Pain relief in labour: a qualitative study to determine how to support women to make decisions about pain relief in labour

Abstract

BackgroundEngagement in decision making is a key priority of modern healthcare. Women are encouraged to make decisions about pain relief in labour in the ante-natal period based upon their expectations of what labour pain will be like. Many women find this planning difficult. The aim of this qualitative study was to explore how women can be better supported in preparing for, and making, decisions during pregnancy and labour regarding pain management.MethodsSemi-structured interviews were conducted with 13 primiparous and 10 multiparous women at 36 weeks of pregnancy and again within six weeks postnatally. Data collection and analysis occurred concurrently to identify key themes.ResultsThree main themes emerged from the data. Firstly, during pregnancy women expressed a degree of uncertainty about the level of pain they would experience in labour and the effect of different methods of pain relief. Secondly, women reflected on how decisions had been made regarding pain management in labour and the degree to which they had felt comfortable making these decisions. Finally, women discussed their perceived levels of control, both desired and experienced, over both their bodies and the decisions they were making.ConclusionThis study suggests that the current approach of antenatal preparation in the NHS, of asking women to make decisions antenatally for pain relief in labour, needs reviewing. It would be more beneficial to concentrate efforts on better informing women and on engaging them in discussions around their values, expectations and preferences and how these affect each specific choice rather than expecting them to make to make firm decisions in advance of such an unpredictable event as labour.

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

“…Similar to other studies, many women preferred to defer decisions about pain medication until labor, as they trusted their maternity care professional to guide them through labor pain with the help of relevant information and available options [42,43]. On the other hand, feelings of loss of control may arise when midwives have difficulty assessing whether pain medication should be provided, as our findings show.…”

“…Moreover, this feeling of uncontrollability might also have a cognitive component and essentially shows the presence of catastrophizing thoughts about labor and labor pain [15,40,19]. Catastrophizing involves focusing on the significance of pain in specific circumstances, and a lack of belief in the ability to work with it [41,42]. Interestingly, women who catastrophized their labor pain in our study were also particularly focused on its physical dimension and had difficulty accepting that their bodies were unable to deal with labor pain the way they expected.…”

Effect of Breathing Exercise on after pains among Postpartum Women

“…Afterpains is one of the postpartum mother's immediate needs. However if the mother use her own efforts to relive it; she can do this without assistance latter on (10). It is a fact that intervention for pain and discomfort during labor and postpartum is a major part of modern obstetric care for laboring women and a challenging issue for nurses designing intervention protocols (11).…”

Satisfaction Level of New Mothers with Prenatal Care and the Healthcare Professionals Who Provide It

“…Ultrasounds are performed, which identify possible fetal abnormalities. Early screening for fetal malformations, in combination with biochemical markers, evaluates the risk of a chromosomal defect (14) in the fetus. In the third trimester, fetal growth is monitored.…”