Women's perceptions of the pain assessment and non-pharmacological pain relief methods used during labor: A cross-sectional survey

Arja Rantala, Mervi Hakala, Tarja Pölkki, Arja Rantala, Mervi Hakala, Tarja Pölkki

Abstract

Introduction: The use of non-pharmacological pain relief methods and pain assessment scales during labor has received limited research attention. This study aimed to describe women's perceptions of the pain assessment and non-pharmacological pain relief methods used during labor.

Methods: A descriptive, cross-sectional survey was conducted. A convenience sample of women (n=204) from one Finnish maternity ward participated in the study. Women who had given birth were asked to respond to a validated questionnaire between November 2018 and February 2019. The statistical significance of observed differences was analyzed using the chi-squared test.

Results: Less than half (46%) of the women who gave birth at the hospital were asked to assess the intensity of their pain on a pain assessment scale. The most commonly used non-pharmacological pain relief methods were encouragement (92%), the presence of a midwife (82%), and proper breathing technique that was taught by a midwife (81%). Aqua blisters (3%), reflexology (e.g. zone magnets, 5%), and music (9%) were the least commonly used non-pharmacological methods during labor. The participants' experiences of fear and pain were significantly associated with the implementation of pain assessment.

Conclusions: Women's pain was rarely evaluated by using a certain pain assessment scale. In addition, non-pharmacological pain relief methods were inadequately used during labor. More specifically, methods that required midwives' own personal contributions were rarely offered to the women.

Keywords: labor; midwife; non-pharmacological methods; pain; quantitative research.

Conflict of interest statement

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.

© 2022 Rantala A. et al.

Figures

Figure 1
Figure 1
Intensity of fear and pain, as evaluated by the participating women (N=204). Intensity of fear and pain was measured by a numerical rating scale (NRS): no/mild (0–3), moderate (3.5–6.5), severe (7–10)
Figure 2
Figure 2
Women’s (N=204) satisfaction with the implementation of pain assessment, as measured by a numerical rating scale (NRS): Not at all satisfied/very little satisfied (0–5), satisfied (6–7), very satisfied (8–9), and extremely satisfied (10)
Figure 3
Figure 3
Use of non-pharmacological pain relief methods during labor, as evaluated by the participating women (N=204)
Figure 4
Figure 4
Women’s satisfaction with the use of pain relief methods (pharmacological and non-pharmacological), as measured by a numerical rating scale (NRS): Not at all satisfied/very little satisfied (0–5), satisfied (6–7), very satisfied (8–9), and extremely satisfied (10)

References

    1. Jones L, Othman M, Dowswell T, et al. Pain management for women in labour: an overview of systematic reviews. Cochrane Database Syst Rev. 2012;(3):CD009234. doi: 10.1002/14651858.CD009234.pub2.
    1. Deng Y, Li H, Dai Y, et al. Are there differences in pain intensity between two consecutive vaginal childbirths? A retrospective cohort study. Int J Nurs Stud. 2020;105:103549. doi: 10.1016/j.ijnurstu.2020.103549.
    1. Lowe NK. The nature of labor pain. Am J Obstet Gynecol. 2002;186(5) suppl:S16–S24. doi: 10.1067/mob.2002.121427.
    1. Manual techniques for pain management . WHO recommendations: intrapartum care for a positive childbirth experience. World Health Organization; 2018. pp. 111–114. Accessed June 10, 2021. .
    1. Borges C, José C, Sancho P, Barros M, Sim-Sim M. Labor Pain: Perception of the Parturient and Midwife Evaluation. American Journal of Nursing Science. 2017;6(2):80–86. doi: 10.11648/j.ajns.20170602.12.
    1. Whitburn LY, Jones LE, Davey MA, McDonald S. The nature of labour pain: An updated review of the literature. Women Birth. 2019;32(1):28–38. doi: 10.1016/j.wombi.2018.03.004.
    1. Veringa-Skiba IK, de Bruin EI, Mooren B, van Steensel FJA, Bögels SM. Can a simple assessment of fear of childbirth in pregnant women predict requests and use of non-urgent obstetric interventions during labour? Midwifery. 2021;97:102969. doi: 10.1016/j.midw.2021.102969.
    1. Bergh IHE, Johansson A, Bratt A, Ekström A, Mårtensson LB. Assessment and documentation of women's labour pain: A cross-sectional study in Swedish delivery wards. Women Birth. 2015;28(2):e14–e18. doi: 10.1016/j.wombi.2015.01.010.
    1. Jones LE, Whitburn LY, Davey MA, Small R. Assessment of pain associated with childbirth: Women's perspectives, preferences and solutions. Midwifery. 2015;31(7):708–712. doi: 10.1016/j.midw.2015.03.012.
    1. Favilli A, Laganà AS, Indraccolo U, et al. What women want? Results from a prospective multicenter study on women's preference about pain management during labour. Eur J Obstet Gynecol Reprod Biol. 2018;228:197–202. doi: 10.1016/j.ejogrb.2018.06.038.
    1. Thomson G, Feeley C, Moran VH, Downe S, Oladapo OT. Women's experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review. Reprod Health. 2019;16(1):71. doi: 10.1186/s12978-019-0735-4.
    1. Lally JE, Murtagh MJ, Macphail S, Thomson R. More in hope than expectation: a systematic review of women's expectations and experience of pain relief in labour. BMC Med. 2008;6:7. doi: 10.1186/1741-7015-6-7.
    1. Mousa O, Abdelhafez AA, Abdelraheim AR, Yousef AM, Ghaney AA, El Gelany S. Perceptions and Practice of Labor Pain-Relief Methods among Health Professionals Conducting Delivery in Minia Maternity Units in Egypt. Obstet Gynecol Int. 2018;2018:3060953. doi: 10.1155/2018/3060953.
    1. Almushait M, Ghani RM. Perception toward Non-Pharmacological Strategies in Relieving Labor Pain: An Analytical Descriptive Study. Journal of Natural Sciences Research. 2014;4(2):5–12. doi: 10.13140/RG.2.2.10859.64805.
    1. Dehcheshmeh FS, Rafiei H. Complementary and alternative therapies to relieve labor pain: A comparative study between music therapy and Hoku point ice massage. Complement Ther Clin Pract. 2015;21(4):229–232. doi: 10.1016/j.ctcp.2015.09.002.
    1. Hosseni SF, Pilevarzadeh M, Vazirinasab H. Non-Pharmacological Strategies on Pain Relief During Labor. Biosci Biotechnol Res Asia. 2016;13(2) doi: 10.13005/bbra/2087.
    1. Cyna AM, McAuliffe GL, Andrew MI. Hypnosis for pain relief in labour and childbirth: a systematic review. Br J Anaesth. 2004;93(4):505–511. doi: 10.1093/bja/aeh225.
    1. Almassinokiani F, Ahani N, Akbari P, Rahimzadeh P, Akbari H, Sharifzadeh F. Comparative Analgesic Effects of Intradermal and Subdermal Injection of Sterile Water on Active Labor Pain. Anesth Pain Med. 2020;10(2):e99867. doi: 10.5812/aapm.99867.
    1. Taheri M, Takian A, Taghizadeh Z, Jafari N, Sarafraz N. Creating a positive perception of childbirth experience: systematic review and meta-analysis of prenatal and intrapartum interventions. Reprod Health. 2018;15:73. doi: 10.1186/s12978-018-0511-x.
    1. Smith CA, Collins CT, Levett KM, et al. Acupuncture or acupressure for pain management during labour. Cochrane Database Syst Rev. 2020;(2):CD009232. doi: 10.1002/14651858.CD009232.pub2.
    1. Czech I, Fuchs P, Fuchs A, et al. Pharmacological and Non-Pharmacological Methods of Labour Pain Relief—Establishment of Effectiveness and Comparison. Int J Environ Res Public Health. 2018;15(12):2792. doi: 10.3390/ijerph15122792.
    1. Perinatal statistics - parturients, delivers and newborns 2020. Finnish Institute for Health and Welfare; Updated December 20, 2021. Accessed March 5, 2021. .
    1. Robertson E, Johansson SE. Use of complementary, non-pharmacological pain reduction methods during childbirth among foreign-born and Swedish-born women. Midwifery. 2010;26(4):442–449. doi: 10.1016/j.midw.2008.10.005.
    1. Polit DF, Beck CT. Nursing research: Generating and assessing evidence for nursing practice. 10th ed. Wolters Kluwer; 2017.
    1. Report in Finnish. Suomalaisen Lääkäriseuran Duodecimin, Suomen Anestesiologiyhdistyksen ja Suomen Yleislääketieteen yhdistyksen asettama työryhmä; 2015. Dec 4, Kipu: Käypä hoito -suositus. 2015. Updated August 22, 2017. Accessed June 10, 2021. .
    1. Simkin P, Bolding A. Update on Nonpharmacologic Approaches to Relieve Labor Pain and Prevent Suffering. J Midwifery Womens Health. 2004;49(6):489–504. doi: 10.1016/j.jmwh.2004.07.007.
    1. Kimber L, McNabb M, Mc Court C, Haines A, Brocklehurst P. Massage or music for pain relief in labour: A pilot randomised placebo controlled trial. Eur J Pain. 2008;12(8):961–969. doi: 10.1016/j.ejpain.2008.01.004.
    1. Arendt KW, Tessmer-Tuck JA. Nonpharmacologic Labor Analgesia. Clin Perinatol. 2013;40(3):351–371. doi: 10.1016/j.clp.2013.05.007.
    1. Medical Research Act, No 488/1999. Ministry of Social Affairs and Health, Finland; 1999. Accessed June 10, 2021. .
    1. World Medical Association World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–2194. doi: 10.1001/jama.2013.281053.
    1. Wickboldt N, Savoldelli G, Rehberg-Klug B. Continuous assessment of labour pain using handgrip force. Pain Res Manag. 2015;20(3):159–163. doi: 10.1155/2015/281976.
    1. O'Connell MA, Leahy-Warren P, Khashan AS, Kenny LC, O'Neill SM. Worldwide prevalence of tocophobia in pregnant women: systematic review and meta-analysis. Acta Obstet Gynecol Scand. 2017;96(8):907–920. doi: 10.1111/aogs.13138.
    1. Gokyildiz Surucu S, Ozturk M, Avcibay Vurgec B, Alan S, Akbas M. The effect of music on pain and anxiety of women during labour on first time pregnancy: A study from Turkey. Complement Ther Clin Pract. 2018;30:96–102. doi: 10.1016/j.ctcp.2017.12.015.
    1. Buglione A, Saccone G, Mas M, et al. Effect of music on labor and delivery in nulliparous singleton pregnancies: a randomized clinical trial. Arch Gynecol Obstet. 2020;301(3):693–698. doi: 10.1007/s00404-020-05475-9.
    1. Bagci Bosi AT, Eriksen KG, Sobko T, Wijnhoven TMA, Breda J. Breastfeeding practices and policies in WHO European Region Member States. Public Health Nutr. 2016;19(4):753–764. doi: 10.1017/S1368980015001767.
    1. Lamminpää R, Gissler M, Vehviläinen-Julkunen K. Utilization of Large Data Sets in Maternal Health in Finland: A Case for Global Health Research. J Perinat Neonatal Nurs. 2017;31(3):236–243. doi: 10.1097/JPN.0000000000000276.
    1. Størksen HT, Garthus-Niegel S, Adams SS, Vangen S, Eberhard-Gran M. Fear of childbirth and elective caesarean section: a population-based study. BMC Pregnancy Childbirth. 2015;15:221. doi: 10.1186/s12884-015-0655-4.
    1. Adams SS, Eberhard-Gran M, Eskild A. Fear of childbirth and duration of labour: a study of 2206 women with intended vaginal delivery. BJOG. 2012;119(10):1238–1246. doi: 10.1111/j.1471-0528.2012.03433.x.
    1. Lundgren I, Dahlberg K. Women's experience of pain during childbirth. Midwifery. 1998;14(2):105–110. doi: 10.1016/s0266-6138(98)90007-9.

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다