Abstract:
Background: Although pain relief is a key component of modern obstetric care, it remains a poorly
established service in sub-Saharan countries such as Kenya. Maternal health care providers have an
extensive role to play in meeting the analgesic needs of women during childbirth. The study sought to
examine the practice of labour pain relief and its deterrents among Kenyan maternal health care
providers.
Methods: This was an institutional based, cross-sectional descriptive survey. The study population
included midwives, obstetricians and anaesthesiologists working at the second largest referral hospital in
Kenya. A structured, self-admininisterd questionnaire was used. The pattern of provision of labour
analgesics, knowledge, attitude and perceived barriers to labour pain management was described.
Results: One hundred and seventeen respondents participated in the study with a response rate of 97.5%.
The prevalence of routine labor analgesia provision was 61.5%. The commonest pharmacological
method prescribed was nonopioids (13.4 %). Regional analgesia was provided by 4(3.6%) of the
respondents. Majority of maternal healthcare providers (53.0%) had poor knowledge of labour pain
management. Almost all (93.9%) of the respondents had a positive attitude towards the provision of
labour analgesia. Non-availability of drugs and equipment (58.1%), lack of clear protocols and guidelines
(56.4%) and absence of adequate skilled personnel (55.6%) were reported as the health system factors
that hinder the provision of labour analgesia.
Conclusions: More than half of maternal health care providers routinely relieve labour pain; gender, cadre,
and years of experience are significantly associated with routine provision of labour analgesia. Epidural
analgesia is still quite underutilized. There is a need for development of institutional labour pain
management protocols to meet the analgesic needs of women during childbirth.
