Between pain and pleasure: Pregnant women's knowledge and preferences for pain relief in labor, a pilot study from Zaria, Northern Nigeria (original) (raw)
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Journal of Pain Research, 2011
The purpose of this study was to assess the attitudes of maternal health care providers to pain relief during labor in Zaria, Nigeria. Methods: This was a multicenter, collaborative, cross-sectional pilot study of provider perspectives concerning pain relief during labor. A structured, self-administered, questionnaire was completed by 95 consenting maternal health care providers at three high-volume facilities in Zaria, an ancient northern Nigerian city. Descriptive statistics was performed on the data. Results: Most respondents (94.8%) agreed that pain relief is needed during labor. Only 2.1% of respondents were undecided about the provision of pain relief during labor and 3.2% were of the opinion that pain relief was not necessary during labor. Most respondents (93.7%) had attended a woman in labor in the 4 weeks preceding the survey. Of these, 56.8% had counseled a parturient in labor. Most of the counseling (42.1%) took place during labor. Less than half of the respondents (48.4%) had administered pain relief in labor in the preceding 4 weeks and systemic opioids was the most commonly form of pain relief. Among the respondents who did not offer pain relief agents in labor, the majority (54.5%) had no reason for not offering it. Unavailability of methods, inability to afford the cost of pain relief, lack of knowledge and skills, as well as lack of essential equipment to provide the procedure were also given by respondents as reasons for not offering pain relief. Conclusion: Even though maternal health care providers in this environment have a positive attitude to pain relief in labor, most women go through labor without the benefit of analgesia. There exists a gap between provider attitudes to pain relief in labor and practice of the same, with many providers having no genuine reason(s) for not offering pain relief to their clients during labor. Providers need to align their practice to their attitudes, and need to be helped to do this through training as well as enhancing their ability to think critically about their practice.
African health sciences, 2015
Nigerian parturients desire, but experience unsatisfactory pain relief as labour analgesia is underutilised and unpopular among skilled-birth attendants. To assess pregnant women's knowledge and willingness to use non-pharmacological labour pain reliefs. Using a descriptive cross-sectional design, a pre-tested, structured questionnaire was interviewer administered to a convenient sample of 245 prenatal women at a specialist maternity hospital in Enugu. Majority (68.6%) of the women knew, but 31.4% were unaware that non-pharmacological labour pain reliefs exist in the study facility. Only 34.7% were able to identify at least four such methods, 21.2% could elicit two (each) advantages and disadvantages, and 0% to 28.3% had perceived self-efficacy of how to use each method. The leading four methods identified were breathing exercises (51.8%), massage (36.7), position changes (32.2%), and relaxation techniques (26.5%). Majority (59.6%) of the women expressed willingness to use non-p...
With the advance in health care delivery, obstetric analgesia is now routinely administered in most developed countries; however, in developing countries including Nigeria, childbirth is still a painful natural process for most women. This study was conducted to assess the awareness and willingness of women within the reproductive age to utilize non-pharmacological obstetric analgesia in reducing labour pain. An explanatory mixed method design was utilized for the study. For the quantitative component, a validated interviewer administered questionnaire was administered to 247 randomly selected women that delivered at AKTH who were attending immunization clinics. The qualitative study utilized an interview guide to conduct 4 key informant interviews with core health care personnel. Quantitative data was analyzed using descriptive statistics while content analysis was used to analyze the qualitative data. Results showed that the respondents have a mean age of 28.30 ± 7.5 years. Less than one fifth 42 (17%) of the respondents were aware of the use of non-pharmacological analgesics in reducing labour pain. An overwhelming majority of the respondents 234 (94.7%) indicated their willingness to use of non-pharmacological obstetric analgesia. More than three quarter 195 (78.9%) of the respondents stated that they will prefer non-pharmacological obstetric analgesia to any other form of pain relief in labour. It was concluded that although majority of respondents were willing to utilize the non-pharmacologic analgesia in reducing labour pains if made available, the level of awareness was ironically low. The study therefore recommends the need to include the teaching of non-pharmacologic analgesia during antenatal sessions. This is with view of increasing the level of awareness of non-pharmacological analgesia among women.
International Journal of Women's Health and Reproduction Sciences
Introduction Pain perception in labor is extremely variable among women depending on the parturient pain threshold and reaction to pain (1). For the majority of women, labor pain is considered severe and may be likened in severity to complex regional pain syndrome or amputation of a digit without anaesthesia (2). According to the American College of Obstetricians and Gynecologists and the American Society of Anaesthesiologists, there is no circumstance where it is acceptable for an individual to experience untreated severe pain, amenable to safe intervention, while under the care of a physician (2). The development of modern analgesia and in particular regional analgesia marked a major turning point in pain management during labor and delivery. Epidural analgesia is considered as the most effective method of pain relief and recommended as the first choice analgesia for women during labor and delivery (3,4). The level of awareness and practice of labor analgesia, particularly epidural analgesia in sub-Saharan Africa is still rudimentary and obstetricians undoubtedly have an important role to play in this regard. In 2012, a survey of the practice of labor analgesia a m o n g t h e obstetricians in Nigeria revealed that only 49% of the respondents offered analgesia to women in labor and of these, a paltry 2% used epidural analgesia (5). Pain management in labor is an important component of active management of labor and even though not all women request pain relief in labor, the obstetrician has a duty to discuss the options, benefits and risks associated with various methods of labor analgesia with the parturient irrespective of his or her belief (6, 7). Optimal pain control in labor is more likely to result in a satisfactory birth experience for the parturient and her care provider (8-12). A critical step in achieving this milestone is to survey the level of awareness of epidural analgesia, determinants and deterrents of its use among obstetricians practicing in Nigeria. Currently, there is no available literature documenting the utilization pattern, determinants and deterrents of epidural analgesia among obstetric care providers such as obstetricians in Nigeria. This study, therefore,
Awareness and Perception of Epidural Labor Analgesia Amongst Parturient in South Eastern Nigeria
Clinical Medicine Research
This study was carried out to assess the awareness, perceptions, acceptance, and the level of utilization of epidural analgesia in relation to other methods of labor pain relief among prospective parturient attending the antenatal clinic in south eastern Nigeria. Women attending the antenatal clinic were interviewed using interviewer administered questionnaires containing both open and closed questions, to evaluate their awareness, perceptions, acceptance and level of utilization of labor analgesia in general and epidural analgesia in particular. Data were analysed using SPSS Statistics Version 21.0. The study included 150 women with mean age of 29.63±5.02. Most of the respondents (94.7%) had at least secondary school education. More than half the respondents (62.7%) knew about labor analgesia and 38.7% knew about epidural labor analgesia. Source of knowledge to vast majority (75.6%) were doctors and nurses. Majority of the multiparous respondents (81.27%) had moderate or severe pain in the previous confinement and only 53% had pain relieve. Of those who had pain relieve, two third hard breathing exercises while 4.8% had epidural analgesia. Majority of the respondents (72.7%) would want to have labor analgesia, and 53.3% desired epidural in their next delivery. There is poor level of awareness and utilization of epidural labor analgesia by women attending an antenatal clinic in south eastern Nigeria.
Pain Relief during Labor: Attitudes of Postpartum Mothers in Selected Hospitals in Ibadan, Nigeria
Background & aim: Giving birth is a painful process, which exposes women to a lot of stress. It is the responsibility of the healthcare practitioners to make this process less burdensome. In this regard, the present study aimed to investigate the attitudes of postpartum mothers towards labor pain relief. Methods: This descriptive cross-sectional study was conducted on 153 females with spontaneous vaginal delivery within September to October of 2012. The study population was selected through convenience sampling technique. Data collection was performed using a semi-structured questionnaire. The data were analysed in SPSS (version 20), using descriptive statistics and Chi-square. P-value less than 0.05 was considered statistically significant. Results: According to the results, 60.8% of the respondents had knowledge about pain relief in labor. However, 58.8% of the participants did not request for pain relief during labor because they believed that their pain could not be relieved. Women's attitude to labor pain relief showed a significant association with their age (P=0.001), education level (P=0.001), and parity (P=0.001). Conclusion: Based on the findings of the study, the midwives are recommended to provide the pregnant women with health education on labor pain relief and dispel any misconceptions in this regard.
BMC Anesthesiology, 2015
Background: Childbirth is one of the most painful experiences of a woman's life. Authorities in the fields of obstetrics and anaesthesia encourage use of labour analgesia. Unlike in high-income countries, pain relief in labour in Africa is not a well established service, especially in the low-income countries like Uganda. Little is known about whether parturients would be amenable to labour analgesia. We sought to determine knowledge, attitudes and use of labour analgesia among women attending the antenatal clinic at Mulago National Referral Hospital. Methods: Upon obtaining institutional approval, we conducted a cross-sectional descriptive study. Women were requested to complete the researcher-administered survey following informed consent. The study was conducted in the general antenatal clinic at the Mulago National Referral Hospital. Results: Of 1293 participants interviewed, only 7 % of the participants had knowledge of labour analgesia. Of the multiparous mothers 87.9 % did not have labour analgesia in their previous deliveries, although 79.2 % of them had delivered in a national referral hospital. The commonest reason for refusal of labour analgesia was to experience natural childbirth. 87.7 % of the participants wanted labour analgesia for their next delivery. Conclusion: There is a wide gap between the desire for labour analgesia and its availability. Obstetricians and anaesthesiologists have a role to educate the women, and to provide this much desired service.
Knowledge and Acceptance of Labour Analgesia in Pregnant Women
Journal of Nepal Health Research Council, 2018
Background: Labour analgesia, though practiced worldwide, is not very popular in low-income countries. The aim of the study was to assess the awareness, attitude, acceptance, and reasons for hindrance of labour analgesia among patients visiting a tertiary care center in the capital city Methods: It was a cross sectional study conducted in Obstetrics and Gynecology outpatient department of Kathmandu Medical College Teaching Hospital in the month of August 2017. All pregnant patients presenting for antenatal checkup was included. Data was collected based on a questionnaire after informed consent. Statistical analysis was done in SPSS version 20 and results were expressed in frequencies and percentage. Results: Total of 270 pregnant women participated in the study. Out of these forty-four (16.3%) patients were aware about labour analgesia. The acceptance rate was high (72.2%). Majority (84.6%) had no problem with expenditure associated with labour analgesia. Conclusions: Despite low awareness about painless delivery among the antenatal women, the acceptance rate is high.
Perceptions and practice of epidural analgesia among women attending antenatal clinic in FETHA
International journal of women's health, 2017
The pain of childbirth is arguably the most severe pain that most women will endure in their lifetime. Epidural analgesia is widely used as an effective method of pain relief in labor. It provides almost complete relief of pain if administered timely, and does not affect the progress of the first stage labor. The objective of this study was to determine the awareness and utilization of epidural analgesia in labor in pregnant women attending the antenatal clinic at Federal Teaching Hospital, Abakaliki (FETHA). This is a cross-sectional study involving 350 women attending the antenatal clinic between April 2016 and July 2016. A total of 335 questionnaires were correctly completed, and used for analysis. The average age and parity of the respondents were 27.6±8.2 years and 2.4±1.8, respectively. About 58.2% of respondents were civil servants, 98.5% were married, and 74.6% had a tertiary level of education. About 43.3% of the respondents are aware of the use of epidural analgesia in lab...
International Journal of Nursing, 2020
Childbirth is perhaps, the most painful experience encountered by most women and just like other forms of pain, the experience of labour pain is unique to individual women, so it is only the woman in labour who can describe the extent of pain she is going through. This study assessed the perceptions, attitude, intention to use, also predict factors that influence intention to use epidural analgesia among pregnant women attending antenatal clinic. The study adopted a cross-sectional design and was conducted among 200 randomly selected pregnant women attending Ante-natal Clinic of Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria. Data were obtained using a structured questionnaire and were analyzed descriptively and inferentially. Statistical significance was determined at p < 0.05. The study revealed that majority (85%) of the respondents had good perception of epidural analgesia but majority (86%) displayed negative attitude toward epidural analgesia. More ...