THE PAIN OF LABOUR: PERSPECTIVES OF TRADITIONAL BIRTH ATTENDANTS IN EDO STATE, NIGERIA (original) (raw)
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Traditional birth attendants' labour pain management experiences from parturients care
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Aim: The study explored Traditional Birth Attendants' (TBAs') perceptions of labour pain management experiences from parturients care in the Ogbia Local Government Area, Bayelsa State Nigeria. Methods: The study adopted a phenomenological-hermeneutics research design. Using the purposive and snowball sampling techniques, 13 TBAs were recruited for this study. The data collection strategy was in-depth face-to-face interviews. Results: Three major themes emerged: (1) TBAs' beliefs and attitude to labour pain, (2) TBAs' experiences of pain management during labour and (3) remedies provided to relieve labour pain and support to speed up childbirth. Conclusions: Pain is a natural phenomenon but expressed differently from one parturient to another. TBAs' perception of labour pain is an indicator of how TBAs interpret and manage labour pain expressed by parturients. TBAs management approaches are more effective with the use of locally available remedies in form of herbs aimed at speeding up the delivery process.
Labour pain experience is distinctive and complex, and women use various coping strategies to cope with it. Hence, this study attempted to explore pain experience and coping strategies employed by women in labor in a secondary health facility in Ilorin, Kwara State, Nigeria. A qualitative exploratory research design was used, and a purposive sampling technique was used to select a total of ten (10) mothers who delivered within 48hours in the healthcare facility. A total of three FGD sessions were conducted, each had between 3 and 4 participants. The semi-structured interview guide was used for data collection, and the data were analyzed using content analysis. The women who participated in this study were between 20 and 42years of age, and they perceived labour pain differently. Some of the women described labour pain as very painful; others said the pain is normal, while some said the pain cannot be compared with anything. The study revealed that younger women who are primiparous perceived labor pain as more severe than the multiparous women. All the participants said that birth information and instructions received from the midwives, as well as the presence of caring midwives, help to relieve labour pains and consequently influence their pain experience(s) positively. The coping strategies used varied among participants, and deep breathing techniques, relaxation, and vertical positions were the major coping strategies used. Therefore, the provision of adequate labour information on coping strategies and the presence of caring midwives influenced the labour experience(s) positively.
Labour pain perception: experiences of Nigerian mothers
Pan African Medical Journal
Introduction: Labour pain perception is influenced by a variety of factors; hence women experience and cope with labour pain differently. This study was designed to assess labour pain perception among parturient. Methods: A cross-sectional study involving 132 pregnant women who had vaginal delivery at two tertiary hospitals in south west Nigeria. A structured questionnaire was administered to women within 24 hours of delivery to record details of labour and delivery. Labour pain perception was assessed using the Visual Analogue Score (VAS). Data analysis were done using IBM-SPSS Statistics for Windows version 21.0 (IBM Corp., Armonk, NY, USA). Results: The mean age of the parturients was 30.6±4.8 years. The mean pain perception of the parturients as assessed by VAS was 7.0 with range of 1.2-10.0. Sixty-six (50%) parturients rated labour pain to be severe (VAS > 7.1). Majority of the respondents 114(86.4%) desired some form of pain relief. The Body Mass Index (BMI) of respondents and birth weight of their babies had statistically significant association with pain perception (p = 0.010; p = 0.038 respectively). Factors associated with increased odds of having severe pain perception include unbooked status, secondary level education, BMI < 30, and gestational age ≥ 37 weeks. Conclusion: Women in south west Nigeria perceived labour pain as severe and many desired pain relief during labour. Occupation, BMI, gestational age and baby's birth weight were significant mediating variables in women's experience of labour pain. Modern methods of labour analgesia should be offered to parturients who express desire for it. This will lead to improvements women's childbirth experience.
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...
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.
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.
S12978 021 01141 8 non pharmacologic pain management in labour
Background: Women have experienced labour pain over the years as various attempts have been made to effectively manage this pain. There is paucity of literature on the experiences and perceptions about labour pain management with the contemporary Ghanaian health system. This study explored the perspective of puerperal women on the use of non-pharmacological labour pain management at Adidome Government Hospital. Methods: The study adopted an exploratory descriptive qualitative approach as data was collected through individual interviews. Informed consent was obtained from all participants who were purposely sampled until data saturation was reached on the 17th participant. Interviews were audio recorded and transcribed immediately. Thematic analysis was engaged in three interrelated stages, namely data reduction, data display, and data conclusion to analyse the transcript and field notes. Results were presented with supporting quotes from the transcripts. Results: The women described labour pain as very severe, severe and moderate as the pain lasted more than 12 h. The various strategies adopted in managing labour pains included shouting and walking around, crying and screaming and staying calm and snapping the fingers. Other pain management strategies adopted during labour included women engaged in deep breathing exercises, chatting with other people and relatives, diversion therapy, reassurance, taking a shower, assuming side lying positions, and receiving intravenous therapy. The presence of the husband of a labouring woman during labour improved pain bearing ability. Conclusion: It is important that midwives institute pragmatic protocols in the labour ward that ensure a relaxing atmosphere for women in labour, respond to the sensitivity and specificity of labouring women needs and when possible significant others (e.g., husband) of the labouring women could be allowed to visit. Labour wards should be made sound proof to allow women the ability to express themselves satisfactorily during labour without fear of being heard outside.
A B S T R A C T Background: Pain relief in labor remains a hot topic and these debates get louder by the day as more women become aware of their rights to better quality of care in labor. This study was conceived in a background where the practice of pain relief in labor is evolving and where women are seeking to fulfill their need for pain-free labor. Objective: To investigate the knowledge, utilization and preferences of methods of pain relief in labor by expectant mothers in order to design a labor analgesia program. Materials and Methods: A questionnaire-based descriptive study involving 124 antenatal clients in a teaching hospital over a 1 week period. Descriptive statistics were carried out using SPSS for windows version 17. Results: The mean age of clients was 28.8 years (standard deviation = 5.17) with median parity of two and mean gestational age was 31.5 weeks. Majority of the respondents (47.9%) were of Hausa/Fulani ethnicity and 97.6% had primary school level education. Majority (87.3%) had heard about pain relief methods with the hospital being the source in 79% of cases. The most common method ever heard about was epidural analgesia (69.4%). Only 4% (n = 5) of respondents remembered ever using any form of pain relief agent in labor, of which three received parenteral opioids. In their current pregnancies, 45.2% consented to the use of pain relief in labor; of which, epidural analgesia was preferred by 92.9% (n = 52). Fear of adverse effects on self and infants were cited as reasons for non-consent by some respondents while others had no reason. Conclusion: The study reveals a high awareness of pain relief methods which is not matched by utilization and low knowledge about side-effects, although fear of side-effects is a factor for under-utilization. There is a need to educate adequately as well provide high quality pain relief services in labor in order to dispel with myths, misconceptions and fears associated with the use of methods of pain relief in labor.
Labour pain experiences and perceptions: a qualitative study among post-partum women in Ghana
BMC Pregnancy and Childbirth, 2017
Background: Women have experienced severe labour pain over the years and various attempts have been made to effectively manage labour pain. However, there is paucity of literature on the labour pain experience and perceptions about labour pain with the contemporary Ghanaian health system. Therefore this study sought to gain an in-depth understanding on labour pain experiences and perceptions of post-partum women. Methods: The study adopted an exploratory descriptive qualitative approach and collected data through individual interviews. Informed consent was obtained from all the participants who were purposively sampled. After transcription of interviews, the data were analyzed inductively using content analysis techniques. Results: Women in this study experienced pain during labour rated as mild, moderate and severe and the pain was felt at the waist area, vagina, lower abdomen and the general body. The women expressed labour pain through crying, screaming and shouting. They prayed to God to help reduce the severe pain. Some women endured the pain, cried inwardly and others showed no sign of pain. Some women believed that crying during labour is a sign of weakness. Pain reliefs such as pethidine (Meperidine) was occasionally given. Non-pharmacologic measures employed included walking around, deep breathing, side-lying, waist holding, squatting, taking a shower and chewing gum. The individuality of pain experience and expression was emphasized and the socio-cultural orientation of women made some of them stoic. Conclusion: We concluded that it is necessary for all health professionals to manage labour pain effectively taking the socio-cultural context into consideration.