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      Labour pain experiences and perceptions: a qualitative study among post-partum women in Ghana

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          Abstract

          Background

          Women have experienced severe labour pain over the years and various attempts have been made to effectively manage labour pain. However, there is paucity of literature on the labour pain experience and perceptions about labour pain with the contemporary Ghanaian health system. Therefore this study sought to gain an in-depth understanding on labour pain experiences and perceptions of post-partum women.

          Methods

          The study adopted an exploratory descriptive qualitative approach and collected data through individual interviews. Informed consent was obtained from all the participants who were purposively sampled. After transcription of interviews, the data were analyzed inductively using content analysis techniques.

          Results

          Women in this study experienced pain during labour rated as mild, moderate and severe and the pain was felt at the waist area, vagina, lower abdomen and the general body. The women expressed labour pain through crying, screaming and shouting. They prayed to God to help reduce the severe pain. Some women endured the pain, cried inwardly and others showed no sign of pain. Some women believed that crying during labour is a sign of weakness. Pain reliefs such as pethidine (Meperidine) was occasionally given. Non-pharmacologic measures employed included walking around, deep breathing, side-lying, waist holding, squatting, taking a shower and chewing gum. The individuality of pain experience and expression was emphasized and the socio-cultural orientation of women made some of them stoic.

          Conclusion

          We concluded that it is necessary for all health professionals to manage labour pain effectively taking the socio-cultural context into consideration.

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          Most cited references47

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          A method of analysing interview transcripts in qualitative research.

          P Burnard (1991)
          A method of analysing qualitative interview data is outlined as a stage-by-stage process. Some of the problems associated with the method are identified. The researcher in the field of qualitative work is urged to be systematic and open to the difficulties of the task of understanding other people's perceptions.
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            Attitude and use of herbal medicines among pregnant women in Nigeria

            Background The use of herbal medicines among pregnant women in Nigeria has not been widely studied. Methods Opinion of 595 pregnant women in three geopolitical zones in Nigeria on the use of herbal medicines, safety on usage, knowledge of potential effects of herbal remedies on the fetus and potential benefits or harms that may be derived from combining herbal remedies with conventional therapies were obtained using a structured questionnaire between September 2007 and March 2008. Descriptive statistics and Fisher's exact tests were used at 95% confidence level to evaluate the data obtained. Level of significance was set at p < 0.05. Results More than two-third of respondents [67.5%] had used herbal medicines in crude forms or as pharmaceutical prepackaged dosage forms, with 74.3% preferring self-prepared formulations. Almost 30% who were using herbal medicine at the time of the study believed that the use of herbal medicines during pregnancy is safe. Respondents' reasons for taking herbal medications were varied and included reasons such as herbs having better efficacy than conventional medicines [22.4%], herbs being natural, are safer to use during pregnancy than conventional medicines [21.1%], low efficacy of conventional medicines [19.7%], easier access to herbal medicines [11.2%], traditional and cultural belief in herbal medicines to cure many illnesses [12.5%], and comparatively low cost of herbal medicines [5.9%]. Over half the respondents, 56.6% did not support combining herbal medicines with conventional drugs to forestall drug-herb interaction. About 33.4% respondents believed herbal medicines possess no adverse effects while 181 [30.4%] were of the opinion that adverse/side effects of some herbal medicines could be dangerous. Marital status, geopolitical zones, and educational qualification of respondents had statistically significant effects on respondents views on side effects of herbal medicines [p < 0.05)] while only geopolitical zones and educational qualifications seemed to have influence on respondents' opinion on the harmful effects of herbal medicines to the fetus [p < 0.05]. Conclusion The study emphasized the wide spread use of herbal medicines by pregnant women in Nigeria highlighting an urgent need for health care practitioners and other health care givers to be aware of this practice and make efforts in obtaining information about herb use during ante-natal care. This will help forestall possible interaction between herbal and conventional medicines.
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              More in hope than expectation: a systematic review of women's expectations and experience of pain relief in labour

              Background Childbirth is one of the most painful events that a woman is likely to experience, the multi-dimensional aspect and intensity of which far exceeds disease conditions. A woman's lack of knowledge about the risks and benefits of the various methods of pain relief can heighten anxiety. Women are increasingly expected, and are expecting, to participate in decisions about their healthcare. Involvement should allow women to make better-informed decisions; the National Institute for Clinical Excellence has stated that we need effective ways of supporting pregnant women in making informed decisions during labour. Our aim was to systematically review the empirical literature on women's expectations and experiences of pain and pain relief during labour, as well as their involvement in the decision-making process. Methods A systematic review was conducted using the following databases: Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Bath Information and Database Service (BIDS), Excerpta Medica Database Guide (EMBASE), Midwives Information and Resource (MIDIRS), Sociological Abstracts and PsychINFO. Studies that examined experience and expectations of pain, and its relief in labour, were appraised and the findings were integrated into a systematic review. Results Appraisal revealed four key themes: the level and type of pain, pain relief, involvement in decision-making and control. Studies predominantly showed that women underestimated the pain they would experience. Women may hope for a labour free of pain relief, but many found that they needed or benefited from it. There is a distinction between women's desire for a drug-free labour and the expectation that they may need some sort of pain relief. Inaccurate or unrealistic expectations about pain may mean that women are not prepared appropriately for labour. Many women acknowledged that they wanted to participate in decision-making, but the degree of involvement varied. Women expected to take control in labour in a number of ways, but their degree of reported control was less than hoped for. Conclusion Women may have ideal hopes of what they would like to happen with respect to pain relief, control and engagement in decision-making, but experience is often very different from expectations. Antenatal educators need to ensure that pregnant women are appropriately prepared for what might actually happen to limit this expectation-experience gap and potentially support greater satisfaction with labour.
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                Author and article information

                Contributors
                00233-244719686 , aziatol@yahoo.com , laziato@ug.edu.gh
                angela_acheampong@yahoo.com , angela.acheampong@wiuc-ghana.edu.gh
                lazeeyuk@gmail.com
                Journal
                BMC Pregnancy Childbirth
                BMC Pregnancy Childbirth
                BMC Pregnancy and Childbirth
                BioMed Central (London )
                1471-2393
                22 February 2017
                22 February 2017
                2017
                : 17
                : 73
                Affiliations
                [1 ]ISNI 0000 0004 1937 1485, GRID grid.8652.9, Department of Adult Health, , School of Nursing, College of Health Sciences, University of Ghana, ; P.O. Box LG 43, Legon Accra, Ghana
                [2 ]GRID grid.442287.f, , School of Nursing, Wisconsin International University College, ; Accra, Ghana
                [3 ]ISNI 0000 0004 1937 1485, GRID grid.8652.9, Department of Adult Health, , School of Nursing, University of Ghana, ; Legon Accra, Ghana
                Author information
                http://orcid.org/0000-0002-7813-5525
                Article
                1248
                10.1186/s12884-017-1248-1
                5322618
                28228096
                f7871a86-baa3-4a18-95b9-19520c512cb3
                © The Author(s). 2017

                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.

                History
                : 6 January 2017
                : 8 February 2017
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/501100005601, University of Ghana;
                Award ID: URF/8/ILG-052/2014-2015
                Award Recipient :
                Categories
                Research Article
                Custom metadata
                © The Author(s) 2017

                Obstetrics & Gynecology
                ghana,labour pain,pain experience,pain,qualitative research
                Obstetrics & Gynecology
                ghana, labour pain, pain experience, pain, qualitative research

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