title: Barriers to spousal contribution to childbirth pain relief in Nigeria.
abstract: OBJECTIVE
  The aim of this study was to investigate the barriers inhibiting the use of spousal presence for childbirth pain relief in health facilities and recommendations from three perspectives: the midwife, the woman, and the spouse.
  
  
  BACKGROUND
  Spousal presence is a non-invasive, participatory and inexpensive technique used in pain management during childbirth. Although it contributes to a large extent in relieving childbirth pain, it is underutilized in Nigerian hospitals. Overcoming the challenges impeding spousal presence and participation during childbirth will improve maternal outcome, satisfaction and midwifery care practices.
  
  
  METHODS
  A cross-sectional survey conducted in four hospitals in Nigeria involving midwives (n = 100), women (n = 142) and their spouses (n = 142) from June to December 2014 using pretested questionnaires.
  
  
  RESULTS
  Five themes were identified: poor infrastructural facility, lack of adequate pain management policy, lack of midwife pain management practices, midwives' attitudes towards spousal presence during childbirth and feelings about spousal presence during childbirth pain relief.
  
  
  CONCLUSIONS
  Infrastructural defects in the health facilities resulting in the lack of privacy in maternity units for both spouses and partners negatively influence the presence of a spouse during childbirth and pain relief. Adopting effective strategies such as good infrastructural facilities, staff training and spouse-friendly hospital policies will encourage spouses to fully participate in and contribute to childbirth pain relief.
  
  
  CONCLUSIONS
  This study identified poor staff attitudes towards pain relief and spousal presence during childbirth as barriers. Providing adequate policies on pain management, continuous staff education and orientation on spousal relationship will improve active spousal participation and maternal satisfaction during childbirth.
authors.affiliation: Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: A U
authors.initials: AU
authors.lastname: Emelonye
authors.affiliation: Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: T
authors.initials: T
authors.lastname: Pitkäaho
authors.affiliation: Kuopio University Hospital, Kuopio, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Aregbesola
authors.affiliation: Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.|Institute of Public Health and Clinical Nutrition, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Vehviläinen-Julkunen
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D036861:Delivery, Obstetric / Q000379:methods* / Q000523:psychology*; D005260:Female; D006801:Humans; D048949:Labor Pain / Q000188:drug therapy*; D008297:Male; D009549:Nigeria; D009721:Nurse Midwives / Q000523:psychology*; D059408:Pain Management / Q000379:methods*; D011247:Pregnancy; D037841:Pregnant People / Q000523:psychology*; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: Intra-Partum Care; Maternity; Midwifery; Nigeria; Pain Management; Qualitative Descriptive