Labor Analgesia in South West Nigeria: Methods and Self-reported Effectiveness

Labor exposes many women to severe pain. Effective labor pain management is one of the prerequisites for a satisfying labor experience.

The aim of this study was to assess the labor pain management practices and patients' assessment of adequacy of pain relief in two tertiary hospitals in South West Nigeria.

This was a cross-sectional study involving 132 pregnant women who had a noninstrumental vaginal delivery at the obstetric units of Babcock University Teaching Hospital and Olabisi Onabanjo University Teaching Hospital, between December 2017 and May 2018. A structured questionnaire was administered to women within 24 h of delivery to record details of labor and delivery, the form of labor analgesia administered and respondents' perceived effectiveness of the analgesia. Data were analyzed using the IBM-SPSS statistics for Windows version 21.0 (IBM, Armonk, New York).

Sixty-six (50%) women rated labor pain to be severe. Thirty-eight women (28.8%) did not receive any pain relief during labor. Nonpharmacological pain management practices such as back massage, breathing exercises, and companionship were administered to 45(34.1%), 79(59.8%), and 45(34.1%) women, respectively. Nine women (6.8%) received intramuscular pentazocine (30 mg) for labor analgesia. There was a statistically significant association between use of back massage and severe labor pain perception (χ ² = 4.080; P = 0.043). Self-reported effectiveness was highest among users of back massage (82.2%) and companionship (77.8%).

There is a large unmet need for labor analgesia in South West Nigeria. Nonpharmacological pain management practices were the most frequently used methods, and most patients experienced reduction in severity of pain. There is need for improvements in obstetric analgesia services in our maternity units.