title: 'Facing the wrong way': Exploring the Occipito Posterior position/back pain discourse from women's and midwives perspectives.
abstract: OBJECTIVE
  to explore back pain in labour from the perspectives of women and midwives.
  
  
  METHODS
  a qualitative study, which generated data through individual semi-structured interviews with postnatal women and focus groups with midwives. Data were analysed thematically.
  
  
  METHODS
  two metropolitan maternity units in Queensland, Australia.
  
  
  METHODS
  nine postnatal women and 11 midwives, all of whom had participated in a randomized controlled trial investigating the use of sterile water injections for back pain in labour.
  
  
  RESULTS
  two major themes were identified, including back pain in labour: accounts, rationalisations and coping strategies, and fetal position: destabilising the Occipito Posterior-back pain discourse.
  
  
  CONCLUSIONS
  back pain may be severe in labour, may impact negatively upon women׳s labour and birth experiences, and interfere with their ability to cope as planned. The assumed relationship between fetal position and back pain in labour is a dominant discourse, albeit one which is lacking in empirical credibility. Nonetheless, the information provided to women by maternity professionals tended to reiterate customary practices and beliefs rather than factual knowledge. Increasingly, women refer to other sources, which may challenge the information provided by health professionals.
  
  
  CONCLUSIONS
  Back pain in labour is an under-researched area and the lack of solid evidence underpinning the advice provided to women has implications for labour management, and possibly for maternal and fetal outcomes. Care providers might usefully consider back pain as multifactorial, not always associated with OP position, and continue to seek evidence-based management strategies which address women׳s needs.
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland 4072, Australia; Midwifery Research Unit, Mater Research Institute-UQ, Aubigny Place, Raymond Terrace, South Brisbane 4101, Queensland, Australia. Electronic address: nigel.lee@mater.uq.edu.au.
authors.forename: Nigel
authors.initials: N
authors.lastname: Lee
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland 4072, Australia; Midwifery Research Unit, Mater Research Institute-UQ, Aubigny Place, Raymond Terrace, South Brisbane 4101, Queensland, Australia; Mater Mothers׳ Hospital, Mater Health Services, Raymond Terrace, South Brisbane 4101, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Kildea
authors.affiliation: School of Nursing, Midwifery and Social Work, University of Queensland, St Lucia, Queensland 4072, Australia; Midwifery Research Unit, Mater Research Institute-UQ, Aubigny Place, Raymond Terrace, South Brisbane 4101, Queensland, Australia.
authors.forename: Helen
authors.initials: H
authors.lastname: Stapleton
mesh_terms: D000328:Adult; D016362:Analgesia, Obstetrical / Q000379:methods*; D005260:Female; D006801:Humans; D048949:Labor Pain / Q000523:psychology / Q000628:therapy*; D017116:Low Back Pain / Q000523:psychology / Q000628:therapy*; D008880:Midwifery / Q000379:methods*; D009035:Mothers / Q000523:psychology*; D009723:Nurse-Patient Relations; D059408:Pain Management / Q000379:methods*; D017060:Patient Satisfaction; D011247:Pregnancy; D011256:Pregnancy Outcome; D036301:Qualitative Research; D011793:Queensland; D012965:Sodium Chloride / Q000008:administration & dosage; D014867:Water / Q000008:administration & dosage; D055815:Young Adult
chemical_list: D014867:Water; D012965:Sodium Chloride
keywords: Back pain; Childbirth; Labour; Occipito-posterior; Sterile water injections