Research Article

Midwives' Attitudes to Painless Delivery: An Observational Study

Abstract

Background: Parturient health is a priority worldwide. In this regard, the promotion of natural childbirth has always been considered by health policy makers. However, the most important cause of parturient tendency to caesarean section is fear of labour pain and lack of information about surgery complications, leading to inappropriate rate of caesarean. Midwives, attending in prenatal visits and labour, may have a key role in encouraging pregnant patients through labour analgesia. In this study we evaluate midwives’ attitude through necessity of labour analgesia and their understanding of neuraxial analgesia for labour pain.
Methods: One hundred and five midwives working educational hospitals, participated in this observational study. All participants were asked to fill questionnaires. Each questionnaire consists of 15 questions, each answer had 1 to 3 points. Total score of 15 to 25 was considered as poor, score 26 to 35 as intermediate and 35 to 45 as good attitude.
Results: Forty-nine percent of midwives had experience with labour analgesia. Forty-one percent participated in relevant educational workshops. About 40% presumed these techniques would result in immobility, while 66% assumed it will lengthen the procedure. 63% believed labour analgesia will increase mother’s satisfaction. Overall, 73% of them agreed with regional analgesia. In regards to attitude score, 22% were scored poor, 65% intermediate and 13% good.
Conclusion: Midwives’ attitude was estimated low. Participating in workshops improved their attitude, yet the difference was not significant. Attitude of those who participated in labour analgesia was significantly better than others.

[1] Rafiei M, Saei Ghare Naz M, Akbari M, Kiani F, Sayehmiri F, Sayehmiri K, et al. Prevalence, causes, and complications of cesarean delivery in Iran: A systematic review and meta-analysis. Int J Reprod Biomed. 2018; 16:221-234.
[2] Negahban T, Ansari Jaberi A, Kazemi M. Preference Method of Delivery and Its Relevant Causes in View of Pregnant Women Referring to Public and Private Clinics in Rafsanjan City. JRUMS. 2006; 5:161-168 (in Persian).
[3] Moasheri B, Sharifzadeh G, Soltanzadeh V, Khosravi Givshad Z, Rakhshany Zabol F. Relationship between fear of pain, fear of delivery and attitude towards cesarean section with preferred mode of delivery among pregnant women. The Iranian Journal of Obstetrics, Gynecology and Infertility. 2016; 18: 8-16 (in Persian).
[4] Anim-Somuah M, Smyth RM, Cyna AM, Cuthbert A. Epidural versus non-epidural or no analgesia for pain management in labour. Cochrane Database Syst Rev. 2018; 5:CD000331.
[5] Vosoughian M, Dahi M, Dabir S, Moshari M, Tabashi S, Madadi F, et al. Pain management of painless labor in a university affiliated hospital: An observational study. Journal of Iranian Society of Anesthesiology & Critical Care. 2022; 2:4-11(in Persian).
[6] Khatony A, Soroush A, Andayeshgar B, Saedpanah N, Abdi A. Attitude of primiparous women towards their preference for delivery method: a qualitative content analysis. Arch Public Health. 2019; 77:38.
[7] Aksoy M, Aksoy AN, Dostbil A, Celik MG, Ince I. The Relationship between Fear of Childbirth and Women's Knowledge about Painless Childbirth. Obstet Gynecol Int. 2014; 2014:274303.
[8] Shaaban OM, Abbas AM, Mohamed RA, Hafiz HAA. Lack of pain relief during labor is blamable for the increase in the women demands towards cesarean delivery: a cross-sectional study. Facts Views Vis Obgyn. 2017; 9: 175–180.
[9] Ramsay MA. John Snow, MD: anaesthetist to the Queen of England and pioneer epidemiologist. Proc (Bayl Univ Med Cent). 2006; 19:24-8.
[10] Fergus P. Meehan. Historical review of caudal epidural analgesia in obstetrics. Midwifery.1987; 3: 39-45.
[11] Dehghanpisheh L, Sabastian G, Fatahi Z. Painless delivery; knowledge and attitude of obstetricians and midwives. Professional Med J. 2016; 23:467-471.
[12] Hillmann BR, Stamm AMNF. Knowledge, attitude and practice regarding pharmacological methods of labor analgesia. BrJP. São Paulo, 2019; 2:14-9.
[13] Geranmayeh M, Hadian T, Rezaepour A, A khondzadeh E, Khaghani H. Effect Of Education On Midwives' Knowledge, Attitude And Practice About Non-Pharmacologic Labor Pain Relieving. JQUMS. 2011; 15:34-40 (in Persian).
[14] Ohaeri B, Owolabi G, Ingwu J. Skilled health attendants' knowledge and practice of pain management during labour in health care facilities in Ibadan, Nigeria. Eur J Midwifery. 2019; 3:3.
[15] Gupta S, Partani S. Neuraxial techniques of labour analgesia. Indian J Anaesth. 2018; 62:658-666.
[16] Wang TT, Sun S, Huang SQ. Effects of Epidural Labor Analgesia with Low Concentrations of Local Anesthetics on Obstetric Outcomes: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Anesth Analg. 2017; 124:1571-1580.
[17] Li X, Wu C, Zhou X, Zhang J, Lu H, Chen S, et al. Influence of painless delivery on the maternal and neonatal outcomes under the guidance of new concept of labor. Am J Transl Res. 2021; 13:12973-12979.
[18] Mahmoodi F, Noroozi M, Mehr LA, Beigi M. Breastfeeding and its outcome in Women Receiving Epidural Analgesia for Childbirth. Iran J Nurs Midwifery Res. 2019; 24:355-359.
[19] Aziato L, Kyei AA, Deku G. Experiences of midwives on pharmacological and non-pharmacological labour pain management in Ghana. Reprod Health. 2017; 14:128.
[20] Endalew NS, Tawuye H Y, Melesse DY. Knowledge and attitude towards pain relief in labor among final year midwifery students: A cross-sectional study. International Journal of Surgery Open. 2020; 24: 38-42.
[21] Wong CA. Neuraxial Labor Analgesia: Does It Influence the Outcomes of Labor? Anesth Analg. 2017; 124:1389-1391.
Files
IssueVol 9 No Supp. 1 (2023): Supplement 1 QRcode
SectionResearch Article(s)
DOI https://doi.org/10.18502/aacc.v9i5.13958
Keywords
Natural vaginal delivery Midwife Attitude Labour analgesia

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Vosoughian M, Dabir S, Dahi M, Moshari M, Tabashi S, Madadi F. Midwives’ Attitudes to Painless Delivery: An Observational Study. Arch Anesth & Crit Care. 2023;9(Supp. 1):401-405.