Satisfaction in childbirth and perceptions of personal control in pain relief during labour.

Satisfaction in childbirth is influenced by individual and environmental factors. Of specific interest in this study is the extent to which women feel that they have been able to control what happened to them during labour. The main purpose of this study was to examine the influence of personal control on women's satisfaction with pain relief during labour. A questionnaire-based retrospective study of women's pain experiences within 48 hours of delivery was carried out on the postnatal ward of one teaching hospital in Northern Ireland. One hundred women who had had a vaginal delivery consented to take part in the study. Two main measures were used in the study; personal control in and satisfaction with pain relief during labour. The key finding of this study indicates that feelings of personal control influenced positively the women's satisfaction with pain relief during labour. Demographic and other psycho-social variables had little impact on the women's satisfaction scores. These findings have implications for clinical practice and for the management of maternity services and are discussed.

Differences in midwives' approaches to pain relief in labour.

OBJECTIVE: To examine the influence of midwives' approaches on the care given to women for pain relief during labour. DESIGN: Non-participant observation was used to collect data on midwives' behaviours during interactions with women in labour. SETTING: A large teaching hospital in Northern Ireland. PARTICIPANTS: Observations focused on interactions that were related to pain relief and involved 11 midwives caring for 15 women throughout the first stage of labour. KEY FINDINGS: Midwives' approaches to pain relief differed; at one extreme the midwife acted as 'a cold professional' whilst at the other extreme she was observed to be 'a disorganised carer'. In the middle of these two extremes was the 'warm professional'; her approach had a positive influence on the women's experience of labour pain. IMPLICATION FOR RESEARCH: Further research is needed to develop a profile of the factors that 'make' for a warm professional. The information gained could be used to teach midwives the skills of being 'a warm professional', in particular, the value of effective communication for sensitive care such as pain relief in labour.