Abstract

In low-resource settings, pain relief during labour is often neglected. Women and health professionals may lack awareness of analgesic options, may not accept these options, or may have concerns regarding their safety.

Furthermore, even if pregnant women preferred labour analgesia, options may not be available at the hospital. One way to promote vaginal delivery and reduce unnecessary cesarean sections is by paying attention to labour pain relief techniques.

This study aimed to explore the perceptions and expectations of pregnant women regarding pain relief during labour at the Regional Hospital Limbe. The study employed a cross-sectional descriptive research design to sample 50 pregnant mothers using a self-administered structure questionnaire using a convenient sampling technique. Collected data were analyzed descriptively using an Excel sheet (2015) and the hypothesis was tested using Chi-square.

The study findings revealed that the majority of women (62.0%) perceived labour pain as a negative experience and find labour pains unbearable, painful and terrifying. It was also revealed that (42.0%) have a negative expectation towards labour pains this has prompted them to resort to options such as prayer, exercise, relaxation methods and using analgesia as a coping strategy to overcome the negative experiences of labour pain.

In conclusion, this study recommended that healthcare providers should provide accurate information about pain relief methods, and individualized care, and consider women’s experiences with pain management during labour. These findings can guide healthcare providers in providing better pain management services for pregnant women during labour.

CHAPTER ONE

INTRODUCTION

1.1 Introduction

Labour pain is a subjective experience that is affected not only by physiological factors but also by psychosocial, cultural, and environmental factors (Leeman et al., 2003; Lindholm & Hildingsson, 2015).

Labour pain has been defined as an “excellent model of acute pain”5 however unlike other acute pains that are usually associated with injury or pathology, labour pain is part of a normal physiological process. The pain associated with labour raises significant philosophical and theoretical questions due to its unique occurrence (Gibson, 2014).

Labour pain has been reported as severe pain and can be considered a model of acute visceral pain (Mamuk & Davas, 2010; Schmidt et al., 2015; Tournaire & Theau-Yonneau, 2007).

The pain experienced during labour can be measured by different pain assessment scales such as the Visual Analogue Scale (VAS) (Jones et al., 2012; Borges et al., 2017). Numeral Rating Scale (NRS), Verbal Rating Scale (VRS) (Whitburn  et al., 2018; Veringa-Skiba et al., 2021).

Women’s past pain experiences, loneliness, ignorance, cultural values and learned behaviors also affect pain perception (Simkin & Bolding, 2004; Waters & Raisler, 2003). Labour is not completely within women’s control due to barriers such as failure to cope with fear and pain. Women need to receive support and feel important in order to cope with labor and experience a healthy labor (Adams & Bianchi, 2008). Professional support provided throughout labor might develop women’s sense of control and ability to cope with labor pain, which may prevent negative labor experiences (Larkin et al., 2009).

Some studies indicate that fear of labour, having had a troubled labour before, and clinical or obstetric complications affect the process of deciding on labour method (Fenwick et al., 2010; Serçekuş & Okumuş, 2009). According to recent studies, neither labour pain nor analgesia greatly affects mothers’ satisfaction with labour. Mothers’ satisfaction is closely associated with receiving support during labour, approach of the person who provides support, past experiences, mothers’ attitude, and implementation of these decisions (Mamuk & Davas, 2010; Huntley et al., 2004). Non-pharmacological methods support these factors and increase mothers’ satisfaction with labor (Huntley et al., 2004).

Most women perceive labour pain and childbirth as most severe and agonizing event of a woman’s existence (Costa-Martins et al., 2014; Wong et al., 2013). This demonstrates how perceived pain is influenced by the intricate and subjective interaction of multiple physiological and psychosocial factors related to a woman’s individual construction of labor stimuli3. For this reason, the World Health Organization (WHO) has provided recommendations for high quality pain management during childbirth (WHO, 2018).

On few occasions, some women disregard labour pain and are stoic (Callister & Khalaf, 2010). Obuna & Umeora, 2014 revealed in Nigeria that ignorance of existing pain relief by women and cultural prejudice accounts for inadequate demand for labour pain relief.

 

Childbirth is a physiologic and natural process that has been undertaken by women over the years with professional assistance (Vargens et al., 2013; Carlsson et al., 2012). At the commencement of labour, the pain occurs intermittently manifesting as abdominal aches, pelvic pain and backache (Dixon et al., 2013). One thing that women recall about labour is high intensity pain. When labour pain intensifies, the women express pain through crying and screaming. Such expressions help women in labour to cope with their pain (Elden et al., 2008).

1.2 Problem Statement

Women experience varying degrees of pain during labour, ranging from minimal pain to extreme, and distressing, levels of pain (Jones et al., 2012; Deng et al., 2020). Although there are no underlying pathological processes, labour is linked with a painful experience (Baker et al., 2001), so a lot of women are worried about labour pain and how they can be relieved of pain (Gibson, 2014; Lally et al., 2008). The women’s experiences with labour make them anticipate the pain with intense worries, panics, and depression, mostly when the progression of labour is delayed (Nystedt et al., 2006; Shirvani & Ganji, 2014).

Studies on labour pain mainly concentrate on removing labour pain, increasing satisfaction with labour and evaluating efficiency of training (Fenwick et al., 2010). It may not be possible to relieve labour pain and increase satisfaction without knowing the feelings women experience at labour.

There are little or no studies aiming to assess the perceptions and expectations of pregnant women regarding pain relief in labour. Therefore, this study was carried out in order to assess the perceptions and expectations of pregnant women regarding pain relief in labour at the Regional hospital Limbe.

 

1.3 Research Questions

1.3.1 Main Research Question

What are the perceptions and expectations of pregnant women regarding pain relief in labour at Regional Hospital Limbe?

1.3.2 Specific Research Questions

1. What are the perceptions of pregnant women regarding pain relief in labour at Regional Hospital Limbe?
2. What are the expectations of pregnant women regarding pain relief in labour at Regional Hospital Limbe?

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