Introduction: Labor pain is the result of a complex interaction of several physiological, psychosocial, cultural, and environmental factors, making its management difficult and challenging for caregivers. This study aimed to explore the needs, barriers, and experiences of parturients and healthcare professionals in managing labor pain in this context. Methods: An exploratory descriptive qualitative design with non-probability sampling was adopted and allowed the recruitment of 40 women who had given birth and 10 health professionals (8 midwives and 2 nurses). The intervention research method of Sidani and Braden (2011) was used for data collection. A thematic analysis with triangulation of experiential, empirical, and theoretical data for understanding the problem has been carried out. Also, using Roy’s model as a theoretical framework, the results were grouped according to the model adaptation modes and in relation to the goals of this stage of the Sidani and Braden (2011) method. Results: Faced with the medicalization of childbirth, women express a strong reliance on non-pharmacological approaches (NPAs) to relieve pain. NPAs promote a more woman-centered model of care, with a holistic view of the woman and consideration of her psycho-socio-cultural particularities. The needs and adaptation difficulties of the parturient in the four adaptation modes (comfort, relief, emotional and psychological support, social support) were identified. Healthcare professionals report a lack of training, clear protocols, and time to implement these methods due to workload and organizational constraints. Identified barriers also include inadequate infrastructure, cultural beliefs, and a preponderance of pharmacological use. PDAs are perceived as effective but not integrated into practices. Conclusion: The adoption of ANPs requires a systemic approach, combining training, awareness-raising, institutional protocols, and appropriate material conditions. Their integration could improve the quality of the childbirth experience, reduce perceived pain, and increase maternal satisfaction, thus contributing to humanizing childbirth in Beninese maternity wards.
References
[1]
Lowe, N. (2002) The Nature of Labor Pain. AmericanJournalofObstetricsandGynecology, 186, S16-S24. https://doi.org/10.1067/mob.2002.121427
[2]
Simkin, P. and Bolding, A. (2004) Update on Nonpharmacologic Approaches to Relieve Labor Pain and Prevent Suffering. JournalofMidwifery&Women’sHealth, 49, 489-504. https://doi.org/10.1016/j.jmwh.2004.07.007
[3]
Bonapace, J., Gagné, G., Chaillet, N., Gagnon, R., Hébert, E. and Buckley, S. (2018) No. 355-Physiologic Basis of Pain in Labour and Delivery: An Evidence-Based Approach to Its Management. JournalofObstetricsandGynaecologyCanada, 40, 227-245. https://doi.org/10.1016/j.jogc.2017.08.003
[4]
Marchand, S. (2009) The Phenomenon of Pain: Understanding to Treat. 2nd Edition, Masson.
[5]
Aziato, L., Acheampong, A.K. and Umoar, K.L. (2017) Labour Pain Experiences and Perceptions: A Qualitative Study among Post-Partum Women in Ghana. BMCPregnancyandChildbirth, 17, Article No. 73. https://doi.org/10.1186/s12884-017-1248-1
[6]
Konlan, K.D., Afaya, A., Mensah, E., Suuk, A.N. and Kombat, D.I. (2021) Non-Pharmacological Interventions of Pain Management Used during Labour; an Exploratory Descriptive Qualitative Study of Puerperal Women in Adidome Government Hospital of the Volta Region, Ghana. ReproductiveHealth, 18, Article No. 86. https://doi.org/10.1186/s12978-021-01141-8
[7]
Jones, L., Othman, M., Dowswell, T., et al. (2012) Pain Management for Women in Labor: An Overview of Systematic Reviews. Cochrane Database of Systematic Reviews, 2012, CD009234.
[8]
Yeung, M.P.S., Tsang, K.W.K., Yip, B.H.K., Tam, W.H., Ip, W.Y., Hau, F.W.L., et al. (2019) Birth Ball for Pregnant Women in Labour Research Protocol: A Multi-Centre Randomised Controlled Trial. BMCPregnancyandChildbirth, 19, Article No. 153. https://doi.org/10.1186/s12884-019-2305-8
[9]
Ballantyne, J., Cousins, M., Giamberardino, M., Jamison, R., McGrath, P. and Rajagopal, M. (2011) Managing Acute Pain in the Developing World. Pain Clin Updates, 19, 1-6.
[10]
World Health Organization (2018) WHO Recommendations on Intrapartum Care for a Positive Childbirth Experience: Transforming the Care of Women and Infants to Improve Their Health and Well-Being: Summary. https://pesquisa.bvsalud.org/portal/resource/pt/who-272434
[11]
Topçu, S. and Brown, P. (2019) The Impact of Technology on Pregnancy and Childbirth: Creating and Managing Obstetrical Risk in Different Cultural and Socio-Economic Contexts. Health, Risk&Society, 21, 89-99. https://doi.org/10.1080/13698575.2019.1649922
[12]
Carricaburu, D. (2008) From the Uncertainty of Birth to Obstetric Risk: The Challenges of a Definition. Sociologie et Sociétés, 39, 123-144. https://doi.org/10.7202/016935ar
[13]
Batram-Zantvoort, S., Razum, O. and Miani, C. (2021) A Theoretical Perspective on Integrity at Birth: Medicalization, Risk Theories, Embodiment, and Intersectionality. Public Health, 33, 645-654.
[14]
Jackson, D.J., Lang, J.M., Ecker, J., Swartz, W.H. and Heeren, T. (2003) Impact of Collaborative Management and Early Admission in Labor on Method of Delivery. JournalofObstetric, Gynecologic&NeonatalNursing, 32, 147-157. https://doi.org/10.1177/0884217503252045
[15]
Rahnama, P., Ziaei, S. and Faghihzadeh, S. (2006) Impact of Early Admission in Labor on Method of Delivery. InternationalJournalofGynecology&Obstetrics, 92, 217-220. https://doi.org/10.1016/j.ijgo.2005.12.016
[16]
Schantz, C., Aboubakar, M., Traoré, A.B., Ravit, M., de Loenzien, M. and Dumont, A. (2020) Caesarean Section in Benin and Mali: Increased Recourse to Technology Due to Suffering and Under-Resourced Facilities. ReproductiveBiomedicine&SocietyOnline, 10, 10-18. https://doi.org/10.1016/j.rbms.2019.12.001
[17]
Jaffre, Y. (2018) What Midwives Have to Say about Their Lives, Their Jobs and Their Healthcare Practices. Sante Publique, 30, 151-166.
[18]
Benyamini, Y., Molcho, M.L., Dan, U., Gozlan, M. and Preis, H. (2017) Women’s Attitudes towards the Medicalization of Childbirth and Their Associations with Planned and Actual Modes of Birth. WomenandBirth, 30, 424-430. https://doi.org/10.1016/j.wombi.2017.03.007
[19]
Sidani, S. and Braden, C.J. (2011) Design, Evaluation, and Translation of Nursing Interventions. Wiley. https://doi.org/10.1002/9781118785553
[20]
Roy, C., Whetsell, M.V. and Frederickson, K. (2009) The Roy Adaptation Model and Research. NursingScienceQuarterly, 22, 209-211. https://doi.org/10.1177/0894318409338692
[21]
Polit, D.F. and Beck, C.T. (2012) Nursing Research: Generating and Assessing Evidence for Nursing Practice. 9th Edition, Wolters Kluwer Health/Lippincott Williams & Wilkins.
[22]
Burns, N., Grove, S. and Gray, J. (2011) Understanding Nursing Research: Building an Evidence-Based Practice. 5th Edition, Elsevier Saunders.
[23]
Morse, J.M. (2015) “Data Were Saturated...”. QualitativeHealthResearch, 25, 587-588. https://doi.org/10.1177/1049732315576699
[24]
Sapkota, S., Kobayashi, T., Kakehashi, M., Baral, G. and Yoshida, I. (2012) In the Nepalese Context, Can a Husband’s Attendance during Childbirth Help His Wife Feel More in Control of Labour? BMCPregnancyandChildbirth, 12, Article No. 49. https://doi.org/10.1186/1471-2393-12-49
[25]
Warren, C., Njuki, R., Abuya, T., Ndwiga, C., Maingi, G., Serwanga, J., et al. (2013) Study Protocol for Promoting Respectful Maternity Care Initiative to Assess, Measure and Design Interventions to Reduce Disrespect and Abuse during Childbirth in Kenya. BMCPregnancyandChildbirth, 13, Article No. 21. https://doi.org/10.1186/1471-2393-13-21
[26]
Vargens, O.M.C., Silva, A.C.V. and Progianti, J.M. (2013) Non-Invasive Nursing Technologies for Pain Relief during Childbirth—The Brazilian Nurse Midwives’ View. Midwifery, 29, e99-e106. https://doi.org/10.1016/j.midw.2012.11.011
[27]
Barrett, S.J. and Stark, M.A. (2010) Factors Associated with Labor Support Behaviors of Nurses. JournalofPerinatalEducation, 19, 12-18. https://doi.org/10.1624/105812410x481528
[28]
Boateng, E.A., Kumi, L.O. and Diji, A.K. (2019) Nurses and Midwives’ Experiences of Using Non-Pharmacological Interventions for Labour Pain Management: A Qualitative Study in Ghana. BMCPregnancyandChildbirth, 19, Article No. 168. https://doi.org/10.1186/s12884-019-2311-x
[29]
Ramasamy, P., Kwena, A., Emarah, A., et al. (2018) Knowledge, Attitude, Practice and Barriers to Educational Implementation of Non-Pharmacological Pain Management during Labor in Selected Hospitals, Kenya. CentralAfricanJournalofPublicHealth, 4, 20-26. https://doi.org/10.11648/j.cajph.20180401.14
[30]
Youness, E.M. and Moustafa, M.F. (2012) Nurses’ Knowledge about Using Hydrotherapy as a Non-Pharmacological Pain Relieving Method in Labor and Its Barriers to Being Used. The Medical Journal of Cairo University, 80, 151-160.
[31]
Behruzi, R., Hatem, M., Fraser, W., Goulet, L., Ii, M. and Misago, C. (2010) Facilitators and Barriers in the Humanization of Childbirth Practice in Japan. BMCPregnancyandChildbirth, 10, Article No. 25. https://doi.org/10.1186/1471-2393-10-25
[32]
Almushait, M. and Ghani, R.A. (2014) Perception toward Non-Pharmacological Strategies in Relieving Labor Pain: An Analytical Descriptive Study. Journal of Natural Sciences Research, 4, 5-12.
[33]
Klomp, T., de Jonge, A., Hutton, E.K., Hers, S. and Lagro-Janssen, A.L.M. (2016) Perceptions of Labour Pain Management of Dutch Primary Care Midwives: A Focus Group Study. BMCPregnancyandChildbirth, 16, Article No. 6. https://doi.org/10.1186/s12884-015-0795-6
[34]
Lee, N., Martensson, L.B. and Kildea, S. (2012) Cross Sectional Study of Australian Midwives Knowledge and Use of Sterile Water Injections for Pain Relief in Labour. WomenandBirth, 25, e74-e79. https://doi.org/10.1016/j.wombi.2011.11.002
