Somali women's perceptions and experiences of pain and pain relief during childbirth in Norway: A qualitative study

INTRODUCTION

Research shows that Somali women are less likely to receive epidural analgesia for labor pain compared to non-immigrant women in Norway. It is unclear why. This study aimed to explore the perceptions and experiences of Somali women regarding pain relief during childbirth.

METHODS

In January 2023, semi-structured interviews were conducted with 10 Somali women who had lived in Norway for at least ten years and given birth within the past 12 months. Data were analyzed using thematic content analysis as described by Graneheim and Lundman.

RESULTS

Three themes emerged from the data: a cultural understanding of epidural analgesia, religious and cultural coping strategies, and the midwife's role during labor. The participants expressed that there is a prevalent understanding in the Somali community that epidural analgesia in childbirth subsequently causes physical problems. Participants felt the influence of friends and family, expressed the need for culturally adapted information prior to labor, and concluded that, ultimately, what they decided upon was their own choice. They emphasized the belief that women were designed by God for childbirth. Prayer and placing oneself in God's hands were mentioned as pain management strategies. Nevertheless, the Somali women highlighted the importance of having a culturally competent midwife who is present when needed, creates trust, and provides information and access to different methods of pain relief, including epidural analgesia.

CONCLUSIONS

Understanding Somali women's cultural and religious background while listening to individual needs for information and pain relief is essential to ensure a positive birth experience for women from a Somali background.

PADGEM-dependent adhesion of platelets to monocytes and neutrophils is mediated by a lineage-specific carbohydrate, LNF III (CD15)

PADGEM (platelet activation-dependent granule-external membrane protein) is a leukocyte receptor of activated platelets that mediates cellular adhesion of platelets to neutrophils and monocytes. To identify the natural ligand on neutrophils and monocytes that interacts with PADGEM, we have evaluated anti-leukocyte antibodies for their ability to block leukocyte-PADGEM binding. Only anti-CD15 antibodies were able to inhibit the binding of neutrophils, monocytes, HL60 cells, and U937 cells to platelets. Anti-CD15 antibodies inhibited the binding of U937 cells to PADGEM-expressing COS cells and to purified PADGEM incorporated into phospholipid vesicles. The CD15 antigen, lacto-N-fucopentaose III (Gal beta 1----4[Fuc alpha 1----3]NAcGlc beta 1----3Gal-beta 1----4Glc), inhibited the interaction of neutrophils or HL60 cells with platelets, whereas lacto-N-fucopentaose I did not; lacto-N-fucopentaose II demonstrated minimal inhibition. Lacto-N-fucopentaose III, and to a lesser extent lacto-N-fucopentaose II, but not lacto-N-fucopentaose I, inhibited the interaction of HL60 cells with COS cells transfected with PADGEM cDNA. CD15, lacto-N-fucopentaose III or Lex, is a component of the PADGEM ligand on neutrophils and monocytes.