Factors Affecting Midwives' Decision to Offer Complementary and Alternative Medicine/Nonpharmacological Pain Relief Methods for Labor and Birth

PURPOSE: This study examines how characteristics of birth settings influence midwives' decision to offer complementary and alternate nonpharmacological pain relief in labor and childbirth.

METHOD: This is a nonexperimental design. A convenience sample of midwives (N = 520), members of the American College of Nurse-Midwives (ACNM), were surveyed using a 51-item Likert-type scale questionnaire. Midwives were assigned to 1 of 3 primary birth settings (hospital, birthing center, home birth) for data analysis to identify if certain characteristics (policies/protocols, use of technology, providers' knowledge and beliefs, and midwives' relationship with collaborating obstetricians) in the birth setting influence a midwife's decision to offer nonpharmacological pain relief methods in labor and birth.

RESULTS: Findings indicate that knowledge and beliefs of health care providers most influenced midwives' decisions. Although factors of the birth environment influence midwives' decisions to offer nonpharmacological pain management in labor, they do not prevent midwives from using most of the nonpharmacological pain relief methods during labor and birth.

CONCLUSIONS: It would appear that the midwives' philosophy of care more than the characteristics of the birth setting influence midwives' decisions to offer nonpharmacological pain relief methods. Educating health care providers about nonpharmacological pain relief methods would further maximize midwives' ability to use these strategies.