title: Journey to confidence: women's experiences of pain in labour and relational continuity of care.
abstract: BACKGROUND
  An evaluation carried out at King's College Hospital Foundation National Health Service Trust in London identified that women who received continuity of carer from the Albany Midwifery Practice were significantly less likely to use pharmacological pain relief when comparisons were made with eight other midwifery group practices and the local maternity service as a whole. This study was designed to explore women's views of this phenomenon.
  
  
  METHODS
  We conducted a thematic analysis of semistructured, audiotaped, in-depth interviews with 10 women who reflected on their experiences of preparation and support for pain in labour and midwifery continuity of carer with Albany midwives, using a qualitative descriptive methodological approach.
  
  
  RESULTS
  Women reflected positively on how, throughout pregnancy and labour, their midwives promoted a sense of their ability to cope with the challenge of labour pain. This building of confidence was enabled through a relationship of trust that developed with their midwives and the value of hearing other women's stories during antenatal groups. These experiences enhanced women's ability to overcome fears and self-doubt about coping with pain and led to feelings of pride, elation, and empowerment after birth.
  
  
  CONCLUSIONS
  Women valued being encouraged and supported to labour without using pharmacological pain relief by midwives with whom they developed a trusting relationship throughout pregnancy. Features of midwifery approaches to pain in labour and relational continuity of care have important implications for promoting normal birth and a positive experience of pregnancy, labour, and birth for women.
authors.affiliation: Centre for Midwifery, Child and Family Health, University of Technology, Sydney, Broadway, NSW 2007, Australia. nicky.leap@uts.edu.au
authors.forename: Nicky
authors.initials: N
authors.lastname: Leap
authors.forename: Jane
authors.initials: J
authors.lastname: Sandall
authors.forename: Sara
authors.initials: S
authors.lastname: Buckland
authors.forename: Ulli
authors.initials: U
authors.lastname: Huber
mesh_terms: D000293:Adolescent; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage; D003266:Continuity of Patient Care; D005260:Female; D006700:Home Childbirth / Q000592:standards; D006801:Humans; D007231:Infant, Newborn; D048949:Labor Pain / Q000188:drug therapy / Q000523:psychology*; D008880:Midwifery / Q000592:standards*; D009035:Mothers / Q000523:psychology*; D009321:Natural Childbirth; D009723:Nurse-Patient Relations; D017060:Patient Satisfaction; D011209:Power, Psychological; D011247:Pregnancy; D035502:Trust; D055815:Young Adult
chemical_list: D000700:Analgesics