Women's perceptions of counselling on pain assessment and management during labour in Finland: A cross-sectional survey

Background: The challenge is to identify pain assessment counselling that are effective and reliable to the woman during labour while also supporting appropriate management of labour pain. Objective: This study aimed to describe women’s perceptions of their counselling on pain assessment and pain management during labour. Design: A descriptive, cross-sectional study. Participants: The sample consisted of women who had given birth (n=204) at a university hospital in Finland; 250 parturients were recruited by convenience sampling. Methods: Data were collected using a questionnaire (P-PAPM) between November 2018 and February 2019. The statistical significance of observed differences was analysed using the Chi-squared test and Fischer’s exact test. Results: Eighty percent of women reported that they had received counselling on pharmacological treatments from midwives, but only 33 % received counselling on pain assessment. The non-pharmacological methods for alleviating labour pain most commonly taught by midwives were proper breathing techniques, cold/heat treatments, and trying different positions and movements. Women were less commonly counselled to try listening to music, thinking about pleasant and positive things, or concentrating their thoughts on something other than pain. The two most commonly used counselling methods were demonstrations and written material and least used Internet-based resources. The personal issue that midwives discussed most frequently during counselling was the women’s individual hopes concerning pain management (91%), while the issue discussed least often was previous experiences of pain (58%). The participants’ experiences of fear, age, and education were significantly associated with aspects of counselling on pain assessment and management. Conclusions: Women’s counselling on pain assessment and management during labour varied widely. Therefore, to improve its quality, counselling should be routinely integrated into daily midwifery work. In particular, the counselling given on non-pharmacological pain relief methods during labour was inadequate. More varied counselling methods should be used in the future. Finally, the results indicate that midwives’ knowledge of counselling should be increased and they should be encouraged to routinely offer counselling on pain assessment and management for parturing women.