Non-pharmacological pain management strategies for labour: Maintaining a physiological outlook
Negotiating the pain and discomfort of labour can be challenging for women, their partners and the midwives attending their births. In current midwifery practice, there are a number of women who express a desire to experience the whole range of sensations accompanying physiological birth without the use of pharmacological agents while retaining a sense of control and dignity. Guidance is available around non-pharmalogical strategies for pain management in labour. Midwives can use the philosophy of normality to thoughtfully support and guide women and their partners, helping them to choose strategies that work with the underlying physiology of pain while enabling women to feel empowered in their birth experience.
Labour pain is complex and multifaceted, existing within an individual perception and context, and arising from individual physiology, psychology and cultural perspectives. Notions of ‘normal labour’ differ depending on cultural background, spiritual practice and a woman's phenomenological experiences (Karlsdottir et al, 2014). The International Association for the Study of Pain (IASP, 2014) defines pain as ‘an unpleasant sensory and emotional experience associated with actual or potential tissue damage’—a distinction from the physiological normal role of pain in a birthing context, which may be challenging for both women's perception and midwifery facilitation (Sanders, 2015). The National Institute for Health and Care Excellence (NICE, 2016) prompts practitioners to reflect on how midwives’ ideologies and beliefs influence how women are supported to handle the experience of labour discomfort (Nursing and Midwifery Council (NMC), 2015; Leap and Hunter, 2016). This article focuses on midwives' capacity, through understanding non-pharmacological strategies, to facilitate practice based on ‘working with pain’ (Leap, 1997) rather than ‘pain relief’.
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