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“We know it’s labour pain, so we don’t do anything”: healthcare provider’s knowledge and attitudes regarding the provision of pain relief during labour and after childbirth.

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McCauley, Mary ORCID: https://orcid.org/0000-0003-1446-0625, Danna, Valentina Actis, Mrema, Dorothy and van den Broek, Nynke ORCID: https://orcid.org/0000-0001-8523-2684 (2018) '“We know it’s labour pain, so we don’t do anything”: healthcare provider’s knowledge and attitudes regarding the provision of pain relief during labour and after childbirth.'. BMC Pregnancy and Childbirth, Vol 18, p. 444.

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Abstract

Background
Most women experience pain during labour and after childbirth. There are various options, both pharmacological and non-pharmacological, available to help women cope with and relieve pain during labour and after childbirth. In low resource settings, women often do not have access to effective pain relief. Healthcare providers have a duty of care to support women and improve quality of care. We investigated the knowledge and attitudes of healthcare providers regarding the provision of pain relief options in a hospital in Moshi, Tanzania.
Methods
Semi-structured key informant interviews (n = 24) and two focus group discussions (n = 10) were conducted with healthcare providers (n = 34) in Tanzania. Transcribed interviews were coded and codes grouped into categories. Thematic framework analysis was undertaken to identify emerging themes.
Results
Most healthcare providers are aware of various approaches to pain management including both pharmacological and non-pharmacological options. Enabling factors included a desire to help, the common use of non-pharmacological methods during labour and the availability of pharmacological pain relief for women who have had a Caesarean section. Challenges included shortage of staff, lack of equipment, no access to nitrous oxide or epidural medication, and fears regarding the effect of opiates on the woman and/or baby. Half of all healthcare providers consider labour pain as ‘natural’ and necessary for birth and therefore do not routinely provide pharmacological pain relief. Suggested solutions to increase evidence-based pain management included: creating an enabling environment, providing education, improving the use of available methods (both pharmacological and non-pharmacological), emphasising the use of context-specific protocols and future research to understand how best to provide care that meets women’s needs.
Conclusions
Many healthcare providers do not routinely offer pharmacological pain relief during labour and after childbirth, despite availability of some resources. Most healthcare providers are open to helping women and improving quality of pain management using an approach that respects women’s culture and beliefs. Women are increasingly accessing care during labour and there is now a window of opportunity to adapt and amend available maternity care packages to include comprehensive provision for pain relief (both pharmacological and non-pharmacological) as an integral component of quality of care.

Item Type: Article
Subjects: WA Public Health > Health Problems of Special Population Groups > WA 310 Maternal welfare
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WQ Obstetrics > WQ 100 General works
WQ Obstetrics > Childbirth. Prenatal Care > WQ 160 Midwifery
WQ Obstetrics > WQ 20 Research (General)
WQ Obstetrics > Pregnancy > WQ 200 General works
WQ Obstetrics > Pregnancy Complications > WQ 240 Pregnancy complications (General)
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.1186/s12884-018-2076-7
Related URLs:
Depositing User: Stacy Murtagh
Date Deposited: 19 Nov 2018 16:01
Last Modified: 19 Nov 2018 16:01
URI: http://archive.lstmed.ac.uk/id/eprint/9637

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