1.1 Introduction
Childbirth is the physiological process through which a fetus, placenta, and membranes are expelled from the uterus at the end of pregnancy. It is a significant event in a woman's reproductive life and is commonly accompanied by pain of varying intensity resulting from uterine contractions, cervical dilatation, and fetal descent through the birth canal (World Health Organization [WHO], 2018). Labour pain is considered one of the most severe forms of pain experienced by women and differs according to individual pain threshold, emotional state, parity, labour progress, and cultural beliefs. Effective management of labour pain is therefore an essential component of quality maternal healthcare because it enhances maternal comfort, promotes positive childbirth experiences, and improves maternal satisfaction (American College of Obstetricians and Gynecologists [ACOG], 2019).
As a prelude to other parts of this study, this chapter will discuss the background upon which this study was initiated, the statement of problems that led to this study, the aim and objectives of the study. Others are significance of the study, scope of work, research hypothesis and questions, limitation of the study and definition of terms.
1.2 Background of Study
Historically, non-pharmacological techniques for pain relief during childbirth dates back to ancient civilizations, where women relied on natural methods to cope with labour pain before the development of modern medical interventions. According to Simkin and Bolding (2004), traditional childbirth practices commonly involved breathing exercises, massage, upright positioning, movement, herbal remedies, and emotional support from experienced birth attendants. World Health Organization (WHO, 2018) reported that, childbirth is a natural physiological process that is often accompanied by pain arising from uterine contractions, cervical dilatation, and the descent of the fetus through the birth canal. Labour pain is a multidimensional experience influenced by physical, psychological, emotional, social, and cultural factors.
Lowe (2002) asserted that unmanaged labour pain may increase maternal stress hormones, reduce effective uterine contractions, and negatively influence the progress of labour. Furthermore, the American College of Obstetricians and Gynecologists (ACOG, 2019) stated that appropriate pain management should not only focus on relieving discomfort but should also support women's autonomy, informed decision-making, and emotional well-being throughout the childbirth process.
According to WHO (2018), pain relief during childbirth may be achieved through pharmacological and non-pharmacological approaches. Pharmacological methods involve the administration of medications such as epidural analgesia, opioids, and inhalational analgesics to reduce the perception of pain. Similarly, ACOG (2019) reported that although pharmacological interventions provide substantial pain relief, they should be offered alongside other evidence-based options that enable women to actively participate in decisions regarding their labour and delivery.
Hodnett et al. (2013) reported that women who receive consistent support from trained birth companions or healthcare providers experience greater satisfaction with childbirth, shorter labour duration, reduced need for medical interventions, and lower rates of operative delivery. Supporting this position, Bohren et al. (2017) stated that respectful maternity care combined with supportive non-pharmacological interventions contributes significantly to positive birth experiences and improved maternal outcomes.
Lally et al. (2014) asserted that adequate knowledge enables pregnant women to make informed choices, develop realistic expectations of labour, and prepare psychologically for childbirth. Additionally, Whitburn et al. (2017) reported that women who possess adequate knowledge of non-pharmacological pain relief methods are more confident during labour and are more likely to utilize these techniques effectively when compared with women who receive little or no antenatal education.
Pinar et al. (2018) contended that awareness serves as the first step toward utilization because pregnant women cannot make informed decisions about interventions they have never heard about. Correspondingly, Adams et al. (2015) stated that increasing awareness through structured maternal education improves women's confidence, reduces fear of childbirth, and promotes greater acceptance of evidence-based labour pain management strategies.
WHO (2022) reported that comprehensive antenatal counselling should include information on both pharmacological and non-pharmacological methods of pain relief to enable women to make informed choices during childbirth. In the same vein, Taheri et al. (2020) affirmed that health education delivered during routine antenatal visits significantly improves pregnant women's knowledge and acceptance of non-pharmacological pain management techniques. This study is set against the backdrop of the need to evaluate the knowledge and awareness of pregnant women on non-pharmacological techniques for pain relief during childbirth.
1.3 Statement of Problems
Investigation revealed that labour pain remains one of the most challenging experiences encountered by women during childbirth, yet many pregnant women enter labour with inadequate knowledge of the available non-pharmacological techniques that can safely relieve pain and improve their childbirth experience. Although international maternal health guidelines recommend the use of evidence-based non-pharmacological pain relief methods alongside respectful maternity care, awareness and utilization of these approaches remain low in many healthcare settings, particularly in developing countries where antenatal education is often inadequate (WHO, 2022).
Studies have shown that a significant proportion of pregnant women are familiar with pharmacological methods of pain relief but possess limited knowledge of alternatives such as breathing exercises, massage, labour positioning, hydrotherapy, relaxation techniques, and continuous labour support (Smith et al., 2018).
Furthermore, many women depend solely on pharmacological interventions or endure severe pain without utilizing simple, safe, and effective coping strategies that could enhance their labour experience and maternal satisfaction (ACOG, 2019). It is against this backdrop that this study seeks to assess the knowledge and awareness of pregnant women on non-pharmacological techniques for pain relief during childbirth.
1.4 Aim and Objectives of Study
The aim of this study is to assess the knowledge and awareness of pregnant women on non-pharmacological techniques for pain relief during childbirth. In achieving this aim, the following specific objectives were laid out as follows to:
- Assess the level of knowledge of pregnant women on non-pharmacological techniques for pain relief during childbirth.
- Determine the level of awareness of non-pharmacological pain relief techniques among pregnant women.
- Identify the sources of information through which pregnant women learn about non-pharmacological pain relief techniques.
- Determine the factors influencing the knowledge and awareness of pregnant women regarding non-pharmacological pain relief techniques.
- Examine the relationship between knowledge and the awareness of non-pharmacological techniques for pain relief during childbirth.
1.5 Research Questions
The study came up with research questions so as to be able to ascertain the above stated objectives. The specific research questions for the study are stated below as follows:
- What is the level of knowledge of pregnant women on non-pharmacological techniques for pain relief during childbirth?
- What is the level of awareness of non-pharmacological pain relief techniques among pregnant women?
- What are the sources of information through which pregnant women learn about non-pharmacological pain relief techniques?
- What factors influence the knowledge and awareness of pregnant women regarding non-pharmacological pain relief techniques?
- What relationship exists between knowledge and awareness of non-pharmacological techniques for pain relief during childbirth?
1.6 Research Hypotheses
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between the level of knowledge of pregnant women and their awareness of non-pharmacological techniques for pain relief during childbirth.
- H1: There is a significant relationship between the level of knowledge of pregnant women and their awareness of non-pharmacological techniques for pain relief during childbirth.
Hypothesis Two
- H0: There is no significant relationship between the sources of information available to pregnant women and their awareness of non-pharmacological pain relief techniques.
- H1: There is a significant relationship between the sources of information available to pregnant women and their awareness of non-pharmacological pain relief techniques.
Hypothesis Three
- H0: There is no significant relationship between the factors influencing pregnant women and their knowledge of non-pharmacological pain relief techniques.
- H1: There is a significant relationship between the factors influencing pregnant women and their knowledge of non-pharmacological pain relief techniques.
Hypothesis Four
- H0: There is no significant relationship between pregnant women's awareness and the utilization of non-pharmacological pain relief techniques during childbirth.
- H1: There is a significant relationship between pregnant women's awareness and the utilization of non-pharmacological pain relief techniques during childbirth.
Hypothesis Five
- H0: There is no significant difference in the knowledge of non-pharmacological pain relief techniques among pregnant women based on selected socio-demographic characteristics.
- H1: There is a significant difference in the knowledge of non-pharmacological pain relief techniques among pregnant women based on selected socio-demographic characteristics.
1.7 Significance of Study
It is believed that at the completion of the study, this research will provide pregnant women with correct information about non-pharmacological techniques that can help reduce labour pain safely. The research will also assist healthcare workers in improving the quality of antenatal health education on labour pain management.
Furthermore, this research will provide hospitals with evidence needed to strengthen maternal education programmes. It will also support government and health agencies in planning programmes that improve maternal healthcare services.
Lastly, this research will serve as useful reference material for students and future researchers interested in maternal health.
1.8 Scope of Study
The scope of the research is focused on the knowledge and awareness of pregnant women on non-pharmacological techniques for pain relief during childbirth. The study covers pregnant women attending antenatal clinics at University of Benin Teaching Hospital (UBTH), Edo State, Nigeria.
1.9 Limitations of the study
During the course of this study, there were some problems encountered which stood as limitations to the research work. Some of the limitations include:
- Access to some respondents was difficult because many attended antenatal clinics on different appointment days.
- Some participants was reluctant to provide complete responses, while the researcher was restricted to the selected health facility and study period, which affected the coverage of the research.
1.10 Definition of Terms
Knowledge:
Knowledge refers to the understanding, information, and facts that pregnant women possess regarding non-pharmacological techniques for pain relief during childbirth. According to Lally et al. (2014), adequate knowledge enables women to make informed decisions and prepare effectively for labour.
Awareness:
Awareness is the state of being informed about the existence, availability, and usefulness of non-pharmacological pain relief techniques during childbirth. According to Pinar et al. (2018), awareness is the first step that encourages women to seek further information and utilize appropriate pain relief methods.
Pregnant Women:
Pregnant women are females carrying a developing fetus from conception until childbirth. According to the World Health Organization (2022), pregnancy is a normal physiological condition requiring appropriate maternal healthcare to ensure the well-being of both mother and baby.
Non-Pharmacological Techniques:
Non-pharmacological techniques are drug-free methods used to reduce labour pain and improve maternal comfort during childbirth. According to Smith et al. (2018), these techniques include breathing exercises, massage, relaxation, movement, hydrotherapy, music therapy, and emotional support.
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