Abstract
BackgroundLabour pain is a major concern for women, their partners and maternity health care professionals. However, little is known about Dutch midwives’ perceptions of working with women experiencing labour pain. The aim of this study was to explore midwives’ perceptions of supporting women in dealing with pain during labour.MethodsWe conducted a qualitative focus group study with four focus groups, including a total of 23 midwives from 23 midwifery practices across the country. Purposive sampling was used to select the practices. The constant comparison method of Glaser and Straus (1967, ren. 1995) was used to gain an understanding of midwives’ perceptions regarding labour pain management.ResultsWe found two main themes. The first theme concerned the midwives’ experienced professional role conflict, which was reflected in their approach of labour pain management along a spectrum from “working with pain” to a “pain relief” approach. The second theme identified situational factors, including time constraints; discontinuity of care; role of the partner; and various cultural influences, that altered the context in which care was provided and how midwives saw their professional role.ConclusionMidwives felt challenged by the need to balance their professional attitude towards normal birth and labour pain, which favours working with pain, with the shift in society towards a wider acceptance of pharmacological pain management during labour. This shift compelled them to redefine their professional identity.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-015-0795-6) contains supplementary material, which is available to authorized users.
Highlights
Labour pain is a major concern for women, their partners and maternity health care professionals
The Netherlands has a tradition of birthing without the use of pharmacological pain management, such as epidural analgesia, the number of Dutch women using epidural analgesia has risen over the past decade [1, 2]
Klomp et al BMC Pregnancy and Childbirth (2016) 16:6 they want to undergo analgesia with pharmacological agents, including epidural or other pain medication, they may have a consultation with an obstetrician, but most of them will start their labour in midwife-led care
Summary
Labour pain is a major concern for women, their partners and maternity health care professionals. Labour pain is a major concern for women, their partners, and maternity health care professionals and has received intense coverage in the Dutch nationwide media. Klomp et al BMC Pregnancy and Childbirth (2016) 16:6 they want to undergo analgesia with pharmacological agents, including epidural or other pain medication, they may have a consultation with an obstetrician, but most of them will start their labour in midwife-led care. As soon as they are in active labour and still choose to undergo pharmacological pain relief, the midwife will refer them to an obstetrician in the hospital setting. Midwives will experience no or hardly any implication in terms of diminishing caseloads or financial penalty
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