Nurses and midwives’ experiences of using non-pharmacological interventions for labour pain management: a qualitative study in Ghana

Abstract

Background: Non-pharmacological interventions hold promise in reducing labour pain, with minimal or no harm to the mother, foetus and the progress of labour and are simple and cost-effective. Yet their use has not been adequately explored in clinical settings, especially in sub-Saharan Africa. Methods: This was a descriptive phenomenological study. Fifteen (15) nurses and midwives working in labour wards of two hospitals in Ghana were interviewed. Data analysis was guided by the principles of coding by Bailey and the constant comparative approach to generate themes. Ethics approval was obtained from the 37 Military Teaching Hospital Institutional Review Board in Ghana. Results: Three major themes were identified that described the experiences of nurses and midwives regarding their use of non-pharmacological interventions in managing labour pain. These were familiarity with nonpharmacological interventions, perceived benefits of non-pharmacological interventions, and barriers to the use of non-pharmacological interventions in the management of labour pain. Conclusions: While some non-pharmacological pain management interventions were known and used by the nurses and midwives, they were not familiar with a good number of these interventions. Nurses and midwives perceived these interventions to be beneficial yet a number of barriers prevented easy utilisation.

Use of Non-pharmacological Methods in Managing Labour Pain: Experiences of Nurse- midwives in Two Selected Districts Hospital of Pwani and Dar es Salaam Region, Tanzania

“…In the current ndings, the nurse-midwives understood the usefulness and bene ts of using non-pharmacological methods in managing labour pain and hence their desire to use. As revealed in our study, similarly, increasing woman`s comfortability, self-con dence and being able to cope with pain were the most reported bene ts [12,29,30]. Moreover, the increase in hospital delivery due to positive childbirth experience was found to be the important aspect stated by the majority.…”

“…The nurse-midwives posited that without pain a baby could not come out and that reducing pain may lead to a labour prolongation. In line with other ndings, they believed that pain is necessary for a woman in labour and that its absence may be a sign of a problem in labour progression [7,12,13].…”

“…However, other non-pharmacological approaches such as education for childbirth preparation, warm bath/shower and music which can be effectively used in our context were not reported by any of participants signifying limited awareness or rare use of these methods among our participants. This is not unique to Tanzania, similar ndings have been reported in other studies where many methods of nonpharmacological pain relief are not well known by the majority of health care providers, thus unable to offer non-pharmacological methods to manage labour pain [2,12,21,23]. This shows that the use of non-pharmacological methods by health care providers is still low and the management of labour pain is not evidence-based [12,24].…”

“…NPM reduce labour pain with less or no effect on the mother, foetus and progress of labour [10,11]. Moreover, NPM have the potential to reduce the consumption of analgesics by women during labour which may be associated with an increased risk of the delayed second stage of labour, instrumental delivery and Caesarean section [12]. To date, the number of women accessing maternal health care is increasing [13].…”

Perceptions of Women toward Non-Pharmacological Methods for Pain Relief during Labor

“…Some of the reasons for the usage of non-pharmacological techniques include their non-invasiveness, inexpensive nature, ease of use, safety, comfort enhancement, and bonding. Yet, barriers such as misconceptions about their efficacy, insufficient staff, and resources prevent optimal use by nurses and midwives [35]. The notion that labor pain is natural and must be endured should be changed during health education programs because it is the right of every woman to have suitable pain relief during labor.…”