Ingram Matilda A, Brady Susannah, Peacock Ann S
School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Australia.
School of Nursing and Midwifery, University of Newcastle, Newcastle, Australia.
Eur J Midwifery. 2022 Jun 10;6:37. doi: 10.18332/ejm/149244. eCollection 2022.
Many women use pharmacological or non-pharmacological pain management (NPPM) during childbirth, however, evidence shows the usage rates of pharmacological pain management are increasing. The shift towards a biomedical approach to birth care opposes the enduring midwifery philosophy of trusting the woman and her body. Identifying midwives' beliefs and attitudes towards perceived and actual barriers to offering NPPM as an initial option will provide insight into the factors that affect this.
This review of the literature sought to understand midwives' beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Peer-reviewed journals were searched for primary research that met the inclusion criteria and explored midwives' beliefs and attitudes towards the barriers to offering NPPM as an initial option for laboring women. Included studies were evaluated for quality according to the Critical Appraisal Skills Programme (CASP) checklists.
Thirteen qualitative studies met the inclusion criteria and four main themes of barriers to midwives offering NPPM emerged: health system-related, health facility-related, health practitioner-related, and health consumer-related barriers.
The review of the literature highlighted there are barriers that prevent or delay the initial utilization of non-pharmacological methods of pain management in labor by midwives. These findings can be used as a platform to inform further research into this topic.
许多女性在分娩期间会使用药物性或非药物性疼痛管理（NPPM），然而，有证据表明药物性疼痛管理的使用率正在上升。向生物医学分娩护理方法的转变与助产士信任女性及其身体的长期理念相悖。确定助产士对将NPPM作为初始选择的感知和实际障碍的信念和态度，将有助于深入了解影响这一情况的因素。
本文献综述旨在了解助产士对将NPPM作为分娩女性初始选择的障碍的信念和态度。在同行评审期刊中搜索符合纳入标准的原始研究，这些研究探讨了助产士对将NPPM作为分娩女性初始选择的障碍的信念和态度。根据批判性评估技能计划（CASP）清单对纳入研究的质量进行评估。
13项定性研究符合纳入标准，出现了助产士提供NPPM的四个主要障碍主题：与卫生系统相关、与医疗机构相关、与卫生从业者相关以及与卫生消费者相关的障碍。
文献综述强调存在一些障碍，阻碍或延迟了助产士在分娩中最初使用非药物性疼痛管理方法。这些发现可作为进一步研究该主题的平台。
