Labour pain relief practice by maternal health care providers at a tertiary facility in Kenya: An institution-based descriptive survey

Abstract

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.