and use of labour pain relief methods and associated factors among obstetric caregivers at public health centers of East Gojjam zone, Amhara region, Ethiopia: a facility based cross- sectional study. BMC Pregnancy Childbirth 2020; 20:180. [PMID: 32293322 PMCID: PMC7092537 DOI: 10.1186/s12884-020-2844-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 02/26/2020] [Indexed: 04/28/2023] Open
Abstract
Background The study was conducted in public health centers of East Gojjam Zone, Amhara region, Ethiopia. The purpose of this study was to assess knowledge, and use of labour pain relief methods and associated factors among obstetric caregivers in the study setting. Methods A facility-based cross-sectional study design was conducted from March 1–30, 2018. The study was conducted among three hundred and nine sampled obstetric caregivers. Structured questionnaire was used to collect the data. The data were entered into Epi-data version 4.2 Software for cleaning and exported to SPSS version 23.0 for data analysis. Multivariate logistic regression was carried out for variables with a p-value < 0.25 in bivariate logistic regression to determine significant relationships between the dependent and independent variables. Statistical significance was determined at 95% confidence interval (CI) and p-value below 0.05. Result The overall use of labour pain relief methods reported was 34.4%, (30.4% non-pharmacological and 8.4 pharmacological, respectively). More than half of the study participants (54.2%) had adequate knowledge about labour pain relief methods. In multivariate analysis, being a midwifery profession [AOR =2.814, 95% CI = (1.574–5.031)], having positive attitude [AOR = 4.370, 95% CI = (2.523–7.567)], and professionals with a medium level of education [AOR = 3.450, 95% CI = (1.993–5.971)] were factors significantly associated with knowledge of obstetric caregivers about labour pain relief methods. In multivariate analysis, knowledge of obstetric caregivers [AOR = 3.821, 95% CI = (2.091–6.980)], positive attitude of obstetric caregivers [AOR = 2.455, 95% CI = ((1.358–4.436))] and experience of obstetric caregivers [AOR = 2.56, 95% CI = (1.350–4.845) were factors significantly associated with the use of labour pain relief methods. Conclusion In this study, the overall use of labour pain relief methods by obstetric caregivers was low. Systemic opioid (Pethdine) was reportedly one of the most known pharmacological pain relief methods in this study. Providers’ knowledge, attitude and work experience had shown statistical significance with the use of labour pain relief methods. Task-oriented in- service training is required to fortify obstetric caregivers’ knowledge and attitude towards the use of labour pain relief methods.
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Affiliation(s)
- Keralem Anteneh Bishaw
- Department of Midwifery, Debre-Markos University, College of Medicine and Health Sciences, Debre-Markos, Ethiopia.
| | - Endalew Gemechu Sendo
- School of Nursing and Midwifery, Addis-Ababa University, College of Health Science, Addis Ababa, Ethiopia
| | - Workinesh Sinshaw Abebe
- School of Nursing and Midwifery, Addis-Ababa University, College of Health Science, Addis Ababa, Ethiopia
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Health system factors influencing nurses’ ethical-decision making for postoperative pain management in Ghana. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2020. [DOI: 10.1016/j.ijans.2020.100257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Akadri A, Odelola O, Adepoju A. Labor analgesia in South West Nigeria: Methods and self-reported effectiveness. JOURNAL OF WEST AFRICAN COLLEGE OF SURGEONS 2019; 9:15-20. [PMID: 35514790 PMCID: PMC9063537 DOI: 10.4103/jwas.jwas_30_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Accepted: 12/30/2021] [Indexed: 11/04/2022]
Abstract
Context: Labor exposes many women to severe pain. Effective labor pain management is one of the prerequisites for a satisfying labor experience. Aim: The aim of this study was to assess the labor pain management practices and patients’ assessment of adequacy of pain relief in two tertiary hospitals in South West Nigeria. Materials and Methods: This was a cross-sectional study involving 132 pregnant women who had a noninstrumental vaginal delivery at the obstetric units of Babcock University Teaching Hospital and Olabisi Onabanjo University Teaching Hospital, between December 2017 and May 2018. A structured questionnaire was administered to women within 24 h of delivery to record details of labor and delivery, the form of labor analgesia administered and respondents’ perceived effectiveness of the analgesia. Data were analyzed using the IBM-SPSS statistics for Windows version 21.0 (IBM, Armonk, New York). Results: Sixty-six (50%) women rated labor pain to be severe. Thirty-eight women (28.8%) did not receive any pain relief during labor. Nonpharmacological pain management practices such as back massage, breathing exercises, and companionship were administered to 45(34.1%), 79(59.8%), and 45(34.1%) women, respectively. Nine women (6.8%) received intramuscular pentazocine (30 mg) for labor analgesia. There was a statistically significant association between use of back massage and severe labor pain perception (χ2 = 4.080; P = 0.043). Self-reported effectiveness was highest among users of back massage (82.2%) and companionship (77.8%). Conclusions: There is a large unmet need for labor analgesia in South West Nigeria. Nonpharmacological pain management practices were the most frequently used methods, and most patients experienced reduction in severity of pain. There is need for improvements in obstetric analgesia services in our maternity units.
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