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Reproductive Health
Published in: Reproductive Health 1/2017

Open Access 01-12-2017 | Research

Experiences of midwives on pharmacological and non-pharmacological labour pain management in Ghana

Authors: Lydia Aziato, Abigail A. Kyei, Godsway Deku

Published in: Reproductive Health | Issue 1/2017

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Abstract

Background

Due to the debilitating effects of severe labour pains, labour pain management continues to be an important subject that requires much attention. Thus, this study sought to gain a detailed insight into the experiences of midwives on pharmacological and non-pharmacological labour pain management strategies in a resource limited clinical context.

Methods

A descriptive exploratory qualitative design was adopted for this study which allowed in-depth follow-up of the midwives’ comments resulting in a full understanding of emerging findings. Face-to-face individual interviews were conducted, transcribed and data were analysed using content analysis procedures. Verbatim quotes were used to support the findings.

Results

Midwives employed different pain control measures including pharmacological and non-pharmacological methods such as psychological care, sacral massage and deep breathing exercises. Doctors prescribed analgesics most of the time while in some cases, the midwives independently administered the drugs. They assisted women who had epidural anaesthesia given by anaesthetists. The midwives did not administer adequate analgesics because of fear of side effects of analgesics. Although the midwives exhibited knowledge on drugs used for labour pain management, they did not regularly administer analgesics and non-pharmacological care provided were inadequate due to increased workload. Some of the midwives showed empathy towards women and supported the women. Most of the midwives perceived labour pain as normal and encouraged women to bear pain.

Conclusion

Midwives require regular education on labour pain management and they should pay attention to women in labour individually and administer the care that meets their need.
Literature
1.
Lavender T, Chapple J. An exploration of midwives’ views of the current system of maternity care in England. Midwifery. 2004;20(4):324–34.CrossRefPubMed
2.
Ghana Statistical Service. Ghana - multiple indicator cluster survey, fourth round. In: Evelyn Amassah Josephine MPS, Crentsil CA, Jolene ALB, Amoo M, Eleanor EA, Asiamah TB, Manu-Larbi D, Agyei CAH, Azure AFZMILL, Rita Osei Owusu NMK, Akomeah MN, editors. Multiple indicator cluster survey with an enhanced malaria module and biomarker. Accra: William Eyimah Ramatu Ussif, Abdallah A. Mogtar; 2011.
3.
Ghana Statistica Service. Ghana demographic and health survey. In: Oklah C, Riis WA, Mensah JO, Nartey M, editors. Demographic and health survey; 2014.
4.
Ogboli-Nwasor E, Adaji SE, Bature SB, Shittu OS. Pain relief in labor: a survey of awareness, attitude, and practice of health care providers in Zaria, Nigeria. J Pain Res. 2011;4:227–32.PubMedPubMedCentral
5.
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):e14–8.CrossRefPubMed
6.
Klomp T, Witteveen AB, de Jonge A, Hutton EK, Lagro-Janssen AL: A qualitative interview study into experiences of management of labor pain among women in midwife-led care in the Netherlands. J Psychosom Obstet Gynaecol 2016:1–9.
7.
Lamm C, Batson CD, Decety J. The neural substrate of human empathy: effects of perspective-taking and cognitive appraisal. J Cogn Neurosci. 2007;19(1):42–58.CrossRefPubMed
8.
Williams AC, Morris J, Stevens K, Gessler S, Cella M, Baxter J. What influences midwives in estimating labour pain? Eur J Pain. 2013;17(1):86–93.CrossRefPubMed
9.
Briggs E. Assessment and expression of pain. Nurs Stand. 2010;25(2):35–8.CrossRef
10.
Ullman R, Smith LA, Burns E, Mori R, Dowswell T. Parenteral opioids for maternal pain management in labour. Cochrane Database Syst Rev. 2010;9:CD007396.
11.
Othman M, Jones L, Neilson JP. Non-opioid drugs for pain management in labour. Cochrane Database Syst Rev. 2012;7:Cd009223.
12.
13.
Afriyie KD, Aryeetey J, Annoh J, Darkwah T, Dogbe J. Utilization of Pethidine injection in a quasi-government hospital in Ghana. Int J Pharm. 2015;5(4):1297–304.
14.
Pang D, O’Sullivan G. Analgesia and anaesthesia in labour. Obstet Gynaecol Reprod Med. 2008;18(4):87–92.CrossRef
15.
16.
Koyyalamudi V, Sidhu G, Cornett EM, Nguyen V, Labrie-Brown C, Fox CJ, Kaye AD. New labor pain treatment options. Curr Pain Headache Rep. 2016;20(2):11.CrossRefPubMed
17.
Jones L, Othman M, Dowswell T, Alfirevic Z, Gates S, Newburn M, Jordan S, Lavender T, Neilson JP. Pain management for women in labour: an overview of systematic reviews. Cochrane Pregnancy Childbirth Group. 2011;1(7):1–16.
18.
19.
Zondag DC, Gross MM, Grylka-Baeschlin S, Poat A, Petersen A. The dynamics of epidural and opioid analgesia during labour. Arch Gynecol Obstet. 2016;294(5):967–77.CrossRefPubMed
20.
Wee M. Alternative pain relief techniques. Women's Health Medicine. 2005;2(4):21–4.CrossRef
21.
Sekhavat L, Karbasi SA, Fallah R, Mirowliai M. Effect of hyoscine butylbromide first stage of labour in multiparus women. Afr Health Sci. 2012;12(4):408–11.PubMedPubMedCentral
22.
Samuels LA, Christie L, Roberts-Gittens B, Fletcher H, Frederick J. The effect of hyoscine butylbromide on the first stage of labour in term pregnancies. BJOG. 2007;114(12):1542–6.CrossRefPubMed
23.
Gutton C, Bellefleur JP, Puppo S, Brunet J, Antonini F, Leone M, Bretelle F. Lidocaine versus ropivacaine for perineal infiltration post-episiotomy. Int J Gynaecol Obstet. 2013;122(1):33–6.CrossRefPubMed
24.
Jagatia K, Mehta J, Patel N. Low dose ketamine for painless labour- a comparative study of 100 patients. Int J Med Sci Public Health. 2013;2(2):707–11.CrossRef
25.
Kaur Makkar J, Jain K, Bhatia N, Jain V, Mal Mithrawal S. Comparison of analgesic efficacy of paracetamol and tramadol for pain relief in active labor. J Clin Anesth. 2015;27(2):159–63.CrossRefPubMed
26.
Vargens OM, Silva AC, Progianti JM. Non-invasive nursing technologies for pain relief during childbirth--the Brazilian nurse midwives’ view. Midwifery. 2013;29(11):e99–e106.CrossRefPubMed
27.
Silva Gallo RB, Santana LS, Jorge Ferreira CH, Marcolin AC, Polineto OB, Duarte G, Quintana SM. Massage reduced severity of pain during labour: a randomised trial. J Physiother. 2013;59(2):109–16.CrossRefPubMed
28.
Simkin PP, O'Hara M. Nonpharmacologic relief of pain during labor: systematic reviews of five methods. Am J Obstet Gynecol. 2002;186(5 Suppl Nature):S131–59.CrossRefPubMed
29.
Gilliland AL. After praise and encouragement: emotional support strategies used by birth doulas in the USA and Canada. Midwifery. 2011;27(4):525–31.CrossRefPubMed
30.
Tournaire M, Theau-Yonneau A. Complementary and alternative approaches to pain relief during labor. Evid Based Complement Alternat Med. 2007;4(4):409–17.CrossRefPubMedPubMedCentral
31.
Borders N, Wendland C, Haozous E, Leeman L, Rogers R. Midwives’ verbal support of Nulliparous women in second stage labor. J Obstet Gynecol Neonatal Nurs. 2013;42(3):311–20.CrossRefPubMedPubMedCentral
32.
Nilsson L, Thorsell T, Wahn EH, Ekström A. Factors influencing positive birth experiences of first-time mothers. Nurs Res Pract. 2013;2013:1–6.CrossRef
33.
Hildingsson I, Westlund K, Wiklund I. Burnout in Swedish midwives. Sex Reprod Healthc. 2013;4(3):87–91.CrossRefPubMed
34.
Nyamtema AS, Urassa DP, Massawe S, Massawe A, Lindmark G, Van Roosmalen J. Staffing needs for quality perinatal care in Tanzania. Afr J Reprod Health. 2008;12(3):113–24.PubMed
35.
Geranmayeh M, Hadian T, Rezaepur A, Akhondzadeh E, Haghani H. Effect of education on midwives’ knowledge, attitude and practice about non-pharmacologic labor pain relieving methods. J Qazvin Univ Med Sci. 2011;15(2):34–40.
36.
Mensah RS, Mogale RS, Richter MS. Birthing experiences of Ghanaian women in 37th military hospital, Accra, Ghana. Int J Afr Nurs Sci. 2014;1:29–34.
37.
Aziato L, Odai PN, Omenyo CN. Religious beliefs and practices in pregnancy and labour: an inductive qualitative study among post-partum women in Ghana. BMC Pregnancy Childbirth. 2016;16(1):138.CrossRefPubMedPubMedCentral
38.
Aziato L, Ohemeng HA, Omenyo CN. Experiences and perceptions of Ghanaian midwives on labour pain and religious beliefs and practices influencing their care of women in labour. Reprod Health. 2016;13(1):136.CrossRefPubMedPubMedCentral
39.
Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res. 2007;42(4):1758–72.CrossRefPubMedPubMedCentral
40.
Askay SW, Bombardier CH, Patterson DR. Effect of acute and chronic alcohol abuse on pain management in a trauma center. Expert Rev Neurother. 2009;9(2):271–7.CrossRefPubMedPubMedCentral
41.
Ditre JW, Brandon TH, Zale EL, Meagher MM. Pain, nicotine, and smoking: research findings and mechanistic considerations. Psychol Bull. 2011;137(6):1065–93.CrossRefPubMedPubMedCentral
42.
Ministry of Health. Ghana Essential Medicines List. Accra: Yamens Press. Ltd.; 2010.
43.
Thelin IL, Lundgren I, Hermansson E. Midwives’ lived experience of caring during childbirth--a phenomenological study. Sex Reprod Healthc. 2014;5(3):113–8.CrossRefPubMed
44.
Adolphson K, Axemo P, Hogberg U. Midwives’ experiences of working conditions, perception of professional roles and attitudes towards mothers in Mozambique. Midwifery. 2016;40:95–101.CrossRefPubMed
Metadata
Title
Experiences of midwives on pharmacological and non-pharmacological labour pain management in Ghana
Authors
Lydia Aziato
Abigail A. Kyei
Godsway Deku
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Reproductive Health / Issue 1/2017
Electronic ISSN: 1742-4755
DOI
https://doi.org/10.1186/s12978-017-0398-y

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