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

Lydia Aziato,Godsway Deku,Abigail A Kyei

doi:10.1186/s12978-017-0398-y

Lydia Aziato, Godsway Deku + Show 1 more

Open Access

https://doi.org/10.1186/s12978-017-0398-y

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Abstract

BackgroundDue 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.MethodsA 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.ResultsMidwives 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.ConclusionMidwives 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.

Highlights

Due to the debilitating effects of severe labour pains, labour pain management continues to be an important subject that requires much attention
We sought to gain an understanding of how midwives in Ghana employ pain relieving drugs and other non-drug measures to relief pain during childbirth
We found that midwives employed different pain control measures including the use of pain relieving drugs and non-drug methods such as psychological care, massaging the lower back and deep breathing exercises

Summary

Introduction

Due to the debilitating effects of severe labour pains, labour pain management continues to be an important subject that requires much attention. Training of midwives is done in nursing and midwifery schools across the country. This includes certificate midwifery programmes which lasts for two years, diploma in midwifery which is a three year programme and Bachelor of Science in midwifery which is a four year programme. It is noted that about 57% of childbirths in Ghana are delivered with the assistance of midwives/nurses [3]. In this light, the experiences and effective interventions of midwives on labour pain management is important to explore since inadequate labour pain management continues to be reported [4]. It is noted that within the Ghanaian clinical context, all midwives are responsible for managing labour pain. In hospitals where obstetricians are available, midwives administer analgesics as prescribed

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