Use of non-pharmacological methods in managing labour pain: experiences of nurse-midwives in two selected district hospitals in eastern Tanzania

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.

Evidence-based intrapartum care during vaginal births: Direct observations in a tertiary care hospital in Central Sri Lanka

“…Furthermore, a Canadian study also reported the use of medication-free pain management during labour (40.0%), contradicting our study findings [ 48 ]. Effective use of non-pharmacological methods to relieve labour pain is believed to reduce anxiety, stress, and fear among women during labour and increase satisfaction, which otherwise may aggravate labour pain and lead to prolonged labour because of stress hormone release [ 49 ].…”

Nonpharmacological pain relief for labour pain: knowledge, attitude, and barriers among obstetric care providers

“…NPPR can delay the use of pharmacological analgesia, decreasing the dose required and consequently decreasing the expected side effects ( Gallo et al., 2018 ; Bonapace et al, 2018 ). Mwakawanga et al (2022) reported that the limited number of healthcare providers and high workload discourage them from applying NPPR or continuing its utilization, especially for some methods that require the continuous presence of the OCPs. In the same line with the current study, the lack of facilities to apply some NPPR methods and client beliefs regarding it were also reported barriers ( Bonapace et al, 2018 ).…”

Effectiveness of Sacral Massage on Labor Pain and Satisfaction Among Antenatal Mothers in Active Phase of Labor

“…Mwakawanga (2022) find effectiveness of Back Massage in First stage labour pain among pregnant women showed that no association with the demographic variables such as age, family income, education, occupation, religion, type of family. 22 Chaillet (2014) uses nonpharmacologic approaches based on continuous support with sacral massage, were the most effective for reducing obstetric interventions during labor. 23…”