1. Lesotho midwives’ utilization of non-pharmacologic pain management methods during the first stage of labor Presenter: M. M. Moru (MRS) Date: 14 th March, 3013

2. CONTENT  Introduction  Problem statement  Aim and objectives  Methodology: -Design -Sample size -Data collection instrument -Data analysis method

3. CONTENT CONT.  Results and discussion  Limitations  Recommendations  Conclusions

4. INTRODUCTION Non-pharmacologic methods of pain management represent a wide repertoire of interventions that can be used during labor by a woman, her support person, and in most cases, independently by the midwife to control pain without harm to a woman, fetus or labor progress.

5. INTRODUCTION CONT. This descriptive study facilitated identification of inadequacies in the utilization of non- pharmacologic pain management methods by midwives in Lesotho. Recommendations to maximize the use of these methods were also made.

6. PROBLEM STATEMENT Non-pharmacologic pain management methods have been woefully neglected by midwives. There is scarcity of literature dealing with the use of these methods.

7. AIM AND OBJECTIVES AIM To determine the use of non-pharmacologic pain management methods by midwives during the first stage of labor.

8. OBJECTIVES To identify the non-pharmacologic methods of pain management used by midwives during the first stage of labor. To identify the factors that influence the use of these methods. To make recommendations of maximizing the use of these methods.

9. METHODOLOGY  Design: A descriptive, non-experimental, quantitative research design.  Data collection instrument: A structured questionnaire.  Sample size: sixty eight (68) (Response rate 79%)  Data analysis: Descriptive statistics on a nominal level.

10. RESULTS AND DISCUSSION Midwives inadequately use Non-pharmacologic methods of pain management during the first stage of labor *Breathing techniques e.g. panting * Comfort majors: -Back rubbing/massage - Sponging - Mental Stimulation Technique *Allow women to scream

11. RESULTS AND DISCUSSION Cont. Several factors that influence the use of these methods by midwives were identified, including: *shortage of staff, e.g. Midwife-mother ratio * lack of privacy and space, * Lack of hospital policies, *inadequate knowledge, * and fragmentation of care.

12. LIMITATIONS Lack of Triangulation -Method -Data source Biasness due to Convenience Sampling method

13. RECOMMENDATIONS Midwives should keep abreast with new developments e.g. refresher courses Formulation of policies to maximize the use of non-pharmacologic interventions Modification of labor wards Strengthen support system from all stake holders Further research

14. CONCLUSION Midwives inadequately use the non- pharmacologic methods of pain management during the first stage due to various factors. Recommendations of maximizing the use of these methods by midwives were made, including in-service training and further research.

15. THANK YOU!