Labour Pain Perception and Management Experiences among Postpartum Women in Urban-Periurban Primary Healthcare Settings in Nigeria: A Cross-Sectional Study

Abstract

Background: Labour pain represents one of the most severe acute pain experiences in obstetrics, profoundly affecting maternal satisfaction, psychological well-being, and postpartum recovery. In urban-periurban primary healthcare settings, where advanced analgesia options are limited, pain perception and management are influenced by physiological mechanisms, obstetric interventions, socio-demographic factors, and deficiencies in access and supportive care. Aims: This cross-sectional study investigated labour pain perception and management experiences among postpartum women in primary healthcare centres in Obio/Akpor, Rivers State, Nigeria. Methods: A descriptive survey design was adopted, targeting postpartum women aged 15–49 years who had vaginal deliveries within three months prior to data collection. Using the Taro Yamane formula, 393 participants were sampled from six facilities via simple random balloting (n = 393). Data were gathered through a structured questionnaire adapted from validated instruments, with test-retest reliability index of 0.82. The instrument was used to assess socio-demographic characteristics and study main variables. Data obtained were analysed in Statistical Product and Services Solution (SPSS) version 27 using descriptive statistics and chi-square tests, with statistical significance set at p < 0.05. Results: Non-pharmacological methods were rated not effective at all by 46.1% of participants, and only 1.0% rated them very effective. Pharmacological approaches were rated moderately effective by 60.3% of participants, while very high effectiveness was uncommon. Overall, 50.9% rated provider-led pain management as moderately effective, while 39.2% disagreed that pain relief was readily accessible. Pentazocine injections were most recommended, 55.0%, while epidural analgesia was rarely recommended, 2.0%. Experiences were mixed: 39.9% agreed or strongly agreed that they had a very good experience, 50.1% disagreed or strongly disagreed, yet 82.9% agreed that providers were attentive and supportive. Perceived effectiveness of labour pain relief had a statistically significant relationship with marital status (p = .001) and pain relief method (p = .027), as well as religion, education, and parity (p < 0.05). Conclusion: Findings underscore constrained access, opioid reliance, and suboptimal benefits from non-pharmacological strategies in the study area. Enhancing multimodal protocols, caregiver competencies in supportive care, and equitable analgesia provision is imperative for advancing woman-centred intrapartum practices.