Department of Reproductive Health, School of Medicine, Moi University, Eldoret, Kenya.
PLoS One. 2024 Mar 7;19(3):e0299211. doi: 10.1371/journal.pone.0299211. eCollection 2024.
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 providers have an extensive role to play in meeting the analgesic needs of women during childbirth. This study sought to examine the practice of labour pain relief among Kenyan maternal health care providers.
This was an institution-based, cross-sectional, descriptive survey. The study included midwives, 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.
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 service of labour pain relief (61.5%). Sixty-four (88.9%) respondents reported providing pharmacological 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 respondents. 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.
More than half of maternal health care providers routinely relieve labour pain. Epidural analgesia is still relatively underutilized. There is a need to develop institutional labour pain management protocols to meet the analgesic needs of women during childbirth.
尽管缓解疼痛是现代产科护理的一个重要组成部分，但在肯尼亚等撒哈拉以南非洲国家，这仍然是一项尚未完善的服务。产妇保健提供者在满足分娩期间妇女的镇痛需求方面发挥着广泛的作用。本研究旨在调查肯尼亚产妇保健提供者的分娩镇痛实践。
这是一项基于机构的、横断面的、描述性调查。研究包括在肯尼亚第二大三级医疗机构工作的助产士、产科医生和麻醉师（n=120）。使用了结构化的自我管理问卷。描述了分娩疼痛缓解的实践、知识、态度以及对分娩疼痛管理的感知障碍。
117 名受访者参加了这项研究，应答率为 97.5%。超过一半的产妇保健提供者常规提供分娩疼痛缓解服务（61.5%）。64（88.9%）名受访者报告提供了药理学和非药理学方法，而 11.1%仅提供药理学方法。规定的最常见的药理学方法是非阿片类药物（12.8%）。最受欢迎的非药物性疼痛管理方法是触摸和按摩（93.8%）。有 3.4%的受访者提供区域镇痛。超过一半的受访者（53%）对分娩疼痛缓解方法的知识掌握较差。几乎所有（94%）的受访者对提供分娩疼痛缓解持积极态度。药物和设备的缺乏（58.1%）、缺乏明确的方案和指南（56.4%）以及缺乏足够的熟练人员（55.6%）被报告为阻碍提供分娩镇痛的卫生系统因素。
超过一半的产妇保健提供者常规缓解分娩疼痛。硬膜外镇痛仍相对未得到充分利用。有必要制定机构性分娩疼痛管理方案，以满足分娩期间妇女的镇痛需求。
