Neonatal pain assessment practices in the maternity ward (delivery room and postpartum ward): We can improve!

Almost 20% of neonates experience pain during delivery or the period following birth.

To describe the practices of pain assessment in the maternity wards in the greater Paris area, France.

An e-mail questionnaire was sent to each practitioner in the 96 maternity units in Île de France between December 2013 and February 2014.

In all, 63 (65%) questionnaires were completed. Pain was assessed in 43 (68%) maternity units, mostly using the French scale "échelle de douleur et d'inconfort du nouveau-né" (EDIN). In total, 20 maternity units (32%) reported no pain assessment, mainly because they considered it to be too time-consuming, or because they argued that no pain scale was adequate; they relied on clinical signs or on the obstetric history for assessing and treating pain. About 40% of the maternity units using the EDIN scale judged it unsuitable for evaluating pain in term neonates in maternity units.

This first regional study on pain assessment in the maternity ward showed that nearly two thirds of centers assessed pain. This rate may be overestimated because of the reporting method used. The EDIN scale is the most widely used tool but seems unsuitable especially for the delivery room setting. Studies should be conducted to test other tools for assessing neonatal pain in the delivery room.