Midwives` experiences of using non-pharmacological methods of relieving labor pain

Uvod: Porodna bolečina je opredeljena kot akutna bolečina, ki je sestavni del poroda. Babica ima tekom celotnega poroda pomembno vlogo pri spopadanju porodnice s porodno bolečino, saj se ji mora v celoti posvetiti in ji znati svetovati o metodah lajšanja bolečine, ki so v danem trenutku primerne zanjo. S pogostejšo uporabo nefarmakoloških oziroma alternativnih načinov lajšanja bolečine lahko zmanjšamo uporabo analgezije, kar bi pomenilo nižje stroške in boljše rezultate z manj neželenimi učinki. Namen: Namen diplomske naloge je predstaviti nefarmakološke načine lajšanja porodne bolečine in raziskati izkušnje babic z uporabo nefarmakoloških načinov lajšanja porodne bolečine v Sloveniji. Metode dela: V prvem delu diplomske naloge je uporabljena deskriptivna metoda pregleda strokovne in znanstvene literature, ki je bila najdena preko svetovnih baz podatkov: PubMed, ScienceDirect, COBISS, Midwifery Research, Wiley Online Library in Cochrane Library. V drugem delu diplomske naloge je bila uporabljena kvalitativna metoda zbiranja podatkov, kjer so bili izpeljani polstruktuirani intervjuji z devetimi babicami iz treh slovenskih porodnišnic. Nato je bila izvedena transkripcija in analiza dobljenih rezultatov s pomočjo vsebinske analize. Rezultati: V kvalitativnem delu smo identificirali enajst kod, ki smo jih razporedili v naslednjih pet kategorij: subjektivni vidik, znanje in uporaba nefarmakoloških načinov lajšanja porodne bolečine, vpliv okolja, perspektiva žensk in izzivi babic. Babice so dobro izobražene na področju nefarmakoloških načinov lajšanja porodne bolečine in imajo veliko izkušenj z uporabo teh načinov. V prihodnje pa bi potrebovali več izobraževanj in praktičnega usposabljanja, da bi dobili izkušnje še z drugimi načini lajšanja porodne bolečine. Razprava in zaključek: Pri nefarmakološkem lajšanju porodne bolečine je zelo pomembna prisotnost babice v porodni sobi. Enako pomembna je tudi prisotnost partnerja ali osebe, ki je ženski zelo blizu, saj ji to omogoči večji občutek varnosti in posledično lažje sproščanje. Za uveljavitev pogostejše uporabe nefarmakoloških načinov lajšanja porodne bolečine bi bilo potrebno večje število raziskav s katerimi bi dobili poglobljen uvid v njihovo delovanje, ter posledično vključili nove metode nefarmakološkega lajšanja porodne bolečine v obporodno obravnavo žensk.Introduction: Labor pain is defined as acute pain that is a normal part of giving birth. The presence of a midwife during labor is very important. She is helping woman to cope with labor pain, as she must devote herself fully and know how to advise on the methods of pain relief that are appropriate for her at a given time. Frequent use of non-pharmacological or alternative methods of relieving labor pain can reduce the use of analgesia, which means lower costs and better results with less side effects. Purpose: The purpose of the diploma thesis is to present non-pharmacological methods of relieving labor pain and to investigate the experience of midwives using non-pharmacological methods of relieving labor pain in Slovenia. Methods: The first part of the thesis uses a descriptive method of reviewing professional and scientific literature, which was found through global databases: PubMed, ScienceDirect, COBISS, Midwifery Research, Wiley Online Library and Cochrane Library. In the second part of the diploma thesis, a qualitative method of data collection was used, where semi-structured interviews with nine midwives from three Slovenian maternity hospitals were conducted. Transcription and analysis of the obtained results were then performed with the help of content analysis. Results: In the qualitative part, we identified eleven codes, which were divided into the folowing five categories: subjective aspect, knowledge and use of non-pharmacological methods of relieving labor pain, environmental impact, women`s perspective and midwifery challenges. Midwives are well educated in non-pharmacological methods of relieving labor pain and have extensive experience in using these methods. In the future, however, more education and practical training would be needed to gain experience with other ways of relieving labor pain. Discussion and conclusion: The presence of a midwife in the labor room is very important in the non-pharmacological relief of labor pains. Equally important is the presence of a partner or person who is very close to the woman, as this gives her a greater sense of security and consequently easier relaxation. In order to introduce more frequent use of non-pharmacological methods of relieving labor pain, a larger number of studies would be needed to gain in-depth insight into their impact, and consequently include new methods of non-pharmacological pain relief in perinatal care of women