Women's Perceptions of Pain and Discomfort after Childbirth in Angola

Elisabeth Jangsten, Roland Strand, Engrácia da Glória Gomez de Freitas, Anna-Lena Hellström, Annika Johansson, Staffan Bergström

Abstract

Prophylactic treatment against postpartum haemorrhage is a widely investigated area and injection of Oxytocics has been considered as the best choice. The occurrence of postpartum pain and discomfort was studied in a population of birthing women in an overcrowded labour ward in Angola where the oxytocin-filled device UnijectTM was used. This study indicates that birthing women's perceived postpartum pain increases with parity and during breastfeeding, but does not confirm that injection of oxytocin increases pain and discomfort. This is an important finding, since it might facilitate the introduction of a management practice, likely to reduce haemorrhage-related maternal morbidity and mortality after delivery in underprivileged populations. The birthing women were, by and large, satisfied with the care and treatment provided, but the encounters with midwives seem to vary in quality. Further investigation is needed to elucidate parturient women's experience of postpartum pain and their perceptions of the quality of care and treatment. (Afr J Reprod Health 2005; 9[3]:148-158) 

 

Keywords: Postpartum haemorrhage, third stage of labour, labour pain, satisfaction with care

Full Text:

PDF

References

McCormick M L, Sanghvi H C G, Kinzie B, McIntosh N. Preventing postpartum haemorrhage in low-resource settings. Int J GynecolObstet 2002; 77: 267-75.

WHO/MCH Safe Motherhood. The Prevention and Management of Postpartum Haemorrhage. Report from a technical working group, Geneva: 1989, 9.

Akins S. Postpartum hemorrhage. A 90s approach to an Age-Old problem. J Nurse Midwifery 1994; 39(2): 123-34.

Prendiville W, Elbourne D, Chalmers I. The effects of routine oxytocic administration in the management of the third stage of labour: an overview of the evidence from Controlled Trials. Br J ObstGyn 1988; 95: 3-1.

Nordström L, Fogelstam K. Routine Oxytocin in the Third Stage of Labour: A Placebo Controlled Randomised Trial. Br J ObstGyn 1997;104: 781-86.

WHO/FRH/MSM- Care in Normal Birth: a practical guide. WHO / FRH / MSM / 96.24.

Enkin M, Keirse M J N C, Renfrew M, Neilson J. Third stage of labour. In: Enkin M (Ed). A Guide to: Effective Care in Pregnancy and Childbirth. 2nd ed. New York: Oxford University press, 1995, 236-42 8. Frid G. Labour pain.[Dissertation]. Gothenburg, Sweden: University of Gothenburg 1988. 35 pp.

Melzack R. Labour pain as a model of acute pain. Pain 1993; 53: 117-20.

Gaston Johansson F, Measurement of Pain: The psychometric properties of the Pain- O-Meter, a simple inexpensive pain assessment tool that could change health care practices. J Pain symptom manage; 1996; 12: 172-81.

Niven C, Murphy-Black T. Memory for labour pain: A review of the literature. Birth 2000; 27: 4, 244-55.

Murray A, Holdcroft A. Incidence and intensity of postpartum lower abdominal pain. BMJ 1989; l: 298.

Ministério de Saúde. Coordenacão do AtendimentoObstétrico de Luanda. Estatística annual de SaúdeMaternaInstitucional 2003. CAOL, Luanda, 2004.

Tsu VD, Sutanto A, Vaidya K, Coffey P. Widjaya A. Oxytocin in prefilled UnijectTM injection devices for managing third stage labor in Indonesia. International Journal of Gynecology and Obstetrics 2003; 83:103-11.

Strand R, Da Silva F, Jangsten E, Bergström S. A new disposable device for oxytocin administration in active management of the third stage of labour: a prospective comparative study in Angola. ActaObstetriciaetGynecologicaScandinavica, in press.

Downe-Wamboldt B. Content analysis: Method, applications, and issues. Health care for Women international 1992;

:313-21.

Campell M J Machin D. Medical Statistics. A Commonsense Approach.2nd ed. Oxford John Wiley & Sons Ltd., 1993: 143.

Holdcroft A, Snidvongs S, Cason A, Doré C J, Berkley K J. Pain and uterine contractions during breastfeeding in the immediate postpartum period increase with parity. Pain 2003; 104: 589-96.

Turner Norvell K, Gaston-Johansson F, Fridh G. Remembrance of labour pain. How valid are retrospective pain measurements? Elsevier Science Publishers B.V 1987; 31:77.

Weisenberg M, Caspi Z Cultural and Educational Influences on pain of childbirth. J Pain Sympt Man 1989; 41: 13-19.

Rofé Y, Algom D Accuracy of remembering post delivery pain. Perceptual and Motor skills 1985; 60: 99-5.

Fitzpatrick R Surveys of patient's satisfaction: Important general considerations. BMJ 1991; 302: 887-89.

Bernardt M H, Wiadnyana I G P, Wihardjo H, Pohan I. Patient satisfaction in developing countries Soc. Sci. Med. 1999; 48:

-96.

Maimbolwa C, Ransjö-Arvidson A-B, Ngándu N, Sikazwe N, Diwan V. Routine care of women experiencing normal deliveries in Zambian maternity wards: a pilot study. Midwifery 1997; 13: 125-31.

Amooti-Kaguna B, Nuwaha F. Factor's influencing choice of delivery sites in Rakai district of Uganda. SocSci Med. 2000;

: 203-13.

Berg M, Lundgren I, Hermansson E, Wahlberg V. Women's experience of the encounter with the midwife during childbirth. Midwifery 1996; 12: 11-15.

Hunter LP. Being with woman: A guiding concept for the care of labouring women. JOGNN 2002; 31:6, 555-62.

Refbacks

  • There are currently no refbacks.