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      Pain perception among parturients at a University Teaching Hospital, South-Western Nigeria

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          Abstract

          Introduction:

          Labour pain is a universal experience. Relief of labour pains and companionship in labour are important aspects of quality of care in labour.

          Objectives:

          To evaluate perception of labour pains among parturients, their knowledge and awareness of pain relief during labour, the types of obstetric analgesia available and the outcome of their labour at the Ekiti State University Teaching Hospital, Ado-Ekiti.

          Materials and Methods:

          A cross-sectional study using questionnaire administered to pregnant women between 37 and 42 weeks gestational age in labour ward of the hospital.

          Results:

          The study revealed that 75.2% of the parturients experienced severe labour pains and 35.3% of them received analgesia in labour with Pentazocine injection being the only analgesic used. Only 18.3% had maximum relief of their pains. Parturients with increasing parity, higher social class and educational attainment and who had antenatal education on labour pains were associated with severe perception of labour pains with P values of 0.03, 0.03, 0.02 and 0.01, respectively. Parturients who were given Pentazocine injection for pains and had relief in labour had more spontaneous vaginal deliveries, P = 0.030 and better outcome for their babies, P = 0.028. Majority of the women reported that the practice of companionship and back rubbing in labour helped them to cope better with the labour process.

          Conclusion:

          Most women desire relief of pains of labour but the practice is still suboptimal in this centre. Efforts should be made towards developing the practice of obstetric analgesia and companionship in labour in this environment.

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          Most cited references14

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          Preparation for pain management during childbirth: the psychological aspects of coping strategy development in antenatal education.

          During childbirth, in addition to or in place of analgesia, women manage pain using a range of coping strategies. Antenatal education provides an opportunity prior to birth to help women to prepare for an often painful event. However, this is usually carried out with little reference to the literature regarding psychological factors which influence the experience of pain. This review seeks to consider how recent developments in psychological knowledge could enhance care. Areas identified include range of coping strategies and factors influencing their efficacy and implementation. This draws on both the literature on management of acute pain in other scenarios and the limited literature related to childbirth related pain. The following recommendations for systematic evaluation in the context of antenatal education are made: (i) Increase the range of coping strategies currently utilized to include cognitive based strategies. (ii) Help women to identify and understand the nature of their own coping styles and preferences, including any unhelpful patterns of pain catastrophizing. (iii) Help women to develop their own unique set of coping strategies for labor. (iv) Strengthen feelings of coping self-efficacy by practice in class and reinforcement by the class teacher. (v) Develop implementation intentions which account for the changing context of childbirth and (vi) Actively develop prompting and reinforcement of use of identified coping strategies by birth partners.
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            Labour pain experience and intensity: a Jordanian perspective.

            In this descriptive study, 100 low-risk participants who delivered vaginally were recruited from the postpartum unit of a major hospital in the city of Amman. Three instruments, the Numeric Pain Intensity Scale (NPIS), a pain assessment questionnaire and a demographic questionnaire were used to assess labour experiences and labour pain intensity levels. The majority of Jordanian parturients did not receive pain relief. Eighty-one women reported pain intensity levels of > or = 8 on the NPIS (ranging from 0-10). The mean pain intensity level during the second stage of labour was 8.83. A significant difference in age was found between primiparas and multiparas. Jordanian parturients reported painful labour experiences; therefore, re-evaluation of current maternity nursing and midwifery practices and roles regarding labour pain management are warranted. The roles of supporter and educator among maternity nurses and midwives in Jordan also need to improve considerably.
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              Attitudes of patients to obstetric analgesia at the University College Hospital, Ibadan, Nigeria.

              Pain relief, for different reasons, is controversial worldwide. We designed this study to assess the level of awareness of antenatal patients to analgesia in labour and to evaluate the effect of age, parity and educational status on the awareness and acceptability of pain relief in labour. A structured questionnaire was administered to 1,000 antenatal patients between 1 June 2000 and 31 May 2001. Spearman's correlation coefficient was applied to estimate the correlation between the ranked dependent variable (awareness and acceptability) and age, parity and educational status (independent variables). Awareness of pain relief methods was seen in only 27.1%. The most common method known was the use of systemic opioids (80%); only 10% were aware of epidural analgesia and about 14% knew of inhalational analgesia. Acceptance of methods was, however, 57.6%. The most common reason for non-acceptance was that 'The pain of labour is natural' in 76.5%, 12% feared complications to the baby and 25% gave other reasons. Age, parity and educational status did not affect awareness. Educational status had positive correlation (rho = 0.13, P < 0.05) with acceptance while age had a negative correlation (rho = -0.124, P<0.05). Awareness of obstetric analgesia is still relatively low in this environment; however, a high proportion of patients would accept analgesia in labour if offered.
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                Author and article information

                Journal
                Niger Med J
                Niger Med J
                NMJ
                Nigerian Medical Journal : Journal of the Nigeria Medical Association
                Medknow Publications & Media Pvt Ltd (India )
                0300-1652
                2229-774X
                Jul-Aug 2013
                : 54
                : 4
                : 211-216
                Affiliations
                [1]Department of Obstetrics and Gynecology, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria
                Author notes
                Address for correspondence: Dr. Olusola Peter Aduloju, Department of Obstetrics and Gynecology, Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. E-mail: peter.aduloju@ 123456yahoo.com
                Article
                NMJ-54-211
                10.4103/0300-1652.119597
                3821219
                24249944
                f72279f3-e850-4d40-86ef-0eca87ecdc32
                Copyright: © Nigerian Medical Journal

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Original Article

                Medicine
                pain,parturients,perception,south-western nigeria
                Medicine
                pain, parturients, perception, south-western nigeria

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