Abstract:
Background
Although pain relief is a crucial component of modern obstetric care, it remains a poorly
established service in sub-Saharan countries such as Kenya. Maternal health care provid-
ers have an extensive role to play in meeting the analgesic needs of women during child-
birth. This study sought to examine the practice of labour pain relief among Kenyan
maternal health care providers.
Methods
This was an institution-based, cross-sectional, descriptive survey. The study included mid-
wives, obstetricians, and anaesthesiologists (n = 120) working at the second-largest tertiary
facility in Kenya. A structured, self-administered questionnaire was used. The labour pain
relief practice, knowledge, attitude, and perceived barriers to labour pain management were
described.
Results
One hundred and seventeen respondents participated in the study representing a response
rate of 97.5%. More than half of maternal health care providers routinely provided the ser-
vice of labour pain relief (61.5%). Sixty-four (88.9%) respondents reported providing phar-
macological and non-pharmacological methods, while 11.1% provided only
pharmacological ones. The most common pharmacological method prescribed was non-
opioids (12.8%). The most preferred non-pharmacological method of pain management
was touch and massage (93.8%). Regional analgesia was provided by 3.4% of the respon-
dents. More than half of the respondents (53%) had poor knowledge of labour pain relief
methods. Almost all (94%) of the respondents had a positive attitude towards providing
labour pain relief. 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. Epidural anal-
gesia is still relatively underutilized. There is a need to develop institutional labour pain man-
agement protocols to meet the analgesic needs of women during childbirth.