This is the process where the midwife minimizes the degree of pain in labour through pharmacological and non-pharmacological approach or both. Methods employ include deep breathing exercises, positioning, sacral massage and psychological care to the client.
Aims
· Provide maximum relief of pain
· Allow labour to progress rapidly
· Ensure a positive experience of labour
· Improves birth experience of mother
· Help the woman maintain control
Types
· Pharmacological
· Non pharmacological
· Combined method
Requirements
· Conducive environment
· Companion of choice
· Pain assessment chart
· Prescribed medication
Steps
1. Establish rapport (refer to steps)
2. Sit near client’s bed and engage her in conversation in a calm manner
3. Involve companion in the management
4. Assess the degree of pain, location, quality intensity, duration and factors that decrease or increase the pain (with a pain assessment chart)
5. Ensure a conducive environment to enhance rest (open windows) and relaxation
6. Introduce the available methods of relieving pain to client and companion
7. Assist client make an informed decision on available methods of pain relief
8. Educate and encourage client to adapt to preferred positions in bed
9. Encourage the companion to give sacral massage with every contraction
10. Encourage companion to engage client in conversation of her interest
11. Introduce client to deep breathing exercises during contractions intermittently
12. Ask client her preferred music and play as such
13. Encourage client to take in cool nourishing fluids if tolerated
14. Assess maternal and foetal condition according to the Labour Chart Guide
15. Assess the degree of dilatation
16. Administer prescribed medications when all non-pharmacological methods fail
17. Monitor client and foetus to rule out any abnormalities
18. Call Obstetrician in-charge if all measures fail and client is in intense pain
19. Record all strategies and management in the Maternal and Child Health Record Book
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