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Women's perceptions of the pain assessment and non-pharmacological pain relief methods used during labor: A cross-sectional survey

Authors: Rantala Arja, Hakala Mervi, Pölkki TarjaJournal: European journal of midwiferyPublished: January 1, 2022DOI: 10.18332/ejm/146136
Q1 JournalSJR: 1h-index: 87SCImago
Limited EvidenceCross Sectionaln=204 participants

In Plain Language: pregnancy, explained

The use of non-pharmacological pain relief methods and pain assessment scales during labor has received limited research attention. This study aimed to describe women's perceptions of the pain assessment and non-pharmacological pain relief methods used during labor. A descriptive, cross-sectional survey was conducted. A convenience sample of women (n=204) from one Finnish maternity ward participated in the study. Women who had given birth were asked to respond to a validated questionnaire between November 2018 and February 2019. The statistical significance of observed differences was analyzed using the chi-squared test. Less than half (46%) of the women who gave birth at the hospital were asked to assess the intensity of their pain on a pain assessment scale. The most commonly used non-pharmacological pain relief methods were encouragement (92%), the presence of a midwife (82%), and proper breathing technique that was taught by a midwife (81%). Aqua blisters (3%), reflexology (e.g. zone magnets, 5%), and music (9%) were the least commonly used non-pharmacological methods during labor. The participants' experiences of fear and pain were significantly associated with the implementation of pain assessment. Women's pain was rarely evaluated by using a certain pain assessment scale. In addition, non-pharmacological pain relief methods were inadequately used during labor. More specifically, methods that required midwives' own personal contributions were rarely offered to the women.

Key Findings: what this cross-sectional study found about pregnancy

  • ✓Less than half (46%) of women who gave birth at the hospital were asked to assess their pain intensity on a pain assessment scale.
  • ✓The most commonly used non-pharmacological pain relief methods during labor were encouragement (92%), the presence of a midwife (82%), and proper breathing technique taught by a midwife (81%).
  • ✓Reflexology was among the least commonly used non-pharmacological pain relief methods during labor, with only 3% utilization rate.

What This Means for You

If you're considering reflexology for labor pain, be aware this small survey found it was rarely used during labor (only 5% of cases), so it may not be readily available at all hospitals and evidence for its use during childbirth remains limited.

What This Means for Practitioners

Reflexology and other hands-on non-pharmacological methods represent an underutilized opportunity in labor care, as this research suggests midwives tend to rely on lower-effort interventions despite women's potential receptiveness to additional pain relief options.

Study Design: how this cross-sectional study was run

Sample Size
204 participants
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Pregnancy: common questions

What does this study say about pregnancy?

If you're considering reflexology for labor pain, be aware this small survey found it was rarely used during labor (only 5% of cases), so it may not be readily available at all hospitals and evidence for its use during childbirth remains limited.

What did this study find?

Less than half (46%) of women who gave birth at the hospital were asked to assess their pain intensity on a pain assessment scale. The most commonly used non-pharmacological pain relief methods during labor were encouragement (92%), the presence of a midwife (82%), and proper breathing technique taught by a midwife (81%). Reflexology was among the least commonly used non-pharmacological pain relief methods during labor, with only 3% utilization rate.

How strong is this evidence?

This is a cross-sectional study and we rate its evidence limited. It covers 204 participants. It was published in European journal of midwifery, a Q1 journal. This study is indexed here for context; it did not test reflexology itself.

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