Non-pharmacological Methods Of Pain Relief Research Articles

Electric massage chairs reduce labor pain in nulliparous patients: a randomized crossover trial

BACKGROUND: Labor pain varies significantly among pregnant women, ranging from mild to extremely distressing. Non-pharmacologic pain relief methods during vaginal birth are increasingly popular, either as a complement to pharmacologic agents or at times as the primary method of pain relief. Multiple trials have reported that manual or by-hand massage reduces labor pain. The effectiveness of full-body mechanical massage using electric massage chairs on labor pain remains unexplored.OBJECTIVE: To evaluate mechanical massage using electric massage chair on labor pain in nulliparous women.STUDY DESIGN: A randomized counterbalanced crossover trial was conducted in a university hospital in Malaysia from August 2022 to February 2023. Eligible nulliparas in labor with a minimum labor pain score of 5 (0-10 numerical rating scale) were enrolled. Participants were randomized to 30 minutes on the massage chair with mechanical massage followed by 30 minutes on the massage chair without mechanical massage, or the other way around in massage sequence. The primary outcome was change in pain score comparing pain with and without mechanical massage as a paired comparison for the entire trial participants. Secondary outcomes were across arms analyses of maternal and neonatal outcomes. The paired t-test, t test, Mann- Whitney U test, Chi square test and Fisher exact test were used as appropriate for the data.RESULTS: 208 women were randomized; 104 to each intervention. Data was available from 204 participants (103 randomized to massage first and 101 to no massage first). The primary outcome of change in labor pain score (0-10 Numerical Rating Scale, NRS) after massage and no massage (all participants included after crossover, paired t-test analysis) was mean±standard deviation 4.51±2.3 vs 5.38±2.1 mean difference - 0.87 (95% CI -1.14 to -0.59), p<0.001, a significant reduction in pain score after electric chair mechanical massage compared to no massage. On the across randomized arms secondary analyses, labor pain score after their first massage chair session was 4.35±2.52 (randomized to massage first, received massage as initial intervention) vs 5.66±1.73 p<0.001 (randomized to no massage first, received no massage as initial intervention) mean difference -1.31 (95% CI -1.91 to -0.748), a significant reduction after mechanical massage. Other distal maternal outcomes (mode of delivery, labor analgesia, duration of labor and maternal agreement that mechanical massage is effective for labor pain) and neonatal outcomes (Apgar score at 1 and 5 minutes, cord artery blood pH and base excess, and neonatal admission) were not different across randomized arms.CONCLUSION: Mechanical massage using an electric massage chair significantly reduces labor pain, offering a potential non-pharmacologic pain management option during labor.

Nonpharmacological pain relief for labour pain: knowledge, attitude, and barriers among obstetric care providers.

Labor pain is considered the worst pain in a woman's life. Hence, pain control should be essential to labor management at any level. There is scarce information, and there are gaps regarding the knowledge, attitude, and barriers to the utilization of nonpharmacological approaches for pain relief in Saudi Arabia. Therefore, the current study aims to evaluate nonpharmacological pain relief (NPPR)-related knowledge, attitudes, and barriers among obstetric care providers in Najran, Saudi Arabia. A cross-sectional analytical study was performed at maternity departments in Maternal and Children Hospital (MCH), Najran, Saudi Arabia, from April 1 to May 26 2023. The study involved 186 obstetric care providers (OPCs), physicians (19), nurses (144), and midwives (23). A structured self-reported questionnaire was used to collect data and involves five main sections: demographic data, work-related data, nonpharmacological pain relief-related attitude, perceived barriers, and knowledge quiz. The adjusted odds ratio (AOR) along with 95% CI was estimated to determine the factors associated with nonpharmacological pain relief-related knowledge and attitude using multivariate analysis in the binary logistic regression. Over three-quarters (79%) of obstetric care providers had adequate knowledge of nonpharmacological pain relief methods. The majority (85.5%) of the participants had a positive attitude toward NPPR in labour pain management, with the mean scores ranging from 3.55-4.23 for all sub-items. Obstetric care providers acknowledged that patient belief, lack of time, and workload were the strongest barriers to offering nonpharmacological pain relief methods for labour pain 67.6%, 64.5%, and 61.3%, respectively. In binary logistic regression analysis, the in-service training related to nonpharmacological pain relief (AOR = 5.871 (2.174-15.857), p=0.000), (AOR = 3.942 (1.926-11.380), p=0.013) and years of work experience (AOR = 1.678 (1.080-2.564), p=0.019), (AOR = 1.740 (1.188-2.548), p=0.003) were significantly associated with obstetric care providers' knowledge and attitudes regarding nonpharmacological pain relief (p≤0.05). Although most OPCs have adequate knowledge and a positive attitude regarding NPPR, they need motivational strategies to enhance their utilization. In addition, an effort should be made to decrease OPCs' workload to provide more time for NPPR application and patient education. Training courses and in-service training can play an important role in enhancing NPPR knowledge and attitude and, consequently, its application. Also, in each working unit, the policymakers should provide clear guidelines and policies that enhance and control the utilization of NPPR.

Childbirth Preparation: Knowledge of the Use of Non-Pharmacological Pain Relief Methods during Childbirth in Tshwane District, South Africa: A Cross-Sectional Study.

Effective management of labour pain is an essential aspect of care provided to women during childbirth. The aim of this study was to assess pregnant women's knowledge of using non-pharmacological pain relief methods during childbirth. Methods: This quantitative descriptive cross-sectional study was conducted at four hospitals in the Tshwane District of South Africa. The sample consisted of 384 pregnant women. Results: The results show that (n = 200, 52.1%) pregnant women lack knowledge regarding non-pharmacological pain relief methods, while a minority (n = 101, 26.3%) had some knowledge, some (n = 73, 19%) were uncertain about these methods and others (n = 10, 2.6%) did not comment. Additionally, most respondents (n = 232, 60%) never received education about the various methods available to manage pain during labour at antenatal care, while others (n = 131, 34%) agreed that they received such education. A significant relationship between the level of education and knowledge about non-pharmacological pain relief methods was noted (p = 0.0082). In conclusion, respondents knew methods such as massage, breathing exercises, movements and birth positions. However, they lacked knowledge of birth companionship, acupuncture, transcutaneous electrical nerve stimulation (TENS), aromatherapy and music. The overall findings revealed that antenatal care services provided by midwives are not effectively preparing pregnant women for pain relief during childbirth.

Effect of audio-visual therapy on pain and anxiety in labor: A randomized controlled trial

BackgroundBirth pain affects women at a physical and psychological level. Pain is subjective, and perception will vary among individuals depending on their health status, pain tolerance, and psychological state. Labor pain can drastically affect the birth process and delivery outcomes if not managed well, ranging from poor maternal satisfaction and impaired maternal-newborn bonding to prolonged labor and fetal distress. Since pharmacological pain relief methods harm the fetus, non-pharmacological pain relief methods are gaining popularity among laboring women and healthcare professionals. ObjectivesThe study aimed to evaluate the effect of audio-visual therapy on labor pain and maternal anxiety. MethodsA randomized, controlled, open-label, single-center trial was conducted among 76 primigravida women with no obstetrical complications during the active phase of labor (4–8 cm cervical dilatation). The participants were randomly assigned to an experimental group receiving 50 min of virtual reality intervention or a control group receiving standard care using a computer-generated random sequence. The data related to pain and anxiety were collected using the personal information form, anxiety assessment scale for pregnant women in labor, present behavioral intensity scale, numerical pain rating scale, and post-delivery birth satisfaction checklist. ResultsGroups were homogenous in terms of demographic and obstetric variables. The virtual reality intervention reduced the experimental group's reported pain intensity and anxiety score. However, no statistically significant difference was noted in maternal vital signs and labor and neonatal outcomes between the groups. ConclusionThe virtual reality intervention reduced labor pain intensity and anxiety among laboring women compared to standard care.

Parents' experiences with interprofessional collaboration in neonatal pain management: A descriptive qualitative study.

To describe parents' experiences with interprofessional collaboration (IPC) in neonatal pain management. Neonatal care should be based on IPC, and non-pharmacological pain-relieving methods are recommended to be used primarily that enables parental participation. However, there is a lack of knowledge about pain management on IPC from the parent's viewpoint. A descriptive qualitative study. The research involved a purposive sample of parents (n = 16) whose infant had been treated at a neonatal intensive care unit in Finland. Interviews were conducted with participants from all over Finland who were recruited through the national association for premature infants. Parents discussed their experiences during semi-structured interviews which were guided by the subareas of IPC, partnership, cooperation and coordination. The data were analysed using deductive-inductive content analysis. The reporting of results followed COREQ guidelines. Based on the parent's experiences the partnership involved themes of understanding the neonatal pain management context, being able to influence the pain management, and feeling valued. Cooperation included themes of identifying different roles and equality. Coordination was described through the sharing of knowledge, skills and expertise, as well as feeling supported by professionals. Parental involvement on IPC should be developed through interventions that involve training around pain assessment and non-pharmacological pain-relief methods. Professionals involved in neonatal care should act in a goal-oriented and unified manner to promote a culture of care that allows for active parental participation. The research has been carried out in accordance with good scientific practice. Only the research team has been involved in the design, conduct, analysis and drafting of the manuscript.

Women's Knowledge about Pharmacological and Non-Pharmacological Methods of Pain Relief in Labor.

This study aimed to assess knowledge about non-pharmacological pain-relief methods in labor among women who have given birth at least once. This cross-sectional study was conducted using an online survey among 466 adult women. The minimum sample size was estimated based on the number of labor admissions in the year before the study in Poland. The survey included questions about respondents' sociodemographics and knowledge of pain-relief methods. The knowledge score was calculated using the sum of correct answers. Non-parametric Spearman's correlation, Kruskal-Wallis and Wilcoxon variance tests were used. Antenatal classes (313/68.9%) and the Internet (248/54.6%) were the most common sources of knowledge. The most popular pharmacological pain-relief methods included epidural anesthesia (386/85.0%) and nitrous oxide (301/66.3%). Massage and breathing techniques were the most commonly known non-pharmacological methods (405/89.2% and 400/88.1%, respectively). The knowledge score about non-pharmacological methods was significantly higher as compared to the pharmacological methods score (rc = 0.85; p < 0.001). Respondents' age correlated with knowledge about non-pharmacological methods (rs = -0.10,p = 0.026) but did not correlate with knowledge about pharmacological methods. Educational level correlated with knowledge about pharmacological (rs = -0.13,p = 0.007) and non-pharmacological (rs = 0.14, p = 0.003) methods concerning pain relief in labor. No correlation was found between respondents' knowledge and gravidity, number of vaginal or cesarean deliveries, and hospital referral levels for previous deliveries. Our findings support the need to implement educational programs to increase evidence-based knowledge about pain-relief methods during labor in women.

Knowledge, Practices, and Attitudes of Nurses Regarding Non-Pharmacological Pain Management in the Midwifery Ward

Background and Objectives: Pregnant women are frequently worried about labor pain, and it is usually the most important problem for them and their relatives. Non-pharmacological pain relief methods provide several benefits, such as no harmful effects on the fetus or baby, no interruption of labor, and even being pleasurable for the mother and fetus. The aim of this study was to assess the nurse’s knowledge, practice, and attitude toward non-pharmacological pain management methods in the delivery room in Erbil Governorate. Method: The descriptive cross-sectional design was utilized to determine nurses' knowledge, practices, and attitudes about labor pain and non-pharmacological pain management, as well as to monitor nurses' practices in the delivery rooms during labor and delivery. A total of 78 nurses from public and private hospitals in Erbil Governorate participated in the study. Structured questionnaires and an observational checklist were used to collect data and used SPSS version 26 was used to analyze it. Result: Nurse’s knowledge (N=27, 50.0%), (N=9, 37.5%) in public and private hospitals was at a good level, and they had a positive attitude (N=32, 59.3%) in public hospitals and a positive attitude (N=14, 58.3%) in private hospitals. But had a fair practice (N=19, 35.18%) in public hospitals and good practice (N=10, 41.7%) in private hospitals towards labor pain and non-pharmacological pain management. This is due to the lack of time, inadequate staff and the great workload of the staff. Conclusion: This survey showed that the knowledge of most of the nurses was at a good level, but it was weak in items such as (cold therapy, acupuncture and acupressure technique), as well as majority of them do the following practices: relaxation technique, give psychological support and, ensure that women's relatives are there during the entire labor process; and they do not use other types of non-Pharmacological

Realidade Virtual como estratégia de alívio da dor no trabalho de parto: protocolo revisão scoping

Introduction During labour, pain can affect the health of the mother and the foetus, and its relief is a right of the mother and a duty of the professionals. In the promotion of a positive experience of labour, it is crucial that nurses specialised in maternal and obstetric health give priority to pain assessment and the use of non-pharmacological methods for pain relief, providing the necessary resources and empowering parturients to use them. Among said methods, virtual reality stands out due to its ease of use and for allowing the reduction of pain levels by diverting attention from the real world, using computers and other devices. Since it is a new approach that is not yet implemented in delivery rooms in Portugal, it is important to map the facilitating factors and barriers associated with its use, so that the dissemination of existing knowledge and its transfer to skilled nursing care during the first stage of labour can be planned. Objective To map the research evidence on the facilitating factors and barriers in the use of VR as a non-pharmacological strategy for pain relief during labour in hospital settings. Methods This protocol follows the guidelines published by the Joanna Briggs Institute. The databases MEDLINE, CINAHL, Cochrane Database of Systematic Reviews and MedicLatina through the EBSCOhost platform, the Joanna Briggs Institute EBP Database, through the Ovid platform are considered for the search and, the grey literature is also included. As inclusion criteria, qualitative, quantitative and mixed studies that address virtual reality as a pain relief strategy during labour in hospital settings (based on the mnemonic PCC - Population, Concept and Context), published in Portuguese, French, Spanish or English language between 2017 and 2022 are considered. The titles and abstracts of identified references will be independently reviewed and assessed for eligibility by two reviewers. In the event of a tie, a third reviewer will be used. Full text studies and data will be extracted using a form. The data extraction table will show the mapped data in a descriptive way answering the research questions. Discussion The results will allow summarising the barriers and facilitating factors in the use of Virtual Reality for pain relief during labour and thus contribute to decision making in planning the dissemination of this strategy to pregnant women and health professionals and its implementation in delivery rooms. Systematic Review Record Open Science Framework : osf.io/4b2sj

The Effect of Music Therapy on the Pain and Anxiety Levels of Patients Experiencing Wound Healing by Suturing in the Emergency Wards.

A patient experiences high pain and anxiety during laceration healing. One of the non-pharmacological methods of pain and anxiety relief is using music. This study was outlined to examine the impact of music therapy on the pain and anxiety levels of patients experiencing wound healing by suturing in the emergency wards. The study population for this randomized controlled clinical trial was all patients aged 18 - 65 years who were referred to the Emergency Ward of Imam Khomeini and Buali Sina hospitals, Sari, Iran, to suture the hand or foot. Thirty people were included from each group in the study. In the intervention group, traditional Iranian wordless music (Peyk Sahar track) was played with headphones from when the patient was placed on the bed for suturing to the end, and the duration was recorded. In the control group, sutures were made according to the usual procedure. The pain level was measured by a visual analog scale in two stages before washing and immediately after the anesthetic injection. Moreover, the anxiety level was assessed in three steps, before washing the wound, after the end of the anesthetic injection, and immediately after suturing. Data were analyzed by the SPSS software version 22. Descriptive statistics, including mean and standard deviation, and inferential statistics, such as Exact Fisher's test, Mann-Whitney test, and Wilcoxon, were used to describe and analyze the variables. The mean pain before washing the wound (before music therapy) and after the end of the anesthetic injection was not significantly different between the intervention group (5.38 ± 1.31 and 3.71 ± 1.98, respectively) and the control group (5.31 ± 1.69 and 4.60 ± 2.31, respectively) (P = 0.27 and 0.057, respectively). The mean anxiety before washing the wound, after the end of anesthesia injection, and immediately after finishing the suture was 3.37 ± 0.89, 2.73 ± 1.23, and 1.27 ± 0.52 in the intervention group, and 3.50 ± 0.97, 3.07 ± 1.33, and 2.07 ± 1.14 in the control group, respectively. The mean anxiety at all three times was significantly different between the two groups (P < 0.001). The study results indicated that music therapy lowered pain without a statistically significant difference. However, music therapy significantly reduced anxiety. Therefore, it is recommended to use music therapy to reduce pain and anxiety in patients.

Evaluation of labor and childbirth care by nurse-midwives in Brazilian private hospitals: results of a quality improvement project

BackgroundIn 2015, a quality improvement project—the “Adequate Childbirth Project” (Projeto Parto Adequado, or PPA)—was implemented in Brazilian private hospitals with the goal of reducing unnecessary cesarean sections. One of the strategies adopted by the PPA was the implementation of labor and childbirth care by nurse-midwives. The objective of this study is to evaluate the results of the PPA in the implementation and adequacy of labor and childbirth care by nurse-midwives in Brazilian private hospitals.MethodsCross-sectional, hospital-based study, carried out in 2017, in 12 hospitals participating in the PPA. We assessed the proportion of women assisted by nurse-midwives during labor and childbirth care and the adequacy of 13 care practices following parameters of the World Health Organization. Women assisted in the PPA model of care and in the standard of care model were compared using the chi-square statistical test.Results4798 women were interviewed. Women in the PPA model of care had a higher proportion of labor (53% × 24.2%, p value < 0.001) and vaginal birth (32.7% × 11.3%, p value < 0.001), but no significant differences were observed in the proportion of women assisted by nurse-midwives during labor (54.8% × 50.1%, p value = 0.191) and vaginal birth (2.2% × 0.7%, p value = 0.142). The implementation of recommended practices was adequate, except the use of epidural analgesia for pain relief, which was intermediate. There was a greater use of recommended practices including “oral fluid and food”, “maternal mobility and position”, “monitoring of labor”, “use of non-pharmacological methods for pain relief” and “epidural analgesia for pain relief” in women assisted by nurse-midwives in relation to those assisted only by doctors. Many non-recommended practices were frequently used during labor by nurse-midwives and doctors.ConclusionsThere was an increase in the proportion of women with labor and vaginal birth in the PPA model of care and an appropriate use of recommended practices in women assisted by nurse-midwives. However, there was no difference in the proportion of women assisted by nurse-midwives in the two models of care. The expansion of nursing participation and the reduction of overused practices remain challenges.

Nonpharmacological Methods to Reduce Pain During Active Labor in A Real-life Setting.

To evaluate the association between pain intensity in the active phase of the first stage of labor with the use or not of nonpharmacological methods for pain relief in a real-life scenario. This was an observational cross-sectional study. The variables analyzed were obtained by a questionnaire with the mothers (up to 48 hours postpartum) to investigate the intensity of pain during labor using the visual analog scale (VAS). The nonpharmacological pain relief methods routinely used in obstetric practice were evaluated by consulting medical records. The patients were separated into two groups: Group I - patients who did not use nonpharmacological methods for pain relief and Group II -patients who used these methods. A total of 439 women who underwent vaginal delivery were included; 386 (87.9%) used at least 1 nonpharmacological method and 53 (12.1%) did not. The women who did not use nonpharmacological methods had significantly lower gestational age (37.2 versus 39.6 weeks, p < 0.001) and shorter duration of labor (24 versus 114 min, p < 0.001) than those who used the methods. There was no statistically significant difference in the pain scale score using the VAS between the group that used nonpharmacological methods and the group that did not (median 10 [minimum 2-maximum 10] versus 10 [minimum 6-maximum 10] p = 0.334). In a real-life setting, there was no difference in labor pain intensity between the patients who used nonpharmacological methods and those who did not use them during the active phase of labor.

REPERCUSSÕES DA PANDEMIA DA COVID-19 NA ATENÇÃO À MULHER NO TRABALHO DE PARTO E PARTO: ESTUDO TRANSVERSAL

ABSTRACT Objective: to analyze the health care provided to women in peripartum and parturition during the pandemic period of COVID-19. Method: analytical and cross-sectional study, conducted with 404 puerperal women from three maternity hospitals in Paraná - Brazil, between the months of September-December/2021. Data were analyzed by chi-square test (p&lt;0.05) to verify the association. Results: care was taken to prevent COVID-19 in peripartum and parturition (physical distance 89.4%, use of mask 96.8%, respiratory etiquette 74.3%, hand hygiene 97.8%), presence of a companion (97.2%), respect for the choice of parturition route (71%) and skin-to-skin contact (70.2%). A high rate of early hospitalization (dilation between 0-3 cm), low offer of non-pharmacological methods for pain relief and low incentive to breastfeeding were observed. Conclusion: the study contributes to improve health actions about the natural physiology of parturition and to strengthen the rights in parturition, even in vulnerable pandemic periods.

Doula support among brazilian women who attended the senses of birth health education intervention – a cross sectional analysis

BackgroundWhile maternal health is a priority in international goals, maternal health outcomes remain poor in many regions of the world. In Brazil, maternal mortality has decreased over the past decades, but the country’s maternal mortality ratio is higher than over half of all countries at 59 deaths per 100,000 live births. The Brazilian maternal health care model facilitates high rates of medical interventions during labor and childbirth; 56% of births are by cesarean birth. Doula support is considered a potential strategy to reduce medically unnecessary interventions during childbirth that contribute to maternal mortality.MethodsThe cross-sectional study analyses associations with use of doula support and normal birth among Brazilian women who participated in a health education intervention named the Senses of Birth (SoB). The SoB intervention, implemented in five cities from 2015 to 2017, was developed to educate about normal birth and to evidence-based practices (EBP) reduce medically in childbirth. Chi-Square tests were performed to identify the relationship between doula support during childbirth and sociodemographic characteristics, childbirth information, perceived knowledge, and use of EBPs during labor. Logistic regression was performed to identify associations in adjusted analysis.ResultsControlling for covariates, doula support was associated with vaginal delivery (OR 2.47, 95% CI: 1.37–4.45.) Findings also suggest that women who had doula support were more likely to use non-pharmacological pain relief methods during labor (OR 9.68, 95% CI: 2.67–34.61), deliver in a public hospital (OR 2.02, 95% CI: 1.09–3.72), and be low and mid-level income compared to women with high income.ConclusionThis study’s findings suggest that doula support is significantly associated with vaginal birth. The results may be useful for advocating for changes to the childbirth care model in Brazil. Incorporating EBPs, such as doula support, for all women who desire may improve maternal and child outcomes.

Knowledge and Attitude Regarding Non-Pharmacological Pain Relief Methods during Labor among Midwives and Nurses at Madina

Background: Pain during labour is a complicated, multidimensional, and subjective issue that both the expecting mother and the maternity healthcare provider are concerned about. The aim was to assess knowledge and attitudes regarding non-pharmacological pain relief methods during labour among midwives and nurses at Madina. Subjects and Methods: The study employed a quantitative descriptive cross-sectional study design; 158 participants (midwives and nurses) were conveniently selected. The study was carried out in the Labour ward and Antenatal ward at Maternity at Medina and the Child Hospital at Medina hospital from January to February (2022). Data was collected through a self-administered questionnaire. Results: The study revealed that 51.9% of participants had adequate knowledge, while 48.1% had inadequate knowledge. In addition, 60.8% of them have a good attitude. Factors associated significantly with knowledge regarding non-pharmacological pain relief include education, working area, and the profession. In addition, the present study reflects that there is a positive correlation between participants' knowledge of non-pharmacological pain relief and their attitude. Recommendations: Nurses and midwives should be involved in several educational and training courses and attend different workshops, conferences, and seminars on non-pharmacological pain relief during labour. Nurses and midwives should utilize the methods of non-pharmacological pain relief during labour to alleviate the complications of pharmacological pain relief as much as possible. Further studies should be conducted by other researchers to investigate other factors that affect and enhance the level of non-pharmacological pain relief methods. Researchers can also incorporate the domain of practise within their future studies.

Effectiveness of birth plan counselling based on shared decision making: A cluster randomized controlled trial (APLANT).

A birth plan (BP) is a written document in which the pregnant woman explains her wishes and expectations about childbirth to the health professionals and aims to facilitate her decision-making. Midwives' support to women during the development of the BP is essential, but it's unknown if shared decision making (SDM) is effective in birth plan counselling. We hypothesized that women who receive counselling based on SDM during their pregnancy are more likely to present their BP to the hospital, more satisfied with the childbirth experience, and have better obstetric outcomes than women who receive standard counselling. We also aimed to identify if women who presented BP to the hospital have better obstetric outcomes and more satisfied with the childbirth experience. This was a randomised cluster trial involving four Primary Care Units. Midwives provided BP counselling based on SDM to the women in the intervention group (IG) during their pregnancy, along with a leaflet with evidence-based recommendations. Women in the control group (CG) only received the standard birth plan counselling from midwives. The primary outcomes were birth plan presentation to the hospital, obstetrics outcomes and satisfaction with childbirth experience. The Mackey Satisfaction with Childbirth Scale (MCSRS) was used to measure childbirth satisfaction. A total of 461 (95.5%) pregnant women received BP counselling (IG n = 214 and CG n = 247). Fewer women in the intervention group presented their BP to the hospital compared to those in the control group (57.8% vs 75.1%; p <0.001). Mean satisfaction with childbirth experience was high in the IG as well as the CG: 150.2 (SD:22.6) vs. 153.4 (SD:21.8); p = 0.224). The information received about childbirth during pregnancy was high in both groups (95.1% vs 94.8%; p = 1.0). Fewer women in the IG used analgesia epidural compared to those in the CG (84.7% vs 91.7%; p = 0.034); women who combined non-pharmacological and pharmacological methods for pain relief were more in number in the IG (48.9% vs 29.5%; p = 0.001) and women who began breastfeeding in the delivery room were more in number in the IG (83.9% vs 66.3%; p = 0.001). Women who presented their BP had a greater probability of using combined non-pharmacological and pharmacological methods for pain relief aOR = 2.06 (95% CI: 1.30-4.30) and early skin-to-skin contact aOR = 2.08 (95% CI: 1.07-4.04). This counselling intervention was not effective to increase the presentation of the BP to the hospital and women's satisfaction with childbirth; however, it was related to a lower usage of analgesia epidural, a higher combination of pharmacological and non-pharmacological methods for pain relief and the initiation of breastfeeding in the delivery room. Presenting the BP to the hospital increased the likelihood of using pharmacological and non-pharmacological methods for pain relief, and early skin-to-skin contact.

Women's perceptions of counselling on pain assessment and management during labour in Finland: A cross-sectional survey

BackgroundThe challenge is to identify pain assessment counselling that are effective and reliable to the woman during labour while also supporting appropriate management of labour pain. ObjectiveThis study aimed to describe women's perceptions of their counselling on pain assessment and pain management during labour. DesignA descriptive, cross-sectional study. ParticipantsThe sample consisted of women who had given birth (n=204) at a university hospital in Finland; 250 parturients were recruited by convenience sampling. MethodsData were collected using a questionnaire (P-PAPM) between November 2018 and February 2019. The statistical significance of observed differences was analysed using the Chi-squared test and Fischer's exact test. ResultsEighty percent of women reported that they had received counselling on pharmacological treatments from midwives, but only 33 % received counselling on pain assessment. The non-pharmacological methods for alleviating labour pain most commonly taught by midwives were proper breathing techniques, cold/heat treatments, and trying different positions and movements. Women were less commonly counselled to try listening to music, thinking about pleasant and positive things, or concentrating their thoughts on something other than pain. The two most commonly used counselling methods were demonstrations and written material and least used Internet-based resources. The personal issue that midwives discussed most frequently during counselling was the women's individual hopes concerning pain management (91%), while the issue discussed least often was previous experiences of pain (58%). The participants’ experiences of fear, age, and education were significantly associated with aspects of counselling on pain assessment and management. ConclusionsWomen's counselling on pain assessment and management during labour varied widely. Therefore, to improve its quality, counselling should be routinely integrated into daily midwifery work. In particular, the counselling given on non-pharmacological pain relief methods during labour was inadequate. More varied counselling methods should be used in the future. Finally, the results indicate that midwives’ knowledge of counselling should be increased and they should be encouraged to routinely offer counselling on pain assessment and management for parturing women.

USE OF NON-PHARMACOLOGICAL PAIN RELIEF METHODS IN LABOR

Objective: to analyze the practice of using non-pharmacological pain relief methods during labor. Method: a quantitative and descriptive cross-sectional study developed from December 2019 to September 2020 in a Maternal and Child Nursing Service from southern Brazil. A total of 560 medical charts were analyzed and data collection took place in the institutional database. The Kolmogorov-Smirnov test was used for normality of the variables and, for associations, the t test for independent samples, chi-square or Fischer’s exact test. Results: It was found that 164 (29.3%) of the parturients resorted to at least one type of method, the most used being hydrotherapy with 137 (24.5%), change of position with 124 (22.1%) and breathing exercises with 121 (21.6%). There was a significant association (p&lt;0.05) between methods, type of delivery, pregnancy and parity. Conclusion: This study highlights the profile of parturients who benefit from these practices and exposes the low frequency of their use, showing a promising area for studies and continuing education activities.

Virtual reality is beneficial in decreasing pain in labouring women: A preliminary study.

Women use a range of non-pharmacological pain relief methods to reduce labour pain intensity and to help manage labour pain. The purpose of this intervention study was to determine whether virtual reality would have an effect on labour pain intensity. Virtual reality has been shown to be effective in reducing pain in other acute pain settings. This study was an intervention study in labour in a cross-over within-subjects design (Clinical Trials Registry Number: ACTRN12618001776291P). Fourteen participants reported their pain and had their heart rate and blood pressure measured during active labour while using and not using virtual reality. There were significantly lower reported pain scores (6.14 compared to 7.61, P< 0.001) and maternal heart rate (79.86 beats per minute compared to 85.57, P =0.033) and mean arterial pressure (88.78 mmHg compared to 92.61 mmHg, P= 0.022) were lower when using virtual reality compared to when not using virtual reality during active labour. This study makes an important contribution to the field of virtual reality in labour and birth. It is consistent with other recent findings of reduced pain in labour and links decreased pain scales to heart rate and blood pressure, the physiological markers of pain.

Obstetrics care providers attitude and utilization of non-pharmacological labor pain management in Harari regional state health facilities, Ethiopia

BackgroundIn a woman’s life, labor pain is the most severe pain that they have ever faced. In Ethiopia, the provision of pain relief in labor is often neglected. Furthermore, evidence strongly urged that further research is needed on non-pharmacological labor pain management. Therefore, obstetrics care providers’ attitudes and utilization of non-pharmacological labor pain management need to be assessed.MethodA facility-based cross-sectional study was conducted from May 20 to June 10, 2021, in Harari regional state health facilities, Ethiopia. All obstetric caregivers in Harari regional state health facilities were included in the study. A structured questionnaire adapted from the previous studies was used to collect data. The data was entered into Epi-data version 3.1 statistical software. Statistical analysis was carried out by using SPSS for windows version 22. Multivariate linear regression analysis was employed to determine the association between independent variables and the outcome variable.ResultThe overall utilization of non-pharmacological labor pain relief methods was 59.3% [(95% CI (53.9,63.4)]. Three hundred five (65.5%) of the study participants had unfavorable attitudes. Females compared to males (β = − 0.420; 95% CI: − 0.667, − 0.173), clinical experience (β = − 0.201; 95% CI: − 0.268, − 0.134), knowledge sum score (β =0.227: 95%; CI: 0.18,0.247), and attitude sum score (β = 0.376; 95% CI: 0.283, 0.47) were showed significantly association with utilization of non-pharmacological labor pain management.ConclusionThe overall utilization of non-pharmacological labor pain relief methods was relatively good compared to other studies done in Ethiopia but all women’s need for labor relief methods should not be ignored. In this study sex of the respondents, clinical experience, individual preference, attitude and knowledge were factors associated with the utilization of non-pharmacological labor pain management. All stake holds need to work together to improve the attitude of health providers and to increase the utilization of non-pharmacologic labor pain management.

Women's perceptions of the pain assessment and non-pharmacological pain relief methods used during labor: A cross-sectional survey.

INTRODUCTIONThe use of non-pharmacological pain relief methods and pain assessment scales during labor has received limited research attention. This study aimed to describe women’s perceptions of the pain assessment and non-pharmacological pain relief methods used during labor.METHODSA descriptive, cross-sectional survey was conducted. A convenience sample of women (n=204) from one Finnish maternity ward participated in the study. Women who had given birth were asked to respond to a validated questionnaire between November 2018 and February 2019. The statistical significance of observed differences was analyzed using the chi-squared test.RESULTSLess than half (46%) of the women who gave birth at the hospital were asked to assess the intensity of their pain on a pain assessment scale. The most commonly used non-pharmacological pain relief methods were encouragement (92%), the presence of a midwife (82%), and proper breathing technique that was taught by a midwife (81%). Aqua blisters (3%), reflexology (e.g. zone magnets, 5%), and music (9%) were the least commonly used non-pharmacological methods during labor. The participants’ experiences of fear and pain were significantly associated with the implementation of pain assessment.CONCLUSIONSWomen’s pain was rarely evaluated by using a certain pain assessment scale. In addition, non-pharmacological pain relief methods were inadequately used during labor. More specifically, methods that required midwives’ own personal contributions were rarely offered to the women.