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Zhang EW, Jones LE, Whitburn LY. Tools for assessing labour pain: a comprehensive review of research literature. Pain 2023; 164:2642-2652. [PMID: 37556378 DOI: 10.1097/j.pain.0000000000003004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/31/2023] [Indexed: 08/11/2023]
Abstract
ABSTRACT The experience of pain associated with labour is complex and challenging to assess. A range of pain measurement tools are reported in the literature. This review aimed to identify current tools used in research to assess labour pain across the past decade and to evaluate their implementation and adequacy when used in the context of labour pain. A literature search was conducted in databases MEDLINE and Cumulative Index of Nursing and Allied Health Literature, using search terms relating to labour, pain, and measurement. A total of 363 articles were selected for inclusion. Most studies (89.9%) assessed pain as a unidimensional experience, with the most common tool being the Visual Analogue Scale, followed by the Numerical Rating Scale. Where studies assessed pain as a multidimensional experience, the most common measurement tool was the McGill Pain Questionnaire. Only 4 studies that used multidimensional tools selected a tool that was capable of capturing positive affective states. Numerous variations in the implementation of scales were noted. This included 35 variations found in the wording of the upper and lower anchors of the Visual Analogue Scale, some assessment tools not allowing an option for "no pain," and instances where only sections of validated tools were used. It is clear that development of a standardised pain assessment strategy, which evaluates the multidimensions of labour pain efficiently and effectively and allows for both positive and negative experiences of pain to be reported, is needed.
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Affiliation(s)
- Erina W Zhang
- Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, Australia
| | - Lester E Jones
- Health Social Sciences Cluster, Singapore Institute of Technology, Singapore
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
| | - Laura Y Whitburn
- Department of Microbiology, Anatomy, Physiology and Pharmacology, School of Agriculture, Biomedicine and Environment, La Trobe University, Bundoora, Australia
- Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Bundoora, Australia
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Meijer M, Brandão T, Cañadas S, Falcon K. Components of obstetric violence in health facilities in Quito, Ecuador: A descriptive study on information, accompaniment, and position during childbirth. Int J Gynaecol Obstet 2019; 148:355-360. [PMID: 31785159 DOI: 10.1002/ijgo.13075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 09/16/2019] [Accepted: 11/29/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To describe three factors of obstetric violence in health centers that attend births in Quito, Ecuador: information; accompaniment; and free position. METHOD A cross-sectional descriptive study of 388 women was conducted, focusing on the analysis of three factors of obstetric violence. This study forms part of a larger study that explores the experiences of women in childbirth in Quito between July 1, 2016 and July 1, 2017. RESULTS Of all procedures, the performance of episiotomies and the application of fundal pressure during the second stage of labor (Kristeller) stand out, as more than 35% of the women were not informed about them. In total, 121 (46.9%) women who gave birth vaginally were not given the opportunity to be accompanied by someone of their choice, neither in labor nor during delivery. While in the cases of cesarean deliveries, this increased to 116 (92.1%) women. A total of 119 (37.2%) women did not have the opportunity to choose their birthing position (or they did not know they could choose). During delivery, 138 (53.5%) women indicated the same. CONCLUSION Obstetric violence is seen in all three components: information; accompaniment; and free position.
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Affiliation(s)
- Magriet Meijer
- Area of Gynecological-Obstetric Violence, El Parto es Nuestro (EPEN), Barcelona, Spain
| | - Thais Brandão
- School of Psychology, University of the Americas, Quito, Ecuador
| | - Sofía Cañadas
- Faculty of Health Sciences, School of Medicine, University of the Americas, Quito, Ecuador
| | - Kirsten Falcon
- Faculty of Health Sciences, Nursing School, University of the Americas, Quito, Ecuador
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Brandão T, Cañadas S, Galvis A, de Los Ríos MM, Meijer M, Falcon K. Childbirth experiences related to obstetric violence in public health units in Quito, Ecuador. Int J Gynaecol Obstet 2018; 143:84-88. [PMID: 30025157 DOI: 10.1002/ijgo.12625] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Revised: 06/29/2018] [Accepted: 07/18/2018] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To explore women's experiences of obstetric violence related to childbirth in Ecuador. METHODS The present cross-sectional descriptive study combined qualitative and quantitative elements of women's childbirth experience in Quito, Ecuador, between July 1, 2016, and July 1, 2017. Women who delivered in public health units providing different levels of care completed a survey of 32 questions, divided into six dimensions of obstetric violence. RESULTS Overall, 388 women completed the survey, of whom 259 (66.8%) delivered vaginally and 129 (33.2%) delivered by cesarean. Among 120 women who delivered for the first time, 62 (51.7%) had an episiotomy. At the second stage of labor, uterine fundus pressure (Kristeller maneuver) was performed for 49 (19.4%) of 252 women. Overall, 196 (50.5%) women reported that they were not allowed to engage in early attachment, and 135 (34.8%) reported that they did not receive support for the initiation of breastfeeding. CONCLUSION Various forms of obstetric violence are occurring in the public health services of Quito, despite World Health Organization recognition of the need for perinatal care at the highest level. Programs designed to prevent and diminish obstetric violence are urgently required.
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Affiliation(s)
- Thais Brandão
- School of Psychology, University of the Americas, Quito, Ecuador
| | - Sofía Cañadas
- Faculty of Health Sciences, School of Medicine, University of the Americas, Quito, Ecuador
| | - Alejandro Galvis
- Faculty of General Training, School of Physical Sciences and Mathematics, University of the Americas, Quito, Ecuador
| | | | | | - Kirsten Falcon
- Faculty of Health Sciences, Nursing school, University of the Americas, Quito, Ecuador
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Zileni BD, Glover P, Jones M, Teoh KK, Zileni CW, Muller A. Malawi women's knowledge and use of labour and birthing positions: A cross-sectional descriptive survey. Women Birth 2016; 30:e1-e8. [PMID: 27329996 DOI: 10.1016/j.wombi.2016.06.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 05/18/2016] [Accepted: 06/06/2016] [Indexed: 11/17/2022]
Abstract
PROBLEM Despite research evidence supporting use of upright birthing positions, most women give birth in supine position. Little is known about women's knowledge and use of labour and birthing positions. Specifically, there is a lack of evidence on Malawi women's knowledge and use of birthing positions, and this limits the possibility of improvement in childbirth practices. AIM To assess women's knowledge and use of different positions during labour and birthing. METHODS The study used a cross-sectional descriptive survey in a Malawi maternity unit where 373 low-risk postnatal women participated in face-to-face exit interviews, using a structured questionnaire. A descriptive analysis of the categorical variables was conducted to examine frequencies and percentages. FINDINGS The majority of women knew about walking (66.4%) and lateral (60.6%) as labour positions, whereas 99.2% knew about the supine as a birthing position. Half of the women (50%) walked during labour and the majority (91.4%) gave birth whilst in supine position. Midwives were the main source of information on positions used during childbirth. DISCUSSION Education about different birthing positions is needed for women who deliver at the maternity unit so that they can make informed decisions on their own options for childbirth. However, midwives must have the competence to encourage and assist women give birth in different positions, so professional development of midwives in childbirth positions is a priority. CONCLUSION Childbirth education should include information on the various labour and birthing positions. Midwives should be equipped with appropriate skills to help women use different positions during childbirth.
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Affiliation(s)
- Barbara Debra Zileni
- Kamuzu College of Nursing, Maternal and Child Health Department, Chipatala Avenue, off Mzimba Street, Opposite Kamuzu Central Hospital, Lilongwe, Malawi.
| | - Pauline Glover
- School of Nursing & Midwifery, Faculty of Health Science, Flinders University, Sturt Road, Bedford Park 5042, South Australia, Australia
| | - Meril Jones
- School of Nursing & Midwifery, Faculty of Health Science, Flinders University, Sturt Road, Bedford Park 5042, South Australia, Australia
| | - Kung-Keat Teoh
- Student Learning Centre, Affiliate member, School of Computer Science, Engineering and Mathematics, Flinders University, Sturt Road, Bedford Park 5042, South Australia, Australia
| | | | - Amanda Muller
- School of Nursing & Midwifery, Faculty of Health Science, Flinders University, Sturt Road, Bedford Park 5042, South Australia, Australia
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Sarmento Filho ED, Macendo Amaral HR, Matos Silva D, Andrade Barbosa TL, Xavier Gomes LM. Repercussões maternas e fetais da analgesia obstétrica: uma revisão integrativa. AVANCES EN ENFERMERÍA 2016. [DOI: 10.15446/av.enferm.v33n2.52176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Reis TDRD, Zamberlan C, Quadros JSD, Grasel JT, Moro ASDS. [Obstetric Nurses: contributions to the objectives of the Millennium Development Goals]. Rev Gaucha Enferm 2015; 36 Spec No:94-101. [PMID: 27057707 DOI: 10.1590/1983-1447.2015.esp.57393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 11/24/2015] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To characterize and analyze assistance to labor and delivery performed by residents in Obstetric Nursing. METHOD Quantitative and retrospective study of 189 normal births attended by residents in Obstetric Nursing in the period between July 2013 and June 2014 in a maternity hospital located in the countryside of Rio Grande do Sul. Data collection took place by gathering information from medical records and the analysis was performed using descriptive statistics. RESULTS It was found the wide use of non-invasive and non-pharmacological pain relief and freedom of position during labor. It is noteworthy that 55.6% of women have not undergone any obstetric intervention. CONCLUSIONS It was possible to identify that the Nursing Residency Program allows the reduction of obstetrical interventions, reflecting directly in the improvement of maternal health.
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Affiliation(s)
- Thamiza da Rosa Dos Reis
- Departamento de Enfermagem, Universidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brasil
| | - Cláudia Zamberlan
- Centro Universitário Franciscano, Santa Maria, Rio Grande do Sul, Brasil
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Women's choice of positions during labour: return to the past or a modern way to give birth? A cohort study in Italy. BIOMED RESEARCH INTERNATIONAL 2014; 2014:638093. [PMID: 24955365 PMCID: PMC4052104 DOI: 10.1155/2014/638093] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 04/03/2014] [Accepted: 04/29/2014] [Indexed: 11/18/2022]
Abstract
Background. Childbirth medicalization has reduced the parturient's opportunity to labour and deliver in a spontaneous position, constricting her to assume the recumbent one. The aim of the study was to compare recumbent and alternative positions in terms of labour process, type of delivery, neonatal wellbeing, and intrapartum fetal head rotation. Methods. We conducted an observational cohort study on women at pregnancy term. Primiparous women with physiological pregnancies and single cephalic fetuses were eligible for the study. We considered data about maternal-general characteristics, labour process, type of delivery, and neonatal wellbeing at birth. Patients were divided into two groups: Group-A if they spent more than 50% of labour in a recumbent position and Group-B when in alternative ones. Results. 225 women were recruited (69 in Group-A and 156 in Group-B). We found significant differences between the groups in terms of labour length, Numeric Rating Scale score and analgesia request rate, type of delivery, need of episiotomy, and fetal occiput rotation. No differences were found in terms of neonatal outcomes. Conclusion. Alternative maternal positioning may positively influence labour process reducing maternal pain, operative vaginal delivery, caesarean section, and episiotomy rate. Women should be encouraged to move and deliver in the most comfortable position.
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