Comparing models: Nonparmacological Approaches to management of labor pain

This week, we are learning about the midwifery approach to labour pain, and the methods with which we as midwives address it. I found this a nice summary of the difference between the two models of care for pregnant women from the 2013 Simkin and Bolding article:

The management of labor pain is a major goal of intrapartum care. There are two general approaches: pharmacologic and nonpharmacologic. Pharmacologic approaches are directed at eliminating the physical sensation of labor pain, whereas nonpharmacologic approaches are largely directed at prevention of suffering. Suffering may be defined in terms of any of the following psychological elements: a perceived threat to the body and/or psyche; helplessness and loss of control; distress; insufficient resources for coping with the distressing situation; fear of death of the mother or baby [1]. Although pain and suffering often occur together, one may suffer without pain or have pain without suffering.

Most women use nonpharmacologic approaches for managing labor pain, with or without pharmacologic approaches [2]. The nonpharmacologic approach to pain management includes a wide variety of techniques that address not only the physical sensations of pain, but also attempt to prevent suffering by enhancing the psycho-emotional and spiritual components of care. In this approach, pain is perceived as a normal accompaniment of most labors. The woman is educated and assisted by her caregivers, childbirth educators, and support people to take an active role in decision-making and in using self-comforting techniques and nonpharmacologic methods to relieve pain. Her caregivers and support people also help her by providing reassurance, guidance, encouragement, and unconditional acceptance of her coping style. By taking an active role in decision-making and receiving appropriate support, women are more likely to be able to transcend their pain and experience a sense of mastery, control, and well-being, factors associated with their ability to cope with labor [1].

I started this blog to post more about midwifery, both to document my journey of becoming a midwife but also to highlight some of the main tenants of the care I will be delivering.

Hope you end up loving the profession as much as I already do 🙂 Next up: different means of approaching nonpharmalogical labour pain reduction.



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