An exploration of the Awareness, Beliefs, and Attitudes Towards Pain Relief Uptake and Prescription During Labor in Blantyre, Malawi: A cross-sectional study of mothers, their guardians and healthcare providers

Background Childbirth is a significant experience in a woman's life, often accompanied by intense labor pain with notable effects on both maternal and neonatal outcomes. Despite the availability of various pain relief methods, underutilization has been noted to be one of the major challenges, especially in low resource settings. However, perspectives on labor pain management remain underexplored, particularly in low to middle-income countries (LMIC) like Malawi. This study aimed to explore the awareness, attitudes, and beliefs of women and their guardians regarding the uptake of pain relief during labor, while also examining healthcare providers' perspectives on the barriers and drivers influencing labor pain management. Methods Using an exploratory cross-sectional design and phenomenological approach, this study investigated the lived experiences of women, their guardians, and healthcare providers at Queen Elizabeth Central Hospital, Lundu Health Center, and Mwaiwathu Private Hospital in Blantyre, Malawi, between August and October 2023. The theory of planned behavior guided the thematic analysis, which involved iterative transcript review, emergent theme identification, and a comparison of normative guidelines to actual practices within these facilities. Results Findings revealed that cultural influences, prior experiences, and support systems shape women’s decisions on pain relief use, with some viewing labor as empowering and others as distressing. Healthcare providers acknowledged the pain intensity of labor and noted several barriers and facilitators influencing pain relief prescription, furthermore suggestions to improve provision included culturally sensitive education, communication skills development, standardized protocols, and creating supportive environments for patient-centered care. Conclusions This study underscores the need for individualized, culturally competent approaches to enhance labor pain management in Malawi.