Prevalence of prescription and effectiveness of analgesia for treating vaginal delivery pain.
Juan Ignacio Calcagno, Sarah Iribarren, Cristiane Flora Villarreal and 2 others
PMID 39607194WHAT IT FOUND
Severe labor pain fell after non-drug methods, and massage was linked to relief.
Drug analgesia was prescribed to only 18.10% of patients and was often delayed, while analgesia requests were sometimes refused.
Key findings
01After non-drug analgesia, severe pain decreased significantly in both the midwife-led unit and the obstetric center.
02Massage was the only non-drug method independently associated with less severe pain.
03Pharmacological analgesia was prescribed to only 18.10% of patients, with mean delay 11.65 hours, and 42.85% of midwife-unit requests were refused.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
This was a single-site, convenience-sample observational study, so it cannot prove that any analgesic method caused the observed pain reduction. Pain and fear were recalled after childbirth, although interviews were done within 24 hours. The study did not measure women's prior knowledge, beliefs, preferences, anxiety, depression, or other mental health problems. The study did not measure healthcare professionals' beliefs, knowledge, concerns, or staffing levels and overcrowding. Pharmacological analgesia was given to a small number of patients, and adverse events and safety were not systematically recorded. The supplied text gives inconsistent pharmacological analgesia prescription counts, with one sentence reporting 18.10% and another reporting 34 patients (15.85%). Women were low-risk or intermediate-risk and had vaginal deliveries, so results may not apply to high-risk pregnancies or cesarean births. The midwife-led unit did not prescribe drug analgesia, and no transfer was recorded despite requests, so the comparison between units is not a controlled treatment comparison.
The easy way to misread this
Do not read the non-significant change in severe pain after pharmacological analgesia as proof it does not work. Only 18.10% of patients were prescribed it, and the authors say the null result may be due to low numbers.