Perspectives and Experiences of First Time Mothers on Pain Management during Labor and Delivery at a Central Hospital in Blantyre, Malawi

Presenter: Lily Caroline Kumbani, Kamuzu College of Nursing

Background: Pain relief during labour is desired by many women, including first-time mothers. Most women found labour pain unmanageable and had wanted pain relief measures. The objective of the study explored expectations and experiences of first time mothers on pain relief measures during labour and delivery.

Methods: A descriptive study design was used with qualitative data collection and analysis methods. Data were collected through twenty-two face-to-face in-depth interviews using a semi-structured interview guide and one focus group of six participants to obtain more data from the first-time mothers as individuals and in a group setting. The mothers had all delivered at Queen Elizabeth Central Hospital, from December 2012 to January 2013. The mothers were asked information on expected and provided pain relief measures during labour and delivery. Data were manually analyzed using thematic analysis.

Findings: Expectations and provision of pain relief measures emerged as two separate themes during the study.  The expectation theme included support and physical presence of the nurse midwife; the provision theme included pharmacological and nonpharmacological interventions.  The majority of first-time mothers expected information on pain relief measures, both pharmacological and nonpharmacological, from the nurse midwives, which was not provided. There was no monitoring of the mothers as regards to the level of pain.  Very few first-time mothers were given an injection for pain relief.

Conclusions: These findings appeal for a change in the management of first-time mothers during labour and delivery and to redirect midwifery care on issues of pain management.