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Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review
BACKGROUND: Many women use pharmacological or non-pharmacological pain relief during childbirth. Evidence from Cochrane reviews shows that effective pain relief is not always associated with high maternal satisfaction scores. However, understanding women’s views is important for good quality materni...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543627/ https://www.ncbi.nlm.nih.gov/pubmed/31146759 http://dx.doi.org/10.1186/s12978-019-0735-4 |
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author | Thomson, Gill Feeley, Claire Moran, Victoria Hall Downe, Soo Oladapo, Olufemi T. |
author_facet | Thomson, Gill Feeley, Claire Moran, Victoria Hall Downe, Soo Oladapo, Olufemi T. |
author_sort | Thomson, Gill |
collection | PubMed |
description | BACKGROUND: Many women use pharmacological or non-pharmacological pain relief during childbirth. Evidence from Cochrane reviews shows that effective pain relief is not always associated with high maternal satisfaction scores. However, understanding women’s views is important for good quality maternity care provision. We undertook a qualitative evidence synthesis of women’s views and experiences of pharmacological (epidural, opioid analgesia) and non-pharmacological (relaxation, massage techniques) pain relief options, to understand what affects women’s decisions and choices and to inform guidelines, policy, and practice. METHODS: We searched seven electronic databases (MEDLINE, CINAHL, PsycINFO, AMED, EMBASE, Global Index Medicus, AJOL), tracked citations and checked references. We used thematic and meta-ethnographic techniques for analysis purposes, and GRADE-CERQual tool to assess confidence in review findings. We developed review findings for each method. We then re-analysed the review findings thematically to highlight similarities and differences in women’s accounts of different pain relief methods. RESULTS: From 11,782 hits, we screened full 58 papers. Twenty-four studies provided findings for the synthesis: epidural (n = 12), opioids (n = 3), relaxation (n = 8) and massage (n = 4) – all conducted in upper-middle and high-income countries (HMICs). Re-analysis of the review findings produced five key themes. ‘Desires for pain relief’ illuminates different reasons for using pharmacological or non-pharmacological pain relief. ‘Impact on pain’ describes varying levels of effectiveness of the methods used. ‘Influence and experience of support’ highlights women’s positive or negative experiences of support from professionals and/or birth companions. ‘Influence on focus and capabilities’ illustrates that all pain relief methods can facilitate maternal control, but some found non-pharmacological techniques less effective than anticipated, and others reported complications associated with medication use. Finally, ‘impact on wellbeing and health’ reports that whilst some women were satisfied with their pain relief method, medication was associated with negative self-reprisals, whereas women taught relaxation techniques often continued to use these methods with beneficial outcomes. CONCLUSION: Women report mixed experiences of different pain relief methods. Pharmacological methods can reduce pain but have negative side-effects. Non-pharmacological methods may not reduce labour pain but can facilitate bonding with professionals and birth supporters. Women need information on risks and benefits of all available pain relief methods. |
format | Online Article Text |
id | pubmed-6543627 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65436272019-06-04 Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review Thomson, Gill Feeley, Claire Moran, Victoria Hall Downe, Soo Oladapo, Olufemi T. Reprod Health Review BACKGROUND: Many women use pharmacological or non-pharmacological pain relief during childbirth. Evidence from Cochrane reviews shows that effective pain relief is not always associated with high maternal satisfaction scores. However, understanding women’s views is important for good quality maternity care provision. We undertook a qualitative evidence synthesis of women’s views and experiences of pharmacological (epidural, opioid analgesia) and non-pharmacological (relaxation, massage techniques) pain relief options, to understand what affects women’s decisions and choices and to inform guidelines, policy, and practice. METHODS: We searched seven electronic databases (MEDLINE, CINAHL, PsycINFO, AMED, EMBASE, Global Index Medicus, AJOL), tracked citations and checked references. We used thematic and meta-ethnographic techniques for analysis purposes, and GRADE-CERQual tool to assess confidence in review findings. We developed review findings for each method. We then re-analysed the review findings thematically to highlight similarities and differences in women’s accounts of different pain relief methods. RESULTS: From 11,782 hits, we screened full 58 papers. Twenty-four studies provided findings for the synthesis: epidural (n = 12), opioids (n = 3), relaxation (n = 8) and massage (n = 4) – all conducted in upper-middle and high-income countries (HMICs). Re-analysis of the review findings produced five key themes. ‘Desires for pain relief’ illuminates different reasons for using pharmacological or non-pharmacological pain relief. ‘Impact on pain’ describes varying levels of effectiveness of the methods used. ‘Influence and experience of support’ highlights women’s positive or negative experiences of support from professionals and/or birth companions. ‘Influence on focus and capabilities’ illustrates that all pain relief methods can facilitate maternal control, but some found non-pharmacological techniques less effective than anticipated, and others reported complications associated with medication use. Finally, ‘impact on wellbeing and health’ reports that whilst some women were satisfied with their pain relief method, medication was associated with negative self-reprisals, whereas women taught relaxation techniques often continued to use these methods with beneficial outcomes. CONCLUSION: Women report mixed experiences of different pain relief methods. Pharmacological methods can reduce pain but have negative side-effects. Non-pharmacological methods may not reduce labour pain but can facilitate bonding with professionals and birth supporters. Women need information on risks and benefits of all available pain relief methods. BioMed Central 2019-05-30 /pmc/articles/PMC6543627/ /pubmed/31146759 http://dx.doi.org/10.1186/s12978-019-0735-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Review Thomson, Gill Feeley, Claire Moran, Victoria Hall Downe, Soo Oladapo, Olufemi T. Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review |
title | Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review |
title_full | Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review |
title_fullStr | Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review |
title_full_unstemmed | Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review |
title_short | Women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review |
title_sort | women’s experiences of pharmacological and non-pharmacological pain relief methods for labour and childbirth: a qualitative systematic review |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6543627/ https://www.ncbi.nlm.nih.gov/pubmed/31146759 http://dx.doi.org/10.1186/s12978-019-0735-4 |
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